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The Journal of the American Board of Family Medicine 20 (1): 52-59 (2007)
DOI: 10.3122/jabfm.2007.01.060117
© 2007 American Board of Family Medicine
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Family Medicine And The Healthcare System

Family Physicians Expedite Diagnosis of Breast Disease in Urban Minority Women

Jeanne M. Ferrante, MD, Susan Rovi, PhD, Kasturi Das, MD and Steve Kim, MD

Department of Family Medicine (JMF, SR), University of Medicine and Dentistry-New Jersey Medical School, Newark, NJ
Department of Pathology (KD), University of Medicine and Dentistry-New Jersey Medical School, Newark, NJ
Department of Surgery (SK), University of Medicine and Dentistry-New Jersey Medical School, Newark, NJ
The Cancer Institute of New Jersey (JMF), New Brunswick, NJ

Correspondence: Corresponding author: Jeanne M. Ferrante, MD, Department of Family Medicine, University of Medicine and Dentistry–New Jersey Medical School, MSB-B648, P.O. Box 1709, Newark, NJ 07101-1709 (E-mail: ferranjm{at}umdnj.edu)

Background: The specialty of a patient’s usual provider of care is associated with use of mammography and stage of breast cancer diagnosis. It is unknown if specialty of usual provider of care affects time from discovery of a breast screening abnormality to diagnostic resolution.

Methods: Retrospective chart review study of 546 women who had breast biopsies at an urban public university hospital from 2001 to 2005. Time from abnormal mammogram or clinical breast examination to pathology report was compared by specialty of usual provider of care, sociodemographic, and clinical factors. Multivariate logistic regression was conducted to assess predictors of having diagnostic interval greater than 60 days.

Results: The median diagnostic interval was 36 days (interquartile range 21 to 63). After controlling for age, race, insurance, specialty of usual provider of care, employment status, and palpable lump, decreased odds of having diagnostic delay (over 60 days) included having a family physician (odds ratio (OR) 0.242; 95% confidence interval (CI), 0.09 to 0.69), private health insurance (OR 0.360; 95% CI, 0.15 to 0.89), and cancer diagnosis (OR 0.324; 95% CI, 0.17 to 0.61).

Conclusions: To improve timely follow-up of minority urban women with breast abnormalities, promoting development of a relationship with a family physician may be an important public health intervention.


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