Evaluation of an Intervention Program for Promoting Breast Self-Examination Behavior in Employed Women in Iran.

INTRODUCTION: Breast cancer is the most common malignancy in the world. Screening is the basis for early detection. However, the mortality rate is still high in Iranian women related to not screening and timely check-ups. We offered a theory-based intervention program to improve breast cancer screening behavior in women. METHODS: This interventional study was conducted in 135 employed women in 2019. Their screening behavior was investigated using a questionnaire based on the Protection Motivation and Social Support Theories. We compared the efficacy of 2 educational interventions (a workshop and an E-learning program) between 2 intervention groups and a control group. The results were collected 3 months after the interventions had taken place. Data were analyzed in SPSS 23 using descriptive statistics, chi-square, analysis of variance (ANOVA), and the paired sample t-test. RESULTS: We found a significant difference between the mean score of knowledge and the theoretical constructs (P value < .001) before and after the interventions. Our results also showed that both the intervention methods had a similar effect and that there was a significant difference in the performance of breast self-examinations between the intervention and control groups after the intervention (P value < .001). CONCLUSION: Given the cost-effectiveness and feasibility of implementing an E-learning program, we would recommend that health care planners assist in designing and implementing this effective form of intervention to encourage many more women to perform self-examinations to aid breast cancer screening.

An Application of the Protection Motivation Theory to Predict Breast Self-Examination Behavior among Female Healthcare Workers.

OBJECTIVE: Breast cancer is the most prevalent cancer among women and has the highest mortality rate among the women around the world. Early diagnosis of this cancer increases the survival of the patients. The aim of this study was to determine the predictor factors for breast self-examination (BSE) based on the Protection Motivation Theory (PMT) among female healthcare workers in Hamadan University of Medical Sciences. MATERIALS AND METHODS: This analytical-descriptive study was conducted on 501 employed women in age range of 20-61 years old in Hamadan University of Medical Sciences in west of Iran during 2018. Participants in the study were random stratified sampling selected. Data collection tools were demographic information and the constructs of PMT. The data were analyzed by descriptive statistics and the logistic regression tests. RESULTS: The results showed that only 9% of participants performed BSE regularly and monthly. The most important reason for lack of BSE was its triviality. Linear regression analysis showed that the structure of perceived threat appraisal is the predictor of the intention to perform BSE (R2=0.027). Moreover, the logistic regression analysis showed that the protection motivation construct was a strong predictor for BSE (R2=0.25). CONCLUSION: The frequency of practice of BSE in female healthcare workers is low. Therefore, it is imperative to periodically emphasize the importance of early breast cancer diagnosis for them and the design of educational programs based on the PMT can increase the regular of BSE behavior.

Lack of Prognostic Impact of Adjuvant Radiation on Oncologic Outcomes in Elderly Women with Breast Cancer.

BACKGROUND: Radiotherapy plays an important role as adjuvant treatment in locally advanced breast cancer and in those patients who have undergone breast-conserving surgery. This study aimed to investigate the prognostic impact of adjuvant radiation on oncologic outcomes in elderly women with breast cancer. MATERIALS AND METHODS: In this retrospective study, we reviewed and analyzed the characteristics, treatment outcome and survival of elderly women (aged ≥ 60 years) with breast cancer who were treated and followed-up between 1993 and 2014. The median follow up for the surviving patients was 38 (range 3-207) months. RESULTS: One hundred and seventy-eight patients with a median age of 74 (range 60-95) years were enrolled in the study. Of the total, 60 patients received postoperative adjuvant radiation (radiation group) and the remaining 118 did not (control group). Patients in the radiation group were significantly younger than those in the control group (P value=0.004). In addition, patients in radiation group had higher node stage (P value<0.001) and disease stage (P=0.003) and tended to have higher tumor grade (P=0.031) and received more frequent (P value <0.001) adjuvant and neoadjuvant chemotherapy compared to those in the control group. There was no statistically significant difference between two groups regarding the local control, disease-free survival and overall survival rates. CONCLUSIONS: In this study, we did not find a prognostic impact for adjuvant radiation on oncologic outcomes in elderly women with breast cancer.

Rectal cancer in pregnancy: a diagnostic and therapeutic challenge.

INTRODUCTION: The occurrence of colorectal cancer during pregnancy is rare and is associated with diagnostic and therapeutic challenges. Herein, we report such a case of rectal cancer in pregnancy and review the literature. CASE REPORT: A 31-year-old multiparous, pregnant woman, in the 20th week of gestation, presented with rectal bleeding progressing to spasmodic abdominal pain and right flank vague pain. A flexible rectosigmoidoscopy showed a large ulcerative mass located in the rectosigmoid junction, 15 cm away from anal verge. Imaging studies and biopsy proved it to be rectal adenocarcinoma with single liver metastasis. The patient's pregnancy was terminated and neoadjuvant therapy followed by curative surgery was performed. She is currently receiving adjuvant systemic therapy to eradicate potential micrometastatic disease. CONCLUSION: This case suggests that colorectal cancer can mimic the signs and the symptoms of pregnancy and tends to present at an advanced stage in pregnant women.