Breast cancer screening for women younger than 40.

ABSTRACT

PIP: In Canada, physicians reviewed the charts of 661 15-39 year old women who had attended the Toronto General Family Practice Unit in 1989 and, in February 1990, distributed a questionnaire to 38 physicians at the same clinic to examine the use of breast cancer screening by family physicians and at what age they begin screening. 2 women underwent a screening mammogram. 74.4% had undergone a breast examination during their visits. Physicians diagnosed an abnormality in 6 of these women, all older than 25 years old. The physicians ordered a diagnostic mammogram in all but 1 of these women. 3 women had a surgical consultation, 1 of whom had a breast biopsy. She was between 25 and 29 years old. The diagnosis is all 3 cases was benign breast problems. 6.5% of all women had a family history of breast cancer. They were not more likely to undergo a breast examination than were those with no such history, though. 41.6% of the women used oral contraceptives (OCs). They were more likely to undergo a breast examination than those who did not use OCs (p = .03). Just 1 of the physicians reported breast cancer in a sister or mother as the single most important risk factor for developing breast cancer besides age. All the physicians used screening mammography on women they considered to be at high risk of breast cancer and just 6 did for low risk women (p .000001). 84.2% were not familiar with the Canadian Task Force guidelines for clinical breast examination (i.e., it should be done annually on all women at least 40 years old). Most physicians taught women under 40 years old, and even teenagers, how to do a breast self-examination. Just 1 physician knew that the Task Force did not promote breast self-examination. It does not promote early screening, because it may do more harm than good. These findings indicated a need for a campaign to increase awareness about these guidelines and of the problems associated with screening younger women.