The effect of benign breast biopsy on subsequent breast cancer detection practices

Abstract

Purpose/objectives: To determine the effect of benign breast biopsy results on the frequency of subsequent breast self-examination (BSE), mammograms, and clinical examinations.

Design: Retrospective, descriptive design.

Setting: Two surgical oncology practices of an academic health science center in the southeastern United States and one surgical oncology practice and three family practices in another southern U.S. city.

Sample: A nonprobability sample consisting of 238 women with benign breast biopsies and a comparison group of 243 women with no histories of breast disease.

Methods: Questionnaires based on American Cancer Society (ACS) breast cancer detection guidelines were designed and mailed to all women who had benign breast biopsies within the past three years at the academic health science center. Similar questionnaires were mailed to women randomly selected from three family practices who had no histories of breast disease. Chi-square, Kruskal-Wallis one-way analysis of variance, and Wilcoxon matched pairs signed-ranks test were used in the data analysis.

Main research variables: Frequency of breast cancer detection practices including BSE, mammography, and clinical breast examinations.

Findings: In the group that had undergone biopsies, breast abnormalities were found by mammogram (38.8%), BSE (28.3%), clinical examination (16.9%), and accidental discovery (8.7%). The percentage of women performing monthly BSE increased from 47.4% to 67.3% postbiopsy (p < 0.0001). The frequency of mammography and clinical breast examinations also significantly increased postbiopsy (p < 0.0001). Similarly, the postbiopsy rate of BSE, mammography, and clinical breast examinations was higher than the rates for the control group. Women whose breast abnormalities were found by mammography became significantly more fearful of mammography (p < 0.05).

Conclusions: Benign breast biopsies are associated with increased breast cancer detection practices.

Implications for nursing practice: All women need to follow ACS guidelines for breast cancer detection. Women who have undergone breast biopsy may be unduly afraid about the results of future detection practices and may need support and encouragement.