[Mammographic surveillance of breast cancer patient relatives; implementation of guidelines formulated by the Netherlands College of General Practitioners].

Objective: To determine the implementation of the guidelines for mammographic screening of breast cancer relatives formulated by the Dutch College of General Practitioners (NHG), in daily practice.

Design: Prospective, descriptive.

Setting: Kennemer Gasthuis, location EG, Haarlem, the Netherlands.

Methods: For all asymptomatic women referred for mammography to our department of radiology by their general practitioners between January 1, 1992 and August 1, 1995 because of a family history of breast cancer, who had normal or benign radiological findings and fulfilled the NHG criteria (aged 35 years or older with a first degree family history of breast cancer), we advised a repeat mammogram within 1-2 years. After 2 years we checked in the hospital information system whether or not a patient had undergone repeat mammography in the Kennemer Gasthuis; in case of non-reattendance at this hospital general practitioners were asked by questionnaire, and if necessary by telephone, if follow-up mammography had been performed elsewhere.

Results: Out of the 510 referred women, 405 (79.4%) met the NHG criteria. In 370 the radiological findings were 'normal' or 'benign' and the follow-up data were complete. Of these 370 women 201 (54.3%) underwent a repeat mammogram within two years. This examination was performed more often if breast cancer of a first degree relative had been diagnosed premenopausally (126/208 = 60.6%) rather than postmenopausally (75/162 = 46.3%; 95% confidence interval for the difference: 3.6-25.0).

Conclusion: General practitioners in 50% of the cases complied with the recommendations for regular mammographic screening of breast cancer relatives. Their compliance may be increased by introduction of simple procedures into the computerized system for identification of risk factors and a systematic planning of screening examinations.