[The clinical breast examination. An experience in general medicine]

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.

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.

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 %.

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.

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.