Detection and description of small breast masses by residents trained using a standardized clinical breast exam curriculum

Elizabeth Steiner, Donald F. Austin, Nancy C. Prouser

    Research output: Contribution to journalArticle

    13 Scopus citations

    Abstract

    OBJECTIVES: We evaluated the effect of standardized clinical breast examination (CBE) training on residents' ability to detect a 3-mm breast mass in a silicone breast model. METHODS: In this nonrandomized controlled trial, 75 first year residents (R1s) at 8 family medicine, internal medicine, and obstetrics and gynecology training programs received the intervention and second year residents (R2s) did not. Trained residency faculty taught R1s vertical strip, three-pressure method (VS3PM) CBE using a standardized curriculum, including a 1- to 2-hour online self-study with video and 2.5-hour practicum using silicone models and a trained patient surrogate. RESULTS: Solitary mass detection: 84% by R1s, 46% by R2s (RR=1.82, 95%CI=1.36, 2.43, P<0.0001). Of those finding a mass, 62% of R1s and 10% of R2s used at least 5 of 8 standardized descriptors (RR=6.19, 95%CI=2.06, 18.59, P=0.001). R1s false positive findings were not statistically different from R2s (P=0.54). Both the use of VS3PM and total time spent on CBE were independently highly predictive of finding the mass in either group. CONCLUSIONS: Most untrained primary care residents are not proficient in CBE. Standardized VS3PM CBE training improves the ability to detect and describe a small mass in a silicone breast model. Better CBE training for residents may improve the early detection of breast cancer.

    Original languageEnglish (US)
    Pages (from-to)129-134
    Number of pages6
    JournalJournal of general internal medicine
    Volume23
    Issue number2
    DOIs
    StatePublished - Feb 1 2008

    Keywords

    • Breast cancer
    • Clinical breast examination
    • Early detection
    • Medical education

    ASJC Scopus subject areas

    • Internal Medicine

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