False alarms of breast cancer.
To assess the morbidity associated with false alarms of breast cancer, 2923 consecutive consultations for a breast disorder were reviewed. 391 women had breast cancer, which was found by accidental discovery in 57%, by breast self-examination in 15%, by routine physical examination in 24%, and by screening mammography in 4%. 20% of women in whom cancers were found by physician screening had had a previous breast cancer. The pathological stages of tumours found by accident were little different from those found by intervention. 87% (2532/2923) of signs/symptoms of breast cancer were false alarms--ie, 86% (565/659) of those found by routine physical examination, 88% (406/462) breast self-examination, 93% (220/237) screening mammography, and 86% (1341/1565) accidental discovery. Spontaneous breast pain was responsible for 575 false alarms and nipple discharge for 126. 534 (20%) of the false alarms could have been avoided if routine physical examinations before the age of 45, breast self-examination before the age of 35, and screening mammography before the age of 60 had been discouraged. Another 30% of false alarms would have been avoided if the patient had realised that breast pain and nipple discharge are not usually symptoms of breast cancer.
Devitt
J E
JE
Department of Surgery, Ottawa Civic Hospital.
D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000517:prevention & control*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000523:psychology; D003951:Diagnostic Errors; D005260:Female; D006266:Health Education; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D010173:Palpation; D010808:Physical Examination; D012189:Retrospective Studies; D013997:Time Factors