الفهرس 
Magnitude of Breast CancerOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common female cancer in the US, the second most common cause of cancer death in women, and the main cause of death in women ages 40 to 59 .The most important risk factors are family history and hormonal factors (Jemal et al., 2010).
Breast cancer screening is defined as the medical screening of asymptomatic, apparently healthy women for breast cancer in an attempt to achieve an earlier diagnosis. The assumption is that early detection will improve outcomes. A number of screening test have been employed including: clinical and self breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging (Schonberg, 2010).
The family physician should be the first doctor that a woman is consulting for general medical ailments because of the built rapport and friendship with the physician and therefore she will be more comfortable and more amenable to advices from him/her (Beswal, 2013). Also, Primary care physicians can significantly alter the behavior of their patients with regard to regular breast examinations (Maria et al., 2013).
Although screening for breast cancer is a routine policy that should be done to every client in the family planning unit at the family medicine centers, physicians don’t perform such function.
The aim of our study is to measure the performance and attitude of the family (primary health care) physicians working in the family medicine center in EL-Sheikh Zayed City, regarding screening for breast masses & to identify different factors that may limit optimum performance.
The number of participated physicians was 10. They were observed during their clinical breast examination to 100 female patients (10 for each physician) who attended for family planning clinic in family medicine centre in EL-Sheikh Zayed city. Half of the physicians are males and the other half are females with the age ranging from 26 to 41years with mean ± SD (30.3±4.3), duration since graduation ranged from 4 to 19 years with mean± SD (8.4±4.3). 30% of participated physician were of family medicine speciality and 50% were primary health care physicians.
The age of studied females ranged from 19 to 50 years with mean ± SD (34.1±7.9). More than half of them are educated (51%) and 49% are non-educated. The age of menarche ranged from 8 to 14 with mean± SD (11.7±1.2). Age of 1st birth ranged from 16 to 30 with mean± SD (22.5±3.1). 49% of the studied females had a family history of breast cancer. 51%had no family history. 58% of studied females have history of hormonal intake. 19% of the studied females had history of previous breast mass or biopsy.
It was observed that one female patient refused doing clinical breast examination because of the presence of male physician.
Also in the present study it was recorded that the female physicians performance including full CBE was more than male physicians (P Value 0.001).
In the present study most of physicians (80%) believed that CBE and also BSE is moderately effective in reducing morbidity and mortality. And all of them (100%) believed that mammography is highly effective in reducing morbidity and mortality.
In the present study physicians’ opinion regarding barriers facing their practice the most dominant barrier was lack of training courses (100%).
The 2nd most effective barrier facing the participated physicians was their low numbers in face of the high flow of patients (80%).
In assessing risk all participated physicians asked about risk factors which are included in the printed sheet that is used in the center to be fulfilled for each patient. It includes family history, past history of breast mass or biopsy, age of menarche and age of 1st birth.
In this study, statistically there was a significant correlation between CBE with history of previous breast mass (>57%). So that women with history of previous breast mass had a higher performance in CBE.
In the current study 100% of patients who were +ve for breast mass or for axillary lymph nodes by CBE were advised to proceed for mammography while 80% of patients with nipple discharge were advised to do mammography.
More than 57% of patients –ve for palpable breast mass were advised & teached to do breast self examination regularly while it was 45% in those –ve for palpable axillary lymph nodes & only 38% in those –ve for nipple discharge .