title: As mammography use increases, are some providers omitting clinical breast examination?
abstract: OBJECTIVE
  To explore use of clinical breast examination (CBE) among women receiving mammography.
  
  
  METHODS
  A retrospective cohort analysis of 100 women aged 50 years or older with at least one bilateral mammogram. Chart review documented demographic information, severity of illness, and performance of CBE (from 1 year prior to 18 months after the mammogram).
  
  
  RESULTS
  The mean age of the 100 women was 63 years. They were predominantly unmarried (60%), nonwhite (58%), and not currently employed (57%). Three quarters (76%) had mammography and CBE (comprehensive screening), while the remaining 24% had mammography only. Sociodemographic factors did not differ for women with and without comprehensive screening (P>.1). However, patients of female providers were more likely to receive comprehensive screening than patients of male providers. Specifically, 95% of women seen by female attending physicians or fellows had comprehensive screening vs 67% for male attending physicians or fellows and 61% for residents (P=.008).
  
  
  CONCLUSIONS
  Mammography may be replacing CBE especially among patients of male providers. Interventions targeted to these providers could help improve the use of CBE and mammography.
authors.affiliation: Evans Department of Medicine, Boston University Medical Center Hospital, Mass, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Burns
authors.forename: K M
authors.initials: KM
authors.lastname: Freund
authors.forename: A S
authors.initials: AS
authors.lastname: Ash
authors.forename: M
authors.initials: M
authors.lastname: Shwartz
authors.forename: L
authors.initials: L
authors.lastname: Antab
authors.forename: R
authors.initials: R
authors.lastname: Hall
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010808:Physical Examination / Q000706:statistics & numerical data*; D010822:Physicians, Women; D010818:Practice Patterns, Physicians'