title: [Reduction of missing report rate of breast cancer in clinical breast examination].
abstract: OBJECTIVE
  To explore the methods of reducing the missing report rate of breast cancer in clinical breast examination (CBE).
  
  
  METHODS
  The investigators analyzed the data of abnormal breast physical examination in 2181 females and the missing report rate of breast cancer in various kinds of examination methods.
  
  
  RESULTS
  Interrogation and inspection reduced the missing report rate by 5% in all cases. And the missing report rate was lowered from 0.9% to 0.4% by multi-position joint palpation among 2839 breast foci in abnormal physical examination. Small breast nodules, marginal foci of mammary gland, axillary fossa and mammary areola had the tendency to be missed. Focal thickening of mammary gland was also easily missed. Compared with the control group, the abnormality of interrogation and inspection in the breast cancer group were statistically significant in the operation group (χ(2) = 9.770, P = 0.002). The missing report rate of breast cancer was 3.7% in CBE, 17% in ultrasonography and 19.4% in mammography.
  
  
  CONCLUSIONS
  The methods of reducing the missing report rate of breast cancer in clinical breast examination are as follows: valuing the importance of interrogation and inspection; using different palpation methods on the basis of different breast morphologic features; paying more attention to the marginal foci of mammary gland, axillary fossa and mammary areola; examining closely the focal thickening of mammary gland. Scirrhosity is inadvisable as an independent predictor for malignant tumor. A clinician should avoid an excessive dependence on palpation and instruments.
authors.affiliation: Department of Health Management Center & Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100032, China.
authors.forename: Sheng-Sheng
authors.initials: SS
authors.lastname: Wang
authors.forename: Yan-Na
authors.initials: YN
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Sun
authors.forename: Zhen-Jie
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Gao-Wa
authors.initials: GW
authors.lastname: Sha-Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D055815:Young Adult