Physicians NOT Doing Physical Examination of the Breasts – Just Relying on Results of Mammograms and Breast Ultrasounds

by Reynaldo O Josonon Tuesday, April 3, 2012 at 11:42pm ·

Today, April 3, 2012, TE, a Filipino patient who stays most of the time in San Diego, California, told me her concerns of physicians in San Diego, California (in at least two clinics) NOT doing physical examination of her breasts whenever she would go for a check-up.  They would just look at the results of the screening mammograms and breast ultrasounds (with normal findings) and then advised her accordingly (usually, on next mammograms and breast ultrasounds). She felt insecure without a physician’s physical examination of her breasts.  That was why she came to me (in the Philippines) for a physical examination of her breasts today.

Is that the usual practice of physicians (not doing physical examination of the breasts) whenever patients already have mammograms and breast ultrasounds? I wonder.

Is that the usual practice of primary care physicians and family physicians?  If yes, why? Is it because they frown on the reliability of physical examination of the breasts and rely more on the results of the mammograms and breast ultrasounds?  Is it because they don’t know how to do accurate physical examination of the breasts? I wonder.

Is that the usual practice of medical oncologists? (I have heard patients also raising this concern in the Philippines.)  If yes, why? Is it because they frown on the reliability of physical examination of the breasts and rely more on the results of the mammograms and breast ultrasounds?  Is it because they don’t know how to do accurate physical examination of the breasts? I wonder.

In the Philippines, general surgeons who are breast specialists give importance on the physical examination of the breast.  They do physical examination of the breasts even in the presence of mammograms and breast ultrasound reports.  They correlate their physical examination findings with the results of the mammograms and breast ultrasounds.  At times, they would find something on physical examination not detected or reported in the mammograms and breast ultrasounds.

As a general surgeon and as a breast specialist, it is my policy to do physical examination of the breasts to complement and counter check the mammograms and breast ultrasounds that were previously done. My physical examination has been beneficial for my patients, particularly, in those where I would discover false positive and false negative reports on the mammograms and breast ultrasounds.  I think this is the way that all  physicians must do in patients with a breast concern and who have mammogram and breast ultrasound reports to present during consult.  This is as long as they can do physical examination of the breasts with at least 90% accuracy.