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Family Practice Vol. 16, No. 5, 463-467
© Oxford University Press 1999

GPs' management of women seeking help for familial breast cancer

GH de Bocka,b, TPM Vliet Vlielandb, M Hakkelinga, J Kievitb and MP Springera

a Department of General Practice and
b Department of Medical Decision Making, Leiden University Medical Centre, The Netherlands.

GH de Bock, Department of General Practice, Leiden University Medical Centre, PO Box 2088, 2301 CB Leiden, The Netherlands.

Objective. We aimed to ascertain how often patients seek help for familial breast cancer in primary care, and to identify GPs management of these patients, in order to see whether guidelines are followed.

Methods. This was a descriptive study. GPs (n = 202) attending a postgraduate education programme were asked to fill in a questionnaire which included questions about the number of patients seeking help for familial breast cancer within the last 3 months and about their management strategies.

Results. About 80% of the GPs reported that they referred women with concerns about familial breast cancer for further diagnostics (mammography or ultrasound). For half these referrals a plan of regular appointments was set up, and one-eighth of the referrals included breast examination by a physician. Breast self-examination was advised in 50% of the cases. Estimates given to women regarding their breast cancer risk varied considerably. There was a strong relationship between risk estimates and management strategies.

Conclusions. Current guidelines regarding surveillance of women with breast cancer in the family were only partly followed. These guidelines do not give sufficient information to define whether there is an increased risk for breast cancer. These guidelines need to be refined.

Keywords. Breast self-examination, familial breast cancer, family physicians, mammography, screening.


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