Quels sont les facteurs motivant ou limitant l'examen clinique des seins par les médecins généralistes bas-normands ?

Abstract : Introduction: in France, organized breast cancer screening proposes to patients aged from 50 to 74 to have a mammography every two years. However, the French Health Authority (FHA) recommends a clinical breast examination (CBE) for women from the age of 25. The aim of our study was to determine the motivating or restraining factors of CBE by the general practitioners from Basse-Normandie. Method: we carried out a qualitative research by sending questionnaires to general practitioners from BasseNormandie at random, from June the 20th to July the 29th and diffusion via general practitioners forum. Results: 93 doctors answered back this questionnaire, 40% of women and 60% of men. The principal restraining factor to breast palpation is gynaecological monitoring by a specialist (36% of physicians), patients’ reluctance (14%) or feeling of futility versus mammography (14%). The main motivation is the feeling of taking care of all aspects of patient (64% of practitioners), patient’s reinsurance (11%) or privileged time to discuss intimate subjects (7%). When patients are worried and contraceptive prescription renewals are the two most frequent reasons for doctors to do a CBE (respectively 87% and 60% of physicians). Conclusion: CBE is widely made and for many reasons par general practitioners from Basse-Normandie. A different medical training could improve their feeling of competence. FHA recommendations should be reviewed in 2018; will CBE be maintained in breast cancer screening?
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Master Thesis
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Amandine Bourgoin. Quels sont les facteurs motivant ou limitant l'examen clinique des seins par les médecins généralistes bas-normands ?. Médecine humaine et pathologie. 2018. ⟨dumas-02114183⟩

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