A study published in Breast Cancer Research reveals that breast asymmetry could be a reliable independent predictor of breast cancer.

The study found that the relative odds of developing breast cancer increased by 1.5 with each 100ml increase in breast asymmetry.

Diane Scutt from the University of Liverpool, UK and colleagues studied the mammograms of 252 women who did not have breast cancer at the time of the mammography, but later on developed the disease. The control group consisted of 252 women matched for age who underwent mammography at the same time, but did not develop breast cancer.

Scutt et al.'s results show that, at the time the mammography was done, women who went on to develop breast cancer had higher breast volume asymmetry than controls. The authors found that the relative odds of breast cancer increased by 1.5 for a 100ml increase in absolute breast volume asymmetry, after adjusting for other potential risk factors. They conclude that breast asymmetry is a significant independent predictor of breast cancer, and could be a reliable indicator of future breast disease.

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"Previous studies have shown that over one-third of breast cancer survivors do not receive annual mammography after treatment, so we know that there are problems with the quality of follow-up care for survivors," says co-author Kenneth Schellhase, M.D., M.P.H., assistant professor of family & community medicine. "However the best approach for delivering such care remains unclear. We wondered whether the specialty of the physician made a difference, so we evaluated mammography use among survivors followed by primary care physicians, cancer specialists, or both. Our results are encouraging that primary care physicians and specialists who cooperate in the care of breast cancer survivors can deliver better quality care."

All women in the study were age 66 or older, and a majority was white and lived in urban areas The SEER Data covered five states and six metropolitan areas, representing 14 percent of the US population. Medicare claims data were used to measure each patient's health care utilization, such as office visits (a total of 123,595 for the 3,828 women) or mammograms. U.S. Census files were used to estimate socioeconomic characteristics for study subjects and the American Medical Association Master File to determine the specialties of the 4,084 physicians involved.

Medical College student Ann Etim was first author of the study. This research was funded by the National Cancer Institute. Biostatistician Rodney Sparapani, M.S., and Lady Riders Professor in Breast Cancer Research Ann B. Nattinger, M.D., MPH, professor of medicine, chief of general internal medicine, and director of the Center for Patient Care and Outcomes Research, were co-investigators.

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