Subtle Differences in Expectation Between Patient and Physician May Hold the Key to Improving Attendance Rates for Breast Cancer Screening

Abstract

Despite the fact that breast cancer is currently an important issue for women, the actual rate of attendance for mass-screening is still unsatisfactory. Therefore physicians need to seek ways of improving this situation. Because the breast is a gender-specific organ for women, it is important for physicians to treat them with careful consideration in any kind of clinical examination. However, whether this approach is sufficiently acceptable for the patients themselves is poorly understood. In the present study we attempted to clarify differences in attitude between patient and physician with regard to breast examination, using a questionnaire survey.
Replies were received from 318 female patients who visited our hospital for screening or treatment and 41 male physicians who were working in the department of breast surgery. The results revealed that patients had more hesitation (47%) about breast palpation than male physicians realized (24%), and this attitude was shared by both elderly and young patients. Even if patients were accustomed to breast examination, their degree of hesitation was not decreased. In fact, 42% of patients stated that breast exposure was unnecessary, and that no consideration was given to this during consultation. Both patients and physicians considered it desirable for a female technician to be present during mammography or ultrasonic study. On the other hand, only 22.1% of patients preferred a female nurse to be in attendance during clinical examination, despite the fact that a majority of physicians (73.0%) had assumed that this would be desirable for the majority of patients. To improve the attendance rate for breast cancer screening, physicians need to be conscious of differences in attitude from patients, and to give due consideration to their expectations.