title: Breast cancer screening for older women in a primary care practice.
abstract: OBJECTIVE
  To determine rates of breast cancer screening for older women cared for in a primary care practice and to identify associations between patient and physician characteristics and breast cancer screening.
  
  
  METHODS
  A retrospective cohort study of older women.
  
  
  METHODS
  An urban hospital-based academic general medicine practice. This practice uses a computerized medical record and office procedures that facilitate tracking and ordering of mammograms.
  
  
  METHODS
  A random sample of 130 women aged 65 to 80 who receive primary care at a hospital-based general medicine practice.
  
  
  METHODS
  Data were collected from the hospital's computerized medical record. We recorded all clinical breast exams and mammograms performed or recommended during the 2-year study period.
  
  
  RESULTS
  The median age of the 130 women studied was 71, and 21% of the women were black. Most patients had no serious comorbid illness (69%) and were independent in their activities of daily living (92%). During the 2-year study period, mammography was recommended for 95% of women and completed for 84%, and clinical breast exam was performed on 75%. Patients of male physicians had higher rates of mammography than patients of female physicians (89% vs. 75%, P = .045). Patients of faculty physicians had higher rates of clinical breast exam than patients of house officers or fellows (83% vs. 56%, P = .001).
  
  
  CONCLUSIONS
  We report a very high rate of mammography for women cared for at a hospital-based primary care practice. The systems in place to facilitate ordering and tracking of mammograms probably contributed to the unusually high rate of mammography observed.
authors.affiliation: Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
authors.forename: J
authors.initials: J
authors.lastname: Tishler
authors.forename: E P
authors.initials: EP
authors.lastname: McCarthy
authors.forename: D M
authors.initials: DM
authors.lastname: Rind
authors.forename: M B
authors.initials: MB
authors.lastname: Hamel
mesh_terms: D000046:Academic Medical Centers; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston; D001943:Breast Neoplasms / Q000175:diagnosis*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D010173:Palpation / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors