[Early detection of breast cancer in relation to patient and physician characteristics]

Higher participation rates of women in regular examination for early cancer detection (Krebsfrüherkennungsuntersuchung, KFU) are expected to improve the effectiveness of breast cancer screening. In the Federal Republic of Germany the law guaranties yearly examination. The detection of early stages is also intended to make breast conserving therapy possible. In our project "Patient- and physician-related problems of early breast cancer detection" we believed that early detection of breast cancer depends not solely on the participation of women entitled to make use of regular examination. We assumed that it depends also on the diagnostic reliability of the examinating physicians. Therefore, we became interested in the factors that cause early or late diagnosis in patients with malignant and good breast lesions. In order to identify these factors, we asked patients and the examinating physicians for case reports. Our qualitative investigations included 50 patients in the area of Munich and Ulm. We found out that, though most patients participated regularly in the early cancer detection examination, participation had no influence on early or late detection of the disease. The majority of patients included in the study, belonged to the group of women with a high participation rate according to the statistics. In general, examination for early cancer detection failed to recognize breast cancer in symptomless women. Not until the patient presented symptoms breast cancer was diagnosed. Early and late diagnoses followed this pattern. Only the patient with early breast cancer and primary surgery by a gynaecologist retained her breast. The surgeons removed the breast. They did not even consider partial resection.(ABSTRACT TRUNCATED AT 250 WORDS)