Multidisciplinary Differences in Approaches to Patients Undergoing Breast Examination and Evaluation of Collaborations

Year 2023, Volume: 14 Issue: 1, 116 - 121, 23.03.2023

Özgür Albuz , Dilek Dülger , Gonca Çabuk , Feray Aydın

https://doi.org/10.18663/tjcl.1250083

Abstract

Objective: The purpose of this study is to examine the outpatient clinics of patients admitted to the hospital for breast examinations and the diagnostic process after these applications. It also compares the results of the examination and diagnosis with the results of the general surgery (GS) outpatient clinic, especially after admission to non-general surgery clinics.
Materials and Methods: The patients who came to the GS, internal medicine (IM), and obstetrics and gynecology (OG) outpatient clinics of our hospital between January 1, 2015, and June 15, 2019, were examined retrospectively. Continuous variables were reported as the mean and standard deviation, whereas categorical nominal variables were expressed as a percentage of the total population.
Results:Between January 1,2015, and June 15,2019, the total number of mammograms required for breast examination was 7998. Of these, 1769 were GS, 456 were IM, and 5773 of them were OG outpatient clinics.The mean age was 48±2.3 years in GS, 48±6.7 years in IM, and 47±3.9 years in OG outpatient clinics(p >0.05).Breast Imaging Reporting and Data System(BI-RADS) distributions of mammography cases of patients admitted to the GS outpatient clinic were: BIRADS 5: 35,BIRADS 4: 15,BIRADS 3: 328,BIRADS 2: 14,BIRADS 1: 2, and BIRADS 0: 1375.BIRADS distributions of mammography of patients admitted to the OG outpatient clinic were:BIRADS 5; 10,BIRADS 4: 36,BIRADS 3: 558,BIRADS 2: 1365,BIRADS 1: 1424, and BIRADS 0: 2380.BIRADS distributions of mammography cases of patients admitted to the IM outpatient clinic were: BIRADS 5; 4, BIRADS 4: 3, BIRADS 3: 37, BIRADS 2: 111, BIRADS 1: 124, and BIRADS 0:177.A total of 15 patients with BIRADS 4 and 5, and 3 patients with BIRADS 3 were referred to the GS outpatient clinic.Malignancy was diagnosed in 21 of them.On the other hand, BIRADS 4 and BIRADS 5 were referred from the IM outpatient clinic to the GS outpatient clinic for a total of seven patients.Then, five of these seven patients were diagnosed with breast cancer.In total, 69 breast cancer diagnoses were made thanks to collaboration with GS, OG, and IM outpatient clinics.
Conclusion:We believe that the first use of physical examination, anamnesis, and imaging techniques in combination with the diagnosis of breast diseases, especially concerning malignancy, will reduce the cases of missed malignancy.In addition, because of sociocultural factors, patients who come to other branches expect the doctor to ask for breast examinations, but breast examination remains incomplete.Also, since GS is the main branch regarding breast diseases, we think that other branches should be coordinated with GS.

Keywords

breast, cancer, clinical examination, interclinical collaboration

Supporting Institution

Yoktur

Project Number

Yoktur

Thanks

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Meme muayenesi yaptıran hastalara yaklaşım ve işbirliğinin değerlendirilmesinde multidisipliner farklılıklar

Abstract

Amaç: Bu çalışmanın amacı meme muayenesi için hastaneye başvuran hastaların polikliniklerini ve bu uygulamalar sonrasındaki tanı sürecini incelemektir. İkincil amacı da meme kanseri tanısı için genel cerrahi (GC) poliklinikleri ile diğer genel cerrahi dışı kliniklerin karşılaştırılmasıdır.
Gereç ve Yöntemler: Hastanemizin 1 Ocak 2015-15 Haziran 2019 tarihleri arasında genel cerrahi(GC), Dahiliye (IM), Kadın Hastalıkları ve Doğum (OG) polikliniklerine başvuran hastalar retrospektif olarak incelendi. Sürekli değişkenler ortalama ve standart sapma olarak rapor edilirken, kategorik nominal değişkenler toplam popülasyonun yüzdesi olarak ifade edildi.
Bulgular: 1 Ocak 2015-15 Haziran 2019 tarihleri arasında meme muayenesi için gerekli olan toplam mamografi sayısı 7998'dir. Bunların 1769'u Gc, 456'sı IM ve 5773'ü OG poliklinikleridir. Yaş ortalaması Gc'de 48±2,3, IM'de 48±6,7, OG polikliniklerinde 47±3,9 idi (p>0,05). Malign meme vaka sayılarının dağılımı sırasıyla GC: 43, OG: 21, IM: 5 şeklindedir. Toplamda 69 meme kanseri teşhisi konulmuştur. Klinik hakimiyet açısından genel cerrahi kliniği meme kanseri koymada en etkili klinik olarak ortaya çıkmıştır [AOR: 0,34 (0,2-0,54) (P <0,001)]. Mamografi BIRADS 4 ve 5 olan hastalarda malignite riski BIRADS 0-1-2-3 olanlara göre daha yüksekti [AOR: 0,81 (0,72-0,9) (P <0,001)].
Sonuç: Özellikle maligniteyi ilgilendiren meme hastalıklarının tanısında en önemli mihenk taşının klinikler arası işbirliği ile yapılan fizik muayene, anamnez ve görüntüleme teknikleri olduğuna inanıyoruz.

Keywords

Meme kanseri, fizik muayene, klinikler arası işbirliği

Project Number

Yoktur

References

• 1. Curado MP (2011). Breast cancer in the world: incidence and mortality. Salud Publ Mex 53:372–34
• 2. Meads C, Ahmed I, Riley RD (2012). A systematic review of breast cancer incidence risk prediction models with meta-analysis of their performance. Breast Cancer Res Treat 132:365–77
• 3. Nederend J, Duijm LE, Voogd AC, Groenewoud JH, Jansen FH, Louwman MW (2012). Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study. Breast Cancer Res 14:R10
• 4. Prasad SN, Houserkova D (2007) A comparison of mammography and ultrasonography in the evaluation of breast masses. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 151:315–22
• 5. Hampton T (2012). Breast cancer symposium highlights risk, recurrence, and research trials. JAMA 307:348–50
• 6. Magarey CJ (1976) Detection and diagnosis of early breast cancer. Med J Aust 2:834–837
• 7. Yubei Huang et al. Scientific RepoRts | 6:39459 | DOI: 10.1038/srep39459. www.nature.com/scientificreports
• 8. May DS, Lee NC, Nadel MR, Henson RM. & Miller DS (1998). The National Breast and Cervical Cancer Early Detection Program: Report on the first 4 years of mammography provided to medically underserved women. AJR Am J Roentgenol 170:97–104
• 9. Centers for Disease Control and Prevention (CDC) (1996). Update: National breast and cervical cancer early detection Program–July 1991-September 1995. MMWR Morb Mortal Wkly Rep. 45:484–7
• 10. Moss SM, Michel M, Patnick J, Johns L, Blanks R, Chamberlain J (1995). Results from the NHS breast screening programme 1990–1993. J Med Screen 2:186–90
• 11. Bennett RL, Blanks RG, Patnick J, Moss SM (2007). Results from the UK NHS breast screening programme 2000–05. J Med Screen 14, 200–4
• 12. Miller AB, Baines CJ, To T, Wall C (1992). Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years. CMAJ 147:1459–76
• 13. Miller AB, Baines CJ, To T, Wall C (1992). Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50 to 59 years. CMAJ 147:1477–88.
• 14. Jiagge E, Oppong J, Bensenhaver J, et al. (2016). Breast Cancerand African Ancestry: Lessons learned at the 10-year anniversary of the Ghana -Michigan Research Partnership and International Breast Registry. J Glob Oncol 2:302–10.
• 15. Sylla BS, Wild CP (2012). A million Africans a year dying from cancer by 2030: what can cancer research and control offer to the continent? Int J Cancer 130:245–50.
• 16. Jan M, Mattoo JA, Salroo NA, Ahangar S (2010). Triple assessment in the diagnosis of breast cancer in Kashmir. Indian J Surg 72:97–103. DOI: 10.1007/s12262-010-0030-7
• 17. Feature and review paper. E.R.S. Brown and et al. Development of Multi-disciplinary Breast Cancer Care in Southern Malawi. Eur J Cancer Care 2017;26:e12658. DOI: 10.1111/ecc.12658.
• 18. McCarthy E, Burns R, Freund K, et al (2000). Mammography use, breast cancer stage at diagnosis and survival among older women. J Am Geriatr Soc 48:1126-33.
• 19. Nystrom L, Rutqvist LE, Wall S, et al (1993). Breast cancer screening with mammography: overview of Swedish randomized trials. Lancet 341:973-8.
• 20. Woolf S (2001). The accuracy and effectiveness of routine population screening with mammography, prostate specific antigen, and prenatal ultrasound: a review of published scientific evidence. Int J Technol Assess Hlth Care 17:275-304.
• 21. Olsen O., Gøtzsche PC (1996). Cochrane Database of Systematic Reviews (Reviews) || Screening for breast cancer with mammography. , 10.1002/14651858(), –. doi:10.1002/14651858.CD001877
• 22. Smith RA, Saslow D, Sawyer KA, et al (2003). American cancer society guidelines for breast cancer screening update. Cancer J Clin 53:141-69.
• 23. Kösters JP, Gǿtzsche PC (2003). Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database Syst Rev CD003373. DOI: 10.1002/14651858.
• 24. ACS (American Cancer Society) (2007). Chronological history of ACS recommendations on early detection of cancer. Available at: http://www.cancer.org. Retrieved on 19 April 2007.
• 25. Secginli S, Nahcivan NO (2004). Reliability and validity of the breast cancer screening belief scale among Turkish women. Cancer Nurs 27:287-94
• 26. Dundar PE, Ozmen DS, Ozturk B, et al (2006). The knowledge and attitudes of breast self examination and mammography in a group of women in a rural area in western Turkey. BMC Cancer 6:43-54