• Jennifer S Haas, Celia P Kaplan, Phyllis Brawarsky, and Karla Kerlikowske.
• Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02120-1613, USA. jhaas@partners.org
• J Gen Intern Med. 2005 Aug 1; 20 (8): 692696692-6.

BackgroundMany women experience a breast lump. Clinical guidelines suggest that a normal mammogram result alone is not adequate to exclude a diagnosis of cancer.ObjectiveTo examine the characteristics of women with a breast lump and a normal mammogram that were associated with receiving further evaluation, and to examine cancer outcomes.DesignObservational cohort.ParticipantsWomen aged 35 to 70 years who participated in a population-based mammography registry and who did not have a history of breast cancer noted at the time of their mammogram that they had a breast lump, and had a "normal" (Breast Imaging Reporting and Data System 1 or 2) mammogram result (n=771).MeasurementsTelephone survey performed 6 months after the mammogram to ascertain information about evaluation. Cancer outcomes within 12 months of the index mammogram were confirmed through linkage with a cancer registry.ResultsOnly 56.9% of women reported receiving an adequate evaluation for their breast lump, including a subsequent clinical breast exam, a visit to a breast specialist, an ultrasound, a biopsy, or aspiration. Latinas were less likely than white women to have received adequate evaluation, as were obese women compared with normal-weight women, and uninsured women compared with women with insurance. Among women with at least 12 months of follow-up, 1.4% were diagnosed with cancer.ConclusionsMany women do not receive adequate evaluation for a recent breast lump. Interventions should be designed to improve the follow-up of women with this common clinical problem.

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