Fletcher S W, O'Malley M S, Bunce L A
JAMA. 1985 Apr 19;253(15):2224-8.
Little is known about how well physicians detect breast lumps in clinical breast examinations. We studied 80 general medicine, family medicine, general surgery, and obstetrics/gynecology physicians to determine their abilities to detect lumps in manufactured breast models. The mean number of lumps detected was 8.0 (44%), with a range of three (17%) to 15 (83%). Detection varied significantly by size (87% of 1.0-cm and 14% of 0.3-cm lumps) and hardness (56% of hard and 40% of soft lumps), but not depth; by specialty (from 50% for general internists to 40% for obstetricians), but not by level of training or experience; and by search duration (r = .59). On multiple regression analysis, only search duration was consistently associated with increased detection. Modest detection rates and wide variation suggest breast lump detection can be improved among physicians. Adequate search duration may be important for high detection rates.
关于医生在临床乳房检查中发现乳房肿块的能力如何,目前所知甚少。我们对80名普通内科、家庭医学、普通外科和妇产科医生进行了研究,以确定他们在人造乳房模型中发现肿块的能力。检测到的肿块平均数量为8.0个(44%),范围从3个(17%)到15个(83%)。检测结果因肿块大小(1.0厘米的肿块为87%,0.3厘米的肿块为14%)和硬度(硬肿块为56%,软肿块为40%)而有显著差异,但与深度无关;因专业不同(普通内科医生为50%,妇产科医生为40%)而有差异,但与培训水平或经验无关;还与检查持续时间有关(r = 0.59)。在多元回归分析中,只有检查持续时间与检测率的提高始终相关。检测率不高且差异很大,这表明医生在乳房肿块检测方面还有提升空间。足够的检查持续时间对于高检测率可能很重要。