[Usefulness of detection of XXXX : the part played by the internist].

@entity5 @entity1 @entity0
The prognosis of @entity0 is the result of many factors, among which the mass of the @entity5 at the time of diagnosis remains the most significant: small @entity5 have a better prognosis than larger ones and are less often accompanied by positive lymph nodes. It is therefore justifiable to search for them systematically by breast examination of all @entity1 over 30. Large-scale mass screening campains in the USA, with clinical and mammographic examination of tens of thousands of @entity1 , have proven that it is possible to detect more "early" @entity5 and reduce general mortality in the groups studied. The number of @entity5 thus detected is nevertheless so small that it does not justify the investment of so much labour and money in this kind of campaign. Systematic breast examination at regular intervals (6 months to 1 year) with regular mammographies should be confined to @entity1 in the high risk groups: @entity1 who have already undergone surgery for @entity5 of one breast, and @entity1 with a marked family history of @entity0 . For the rest of the female population, the solution seems obvious: every physician should get into the habit of performing regular clinical examination of the breasts. Most gynecologists are already doing so, but they only examine a small part of the population. The most important role in the detection of @entity0 falls to the internists and the general practitioners: they should assume responsibility for all their @entity1 ' breasts, in the same manner as they do for heart and lung examinations. They will then request additional examinations (mammography, thermography) as soon as clinical examination reveals a pathological finding. The results of GILBERTSEN [5] confirm that clinical examination remains the most valuable and least expensive method for @entity0 detection.
