[The clinical breast examination. An experience in general medicine]. / L'examen clinique des seins. Une expérience en médecine générale.

ABSTRACT

BACKGROUND: A Tunisian woman from 27 will be affected by breast cancer between 0 and 74 years of her life. Evolution of this cancer is relatively short. Its mortality is 10% when not detected. The regular practice of clinical breast examination is one of the tools of awareness and adherence to screening women for breast cancer. AIM: To describe the results and the obstacles to the realization of the early diagnosis of the breast cancer for the clinical examination by the general practitioner. METHODS: A forward-looking study realized over 9 months which concerned 105 women of more than 24 years old, consulting for the other motive, in a basic health center. The appropriate statistical tests had been used at the risk of 5 %. RESULTS: The rate of participation was 12 %. The age mean was 46.4 ± 10 years old. An abnormal clinical examination, was identified at 36.2% of the women. The multi parity decreases the risk of developing a breast clinical abnormality, with OR= 0.14 (IC 95 % [0.035-0.580]) while histories favoring the breast cancer increase this risk with an OR=2.79; (IC 95 % [1.09-7.13]). The general practice had asked for a radiological examination for 67.5 % of the women. His request was influenced by the result of the clinical examination (OR= 20.42 (IC 95 % [7.01-59.49])). Four cases of malignant tumors had been diagnosed. CONCLUSION: We recommend giving the general practitioners responsibilities for the women gynecological health and for the coordination between the different actors, via a weekly day of prevention.