"A woman with a family history of breast cancer is at greater risk of developing breast cancer than women without relatives with breast cancer and as such, many guidelines recommend more intense breast cancer screening for women with positive family histories," states Harvey J. Murff, MD, lead researcher for the study.
However, after studying the medical records of almost 2000 women, only 1 in 4 were found to have had this important documentation. Researchers found that "less than 1 in 7 of African-American and Hispanic women less than 40 years of age, a group in which the early identification of risk status could influence screening practice behavior, had documentation concerning familial breast cancer."
Little research has been done to examine how family cancer histories are obtained and utilized in clinical practice. Thus, the study focused on how women were asked about their family histories and if any specific patient characteristics affected whether or not the discussion took place. As disparities were observed between minority and white women, it is suggested that minority women at increased risk for breast cancer may be at particular risk of not being identified.
Overall, the need for more attention to collecting this data is emphasized to benefit high-risk groups. Early identification can lead to receiving a mammography at an early stage or even genetic testing, and avoid discovering breast cancer at already advanced stages. The American Cancer Society suggests breast cancer screenings for women at age 30 who are at increased risk for the disease.
The lack of documentation suggests that primary care providers are infrequently inquiring about breast cancer histories with their patients. However, researchers were unable to determine whether the information was asked about and just not recorded or not inquired about at all. Additional factors that may have an impact on this discussion between patient and doctor may include brevity of patient visits or relevance to the actual ailment for which the patient is being seen.
About the Author
Harvey J. Murff, MD, MPH is currently Staff Physician at Nashville Veterans Affairs Hospital and Assistant Professor in Medicine at Vanderbilt University. He has conducted prior research on the accuracy of family cancer histories and also the adequacy of family history collection practices in primary care. Dr. Murff can be reached for questions and interviews at 615-327-4751 ext 6823 or Harvey.murff@med.va.gov.
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About the Journal of General Internal Medicine
The Journal of General Internal Medicine (JGIM ) is the official scientific publication of the Society of General Internal Medicine, whose mission is to promote improved patient care, research, and education in primary care and general internal medicine. JGIM articles focus on topics such as clinical research, curriculum development, epidemiology, prevention, and health care delivery in general internal medicine.
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Journal of General Internal Medicine