RT Journal Article SR Electronic T1 Physicians’ attitudes and behaviour toward screening mammography in women 40 to 49 years of age JF Canadian Family Physician JO Can Fam Physician FD The College of Family Physicians of Canada SP e508 OP e513 VO 58 IS 9 A1 Patricia Smith A1 Susan Hum A1 Vered Kakzanov A1 M. Elisabeth Del Giudice A1 Ruth Heisey YR 2012 UL http://www.cfp.ca/content/58/9/e508.abstract AB Objective To determine family physicians’ attitudes and behaviour toward screening mammography, breast self-examination, and breast awareness in women aged 40 to 49 at average risk of breast cancer. Design Cross-sectional survey. Setting Women’s College Hospital and Sunnybrook Health Sciences Centre, both in Toronto, Ont. Participants Family medicine residents, fellows, and staff physicians at 2 academic family practice health centres affiliated with the University of Toronto (n = 95). Main outcome measures Physicians’ answers to questions about offering screening mammography and promoting breast self-examination and breast awareness. Results Fifty-two completed surveys were returned (response rate 55%). Less than half of all surveyed family physicians (46%) routinely offered screening mammography to women aged 40 to 49 who were at average risk of breast cancer. Although 40% of physicians did not think breast cancer screening was necessary for women aged 40 to 49, 62% indicated that they would offer screening if their patients requested it. Physicians’ reasons not to offer screening included no evidence of decreasing breast cancer deaths (63%), grade A recommendation to screen women starting at age 50 and not at age 40 (25%), and the harms of screening outweighing the benefits (19%). Physicians’ reasons to offer screening included patient request (55%), personal clinical practice experience or mentors’ recommendations (27%), and guideline recommendations (18%). Breast self-examination was not recommended by most physicians (74%), yet most encouraged women to practise breast awareness (81%). Conclusion Many women at average risk of breast cancer are not being offered the opportunity to discuss and initiate mammographic screening before 50 years of age. While breast-self examination is not recommended, most physicians promote breast awareness.