Evaluation of Attitude and Skills of Female General Practitioners in Mashhad, Iran in Approach to a Breast Mass

Document Type : Original Article


1 Associate Professor , Department of Surgery, Endoscopic and Minimally Invasive Surgery Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor , Department of Surgery, Endoscopic and Minimally Invasive Surgery Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 General Practitioner, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Breast cancer is the most prevalent cancer among women, and it is one of the important health issues. General Practitioners in Iran visit most of the patients with breast complaints for the first time, so the knowledge and skills of these physicians are the key point for the best approach to breast cancer. The aim of this study was to evaluate the attitude and skills of female physicians (general practitioners) with this common health problem in Mashhad, Iran.
Methods: This prospective study was conducted on 50 female physicians that have office in Mashhad, Iran in 2011. Data tool was a 35 years old healthy woman who had normal sonography and mammography with no history of any diseases. She and the researcher have gone to the physician's office with complain of a breast mass. The researcher filled out a check list immediately after the visit.
Results: 32 physicians ( 64%) knew the age of breast cancer, and 30 physicians (60%) knew its relation with pregnancy, but only 12 physicians (24%) asked about the risk factors of breast cancer. 7 physicians (14%) used inspection maneuvers of breast exam and 32 physicians (64%) used palpation maneuvers, but 33 physicians (66%) did not examine lymph nodes completely. 23 physicians (56%) diagnosed incorrectly a mass in the breast, and 19 physicians  (38%) definitely exclude a mass in examination.
Conclusion: The attitude of female general practitioners towards the breast problems is not sufficient, so better training and more feedback after education is recommended.


  1. Ministry of Health and Medical Educations. [Research center of breast cancer]. Tehran:Tehran University of Medical Sciences;2009. [in Persian].
  2. Mousavi SM, Montazeri A, Mohagheghi MA, Jarrahi AM, Harirchi I, Najafi M, et al. Breast cancer in Iran: an epidemiological review. Breast J 2007 Jul-Aug;13(4):383-91.
  3. van der Vleuten CP, Schuwirth LW. Assessing professional competence: from methods to programmes. Med Educ 2005 Mar;39(3):309-17.
  4. Khalili AF, Shahnazi M. Breast cancer screening (breast self-examination, clinical breast exam, and mammography) in women referred to health centers in Tabriz, Iran. Indian J Med Sci 2010 Apr;64(4):149-.26
  5. Mahoori KH SHA, Talei AR. [Knowledge and practice of women referring to Shiraz health centers about breast cancer screening] [Article in Persian]. J Hormozgan Univ Med Sci 2003;7:68-.57
  6. Baradaran R , Barzaje AS. [Breast cancer screening methods in women Zanjan, Iran]. Proceedings of Health Promotion Seminar of Zanzan University of Medical Sciencesn 2003:38. [in Persian]
  7. Jensen LF, Mukai TO, Andersen B, Vedsted P. The association between general practitioners' attitudes towards breast cancer screening and women's screening participation. BMC Cancer 2012 Jun 18;12:254.
  8. Dixon JG, Bognar BA, Keyserling TC, Du Pre CT, Xie SX, Wickstrom GC, et al. Teaching women's health skills: confidence, attitudes and practice patterns of academic generalist physician. J Gen Intern Med 2003 Jun;18(6):411-8.
  9. El Saghir NS. Responding to the challenges of breast cancer in egypt and other arab countries. J Egyp Natl Cancer Inis 2008 Dec;20(4):309-.21
  10. Miranda PY, Tarraf W, Gonzalez HM. Breast cancer screening and ethnicity in the United States: implications for health disparities research. Breast Cancer Res Ttreat 2011 Jul;128(2):535-.24
  11. Kotranza A, Lind DS, Lok B. Real-time evaluation and visualization of learner performance in a mixed-reality environment for clinical breast examination. IEEE Trans Vis Comput Graph 2012 Jul;18(7):1101-.41
  12. Bryan T, Snyder E. The clinical breast exam: a skill that should not be abandoned. J Gen Intern Med 2013 May;28(5):719-22.
  13. Steiner E, Austin DF, Prouser NC. Detection and description of small breast masses by residents trained using a standardized clinical breast exam curriculum. J Gen Intern Med 2008 Feb;23(2):129-34. Epub 2007/12/07.
  14. Lindberg NM, Stevens VJ, Smith KS, Glasgow RE, Toobert DJ. A brief intervention designed to increase breast cancer self-screening. Am J Health Promot 2009 May-Jun;23(5):320-3.