Detecting breast cancer in a general practice - Like finding needles in a haystack?

Breast cancer contributes the largest burden of cancer related disease in Australian women. Early detection is an important part of the general practitioner's work, with clinical audit recommended to help improve the quality of such work.

A clinical database was analysed for newly diagnosed breast cancer patients of one GP for the years 1986-2006.

Thirty new cases of breast cancer were diagnosed, with 87% in the 'early' stages. Fifty-seven percent were outside the target age of 50-69 years used by BreastScreen to recruit women for screening. Apparent false-negative investigations occurred in 33% of cases. The mean time interval between women noting symptoms and consulting the GP was 84 days and the mean time interval from first presentation to final diagnosis was 54 days.

The diagnosis of breast cancer in this series was relatively infrequent, and prior apparent false-negative investigations were not uncommon. As many women diagnosed were outside the usual mammography screening age range of 50-69 years, there is a need for constant awareness of the possibility of breast cancer in all female patients. Encouraging women to present early with breast symptoms and adherence to the 'triple test' recommendation of clinical breast examination, imaging and biopsy for women with breast symptoms is important to minimise the risk of diagnostic delay.