Breast cancer screening (breast self-examination, clinical breast exam, and mammography) in women referred to health centers in Tabriz, Iran.

Background : Breast cancer is the most common cancer and the most common cause of death in Iranian women aged 35-55 years. Breast cancer screening comprises breast self-examination (BSE), clinical breast examination (CBE) and mammography. Objective:0 The study aimed to examine the performance of screening methods among women referring to health centers of Tabriz, Iran. Materials and methods : This was a descriptive-analytical research carried out on 400 women aged 20-50 years. The samples were chosen through random multistage sampling among health centers of Tabriz then active records of women. A questionnaire and observational checklist was used to elicit socio-demographic information and performance of women towards breast cancer screening methods. Descriptive and inferential statistics (chi-square and Fisher's exact test) were used to analyze the data. Results: Only 18.8% of women did breast self-examination, 19.1% had clinical breast examination and 3.3% had mammogram. Statistical test showed a significant relationship between performing BSE and educational level, employment, income, number of children, breastfeeding history, breastfeeding quality and family history of breast cancer. There was a significant correlation between performing CBE and history of breast tumor and also, between performing the mammography and family history of breast cancer and history of breast tumor (P < 0.05). Conclusions: The findings showed that the performance of breast cancer screening methods was not satisfactory. Performance in high risk women was very desirable than others. Implication for Practice: The presentation of imperative education about breast cancer screening methods through health staff especially in pregnancy, post-partum and even in pre marriage counseling periods seems necessary.

effects of breast cancer early detection training program on the knowledge, attitudes, and practice of female PHHC physicians [Eastern Province; 2004]

It has been shown by many studies that early detection and management of breast cancer had decreased mortality and morbidity from the disease. Several studies showed that physicians' ordering of screening depended on: levels of confidence and comfort, and knowledge of breast screening guidelines, 11 their colleague's mammography practices, the adequacy of insurance coverage, and how often they had spent an unreasonable time explaining mammography results, 12 and beliefs of physicians.1 The present study studied the effects of breast cancer early detection training program on the knowledge, attitudes, and practice of female PHHC physicians. This is a non-r and omized experimental design with 45 PHCCs' female physicians in Al Khobar, and Al Qatif cities [experimental group] during the period: Oct 2003- Feb 2004 participating. A workshop on knowledge of BC concepts and skills was developed and implemented on the participants. A 3-part structured questionnaire [demographic data, general knowledge, and early detection] based on fundamental knowledge of breast cancer and early detection was used as pre-post test instrument. The knowledge measurement is composed of 65 close-ended items with two choices [agree/disagree]. A 30-item likert type of 5 choices questions were used to assess the attitudes of physicians. The Mamma Care program models were used to assess the ability of the physicians in detecting lumps and evaluating the nature of breast tissues. Another part of the assessment tool was the practice part totaling to 16 points, which assessed the lumps using two breast models with 5 lumps. The cut-off points of Knowledge and Practice are: Poor < 60%, Good 6 1-80%, Excellent > 80%. The cut-off points of attitudes were determined after taking the mean of all the respondents. 65% of the respondents were Saudis, 95% hold bachelor's degree and 5% held master's degree. The mean age was 35.91 years. The mean duration of PHHC practice was 6.065 years, and mean duration of practice is 8.35 years. The findings of the study show that the program improved the PHC physicians' KAP significantly. Before intervention was given, the physicians had good knowledge about breast cancer and early detection [67%], but scored low regarding practice of BC [36%], and just 37% had a positive attitude. The pre and post-test mean scores of female physicians on the study group show a marked significant increase on the indicators of KAP after intervention; for knowledge from 67% to 96% [p < 0.001], attitude from 68% to 78% [p < 0.001], and for examination skills from 33% to 77% [p < 0.001]. Before intervention was given, the physicians had good knowledge about breast cancer and early detection but scored low regarding practice of BC early detection and had a negative attitude of it too, and after the educational program, there were significant positive changes in physicians KAP