The Breast Is Close to the Heart
Authors: Suzanne W. Fletcher, Robert H. Fletcher
Journal: Annals of Internal Medicine (1992)

Editorials1 December 1992The Breast Is Close to the HeartSuzanne W. Fletcher, MD, Robert H. Fletcher, MDSuzanne W. Fletcher, MDSearch for more papers by this author, Robert H. Fletcher, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-11-969 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptYears ago, like thousands of second-year medical students before and since, we began mastering the mysteries of physical diagnosis. We learned the secrets of heart sounds—the systolic ejection murmur, the diastolic whiff, the rumble at the apex—and how to palpate, percuss, and auscultate the chest for breath sounds, rales, rhonchi, dullness, and egophony. It was heady stuff. We concentrated on the examination of the chest, perhaps because we were taught by internists (most physical diagnosis courses still are), and internists love examining the heart and lungs. Neither of us has any memory of being taught how to examine the breast....References1. Shapiro S. Periodic screening for breast cancer: the Health Insurance Plan project and its sequelae, 1963-1986. Baltimore: Johns Hopkins University Press; 1988. Google Scholar2. ShapiroStraxVenet SPL. Periodic breast cancer screening in reducing mortality from breast cancer. JAMA. 1971;215:1777-85. CrossrefMedlineGoogle Scholar3. O'MalleyFletcherMorrison MSB. Does screening for breast cancer save lives? Effectiveness of treatment after breast cancer detection following screening by clinical breast examination, mammography and breast self-examination. In: Goldbloom RB, Lawrence RS; eds. Preventing Disease: Beyond the Rhetoric. New York: Springer Verlag; 1990. CrossrefGoogle Scholar4. MillerBainesToWall ACTC. Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years. Can Med Assoc J. 1992;[In press]. Google Scholar5. MillerBainesToWall ACTC. Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50 to 59 years. Can Med Assoc J. 1992;[In press]. Google Scholar6. ColemanFeuer EE. Breast cancer screening among women 65 to 74 years of age in 1987-88 and 1991. Ann Intern Med. 1992;117:961-6. LinkGoogle Scholar7. TabarFagerbergDuffyDayGasGrontoft LGSNAO. Update of the Swedish Two-County Program of mammographic screening for breast cancer. Radiol Clin North Am. 1992;30:187-210. MedlineGoogle Scholar8. AnderssonAspegrenJanzonLandbergLindholmLinell IKLTKF. Mammographic screening and mortality from breast cancer: the Malmo mammographic screening trial. BMJ. 1988;297:943-8. CrossrefMedlineGoogle Scholar9. RobertsAlexanderAndersonChettyDonnanForrest MFTUPP. Edinburgh trial of screening for breast cancer: mortality at seven years. Lancet. 1990;335;241-6. CrossrefMedlineGoogle Scholar10. FrisellEklundHellstromLidbrinkRutgvistSomell JGLELA. Randomized study of mammography screening—preliminary report on mortality in the Stockholm trial. Breast Cancer Res Treat. 1991;18:49-56. CrossrefMedlineGoogle Scholar11. ChuSmartTarone KCR. Analysis of breast cancer mortality and stage distribution by age for the Health Insurance Plan clinical trial. J Natl Cancer Inst. 1988;80:1125-32. CrossrefMedlineGoogle Scholar12. Miller A. Re. "Author of Canadian breast cancer study retracts warnings," [Letter] with Response, Warren L; Response, Kopans DB; Response, Moskowitz M. J Natl Cancer Inst. 1992;84:1365-70. CrossrefMedlineGoogle Scholar13. Bassett A. Physical examination of the breast and breast self-examination. In: Miller AB; ed. Screening for Cancer. Orlando: Academic Press; 1985. Google Scholar14. AdamsHallPennypackerGoldsteinHench CDHML. Lump detection in simulated human breasts. Percept Psychophys. 1976;20:163-7. CrossrefGoogle Scholar15. BloomCriswellPennypackerCataniaAdams HEHAC. Major stimulus dimensions determining detection of simulated breast lesions. Percept Psychophys. 1982;32:251-60. CrossrefMedlineGoogle Scholar16. HallGoldsteinStein DMG. Progress in manual breast examination. Cancer. 1977;40:364-70. CrossrefMedlineGoogle Scholar17. CampbellFletcherPilgrimMorganLin HSCTS. Improving physicians' and nurses' clinical breast examination: a randomized controlled trial. Am J Prev Med. 1991;7:1-8. CrossrefMedlineGoogle Scholar18. FletcherO'MalleyEarpMorganLinDegnan SMJTSD. How best to teach women breast self-examination. A randomized controlled trial. Ann Intern Med. 1990;112:772-9. LinkGoogle Scholar19. FletcherO'MalleyBunce SML. Physicians' abilities to detect lumps in silicone breast models. JAMA. 1985;253:2224-8. CrossrefMedlineGoogle Scholar20. . Mammography Attitudes and Usage Study, 1992. 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Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBias in the Medical Journals: A CommentaryReducing the cost of diagnosis of breast carcinomaThe Breast Cancer Screening Controversy and the National Institutes of Health Consensus Development Conference on Breast Cancer Screening for Women Ages 40-49Dismantling the master's house: Cancer activists, discourses of prevention, and environmental justiceBiasing the Interpretation of Mammography Screening Data by Age Grouping: Nothing Changes Abruptly at Age 50Updated Results of the Trials of Screening MammographyResults from a Multidisciplinary Breast CenterAn economic rationale forprostate cancer screeningMAMMOGRAPHY SCREENING OF WOMEN AGED 40 TO 49 YEARSStatistical power in breast cancer screening trials and mortality reduction among Women 40-49 years of age with particular emphasis on the national breast screening study of CanadaTumor Markers for Breast Cancer: Current Utilities and Future ProspectsMethod of tumor detection influences disease-free survival of women with breast carcinomaScreening for breast cancer and mortality reduction among women 40���49 years of ageChanges in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys. 1 December 1992Volume 117, Issue 11Page: 969-971KeywordsHeartLungsMemorySystolic ejection murmurThorax Issue Published: 1 December 1992 PDF DownloadLoading ...