Physician compliance with mammography guidelines: a retrospective chart review

Annual mammography is recommended by the American Cancer Society as an effective technique for the early detection of breast cancer in women aged 50 and older. This paper reports on a study conducted in a large group family practice in an urban academic setting to examine the frequency with which physicians were ordering mammograms for one age-appropriate group of female patients. The charts of a random sample of 88 females over age 55 who had been patients in the practice for at least five years were abstracted for information on mammography and breast examination as well as background clinical history. Within this sample, 56% had no mammograms recorded over the five-year study period, and only 19% had a mammogram within the most recently completed year. The average interval between mammograms over five years for subjects with one or more mammograms was 3.5 years. For 18% of all ordered mammograms the results could not be located in the chart. These findings suggest that family physicians need to improve adherence to recommended guidelines for mammography and to improve documentation of screening activities in the medical record.