The relative diagnostic impact of screening mammography and physical examination.
OBJECTIVE
To determine the relative diagnostic impact of screening mammography and physical examination.


METHODS
Data from the first 3.5 years of operation of the Ontario Breast Screening Program's regional facility in London were analyzed. A total of 14,646 women underwent screening, which involved both mammography and physical examination. The authors examined the relative contribution of the two types of examination according to detection rate, as well as size, stage and histologic type of the identified breast cancers.


RESULTS
In total, 135 cancers were detected. Mammography revealed 131 (97.0%) of all cancers, whereas physical examination revealed only 66 (48.9%). Furthermore, the lesions detected by mammography were generally smaller and found at an earlier stage.


CONCLUSIONS
Although most other screening programs involve mammography only, physical examination did make a contribution to the detection rate at the authors' facility. However, in an era of declining resources and cost containment, critical analysis of the value added by physical examination is necessary.
Taves
D H
DH
Department of Radiology, St. Joseph's Health Centre, London, Ont.
McCurdy
L I
LI
Sparrow
R K
RK
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control*; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control; D003363:Cost Control; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009864:Ontario / Q000453:epidemiology; D010808:Physical Examination / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity