Early Detection and Screening for Breast Cancer.

OBJECTIVE: To review the history, current status, and future trends related to breast cancer screening. DATA SOURCES: Peer-reviewed articles, web sites, and textbooks. CONCLUSION: Breast cancer remains a complex, heterogeneous disease. Serial screening with mammography is the most effective method to detect early stage disease and decrease mortality. Although politics and economics may inhibit organized mammography screening programs in many countries, the judicious use of proficient clinical and self-breast examination can also identify small tumors leading to reduced morbidity. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have exciting opportunities to lead, facilitate, and advocate for delivery of high-quality screening services targeting individuals and communities. A practical approach is needed to translate the complexities and controversies surrounding breast cancer screening into improved care outcomes.

Breast self examination practice and breast cancer risk perception among female university students in Ajman.

Breast cancer is the top cancer in women worldwide and its incidence is increasing, particularly in developing countries. In the United Arab Emirates (UAE), many cases are first diagnosed in later stages and at younger age compared to those seen in developed countries. Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. Performance of breast self examination is one of the important steps for identifying breast disease at an early stage, by the woman herself. No information has hitherto been available about the frequency of this practice among female university students in UAE or about their breast cancer risk perception and therefore the present study was conducted in Ajman. It was found that 22.7% of the participants practiced BSE but only 3% of them practiced BSE monthly. Marital status but not age as significantly associated with age likelihood. The most frequent reported barriers for BSE were lack of knowledge, considering oneself not at risk and the absence of doctor advice. These factors need to be taken into account in intervention efforts.

Mujer con patología mamaria. ¿qué factores se asocian a la práctica de la autoexploración? / Profile of women with breast disease wich does self-exploration. Which are the factors associated with this practice?

Antecedentes. En las últimas décadas la lucha contra el cáncer de mama se ha centrado, básicamente, en el tratamiento y en la prevención secundaria (fundamentalmente la detección precoz). La autoexploración mamaria, aunque no se ha demostrado que reduzca la mortalidad, sí es importante respecto a los casos detectados por la propia mujer (se estima que un 90% del total) y principalmente en los cánceres de intervalo. Objetivos. Identificar entre mujeres con cáncer de mama, cuántas realizan la autoexploración y los factores asociados. Describir las características clínico-patológicas de los cánceres en las mujeres que sí realizan la autoexploración. Metodología. En mujeres diagnosticadas de cáncer de mama, en un hospital de la provincia de Cádiz, España, se reconstruye de manera retrospectiva la historia relacionada con el proceso del cáncer, es decir, sintomatología, factores psicosociales que determinan el contacto con el sistema sanitario, realización de prácticas preventivas (participación en el Programa de Detección Precoz del Cáncer de Mama –PDPCM–, autoexploración mamaria,...). Se realiza una descripción clínico-patológica del tumor: síntoma de presentación, tamaño tumoral, ganglios negativos, grado de diferenciación histológica. Resultados. Se estudiaron 149 mujeres con cáncer de mama, de las cuales el 52% realizaba autoexploración. Las mujeres que realizan autoexploración son más jóvenes (54,78 años frente a 65,63), están casadas (66,2%), se encuentran laboralmente activas y tienen un nivel de estudios mayor. La valoración de la aparición del primer síntoma como algo importante se correlaciona positivamente con aquellas mujeres que practican la autoexploración. En cuanto a otras prácticas preventivas, las que se autoexploran son también las que más acuden al programa de detección precoz (74,4% frente a 29,5% en las que no se autoexploran). En cuanto a las características clínico-patológicas del tumor en las mujeres que se autoexploran: el tamaño tumoral medio es de 2,5 cm; el 50,7% se halla bien diferenciado, y en un 59,1% de los casos los ganglios son negativos. Conclusiones. Las mujeres que se autoexploran son más jóvenes, tienen un nivel educativo mayor, están casadas, se encuentran laboralmente activas y suelen participar en otras prácticas preventivas. En ellas, los tumores diagnosticados presentan un menor tamaño, se diagnostican en estadios más precoces y por lo general presentan mejor grado de diferenciación(AU)

Background/Aims: In recent decades the fight against breast cancer has focused primarily on the treatment and secondary prevention (early detection mainly). In the case of breast self-examination, althought it has not been prove to reduce mortality, it is important in cases detected by women themselves (it is estimated 90% of total), mainly in the interval cancers. Objectives: To identify within women with breast cancer, how many do self-examination and identify associated factors. Describe the clinical and pathological features of cancers in women who do perform self-examination. Methodology: In women diagnosed with breast cancer during 2007 in a hospital in the province of Cadiz, Spain, is reconstructed in retrospect the story related the cancer process: symptoms, psychosocial factors that determine the contact with the health system, preventive practices (self-examination, mammography screening). A description of the pathological tumor: presenting symptom, tumor size, node negative, grade of differentiation… Results: We studied 149 women with breast cancer, from whom 52% did self-exploration. Women who performed self-examination were younger (54.78 years) against the women who did not (65.63 years), married (66.2%), active workers and have a higher educational level. The assessment of the first symptoms in these women as «important» is positively correlated with those women who practice self-examination. For other preventive practices, women who does self-examination are also the most actives in early detection programs (74.4% against 29.5% which didn’t do self-examination). For the pathologic characteristics of tumor in women who did self-examination: the tumor size was 2.5 cm, 50.7 / are well differentiated, and 59.1% of cases the nodes are negative. Conclusions: Women who does self-examination are younger, have higher educational level, are married, are active workers and are often involved in other preventive practices. On them, the tumors diagnosed have a smaller size, are diagnosed at earlier stages and usually present better degree of differentiation(AU)

La autoexploración mamaria como principal técnica de prevención del cáncer de mama / Breast self-examination as main technique for breast cancer prevention

El cáncer de mama es la neoplasia más frecuente en la mujer. Como principal medida preventiva destaca la autoexploración mamaria, ya que casi el 95% de los tumores mamarios es detectado por la propia mujer a través de esta técnica. La enfermería constituye el grupo sanitario más relacionado con la enseñanza de las pautas adecuadas para realizar la técnica de forma correcta: práctica mensual, reconocimiento de anomalías en la mama, acudir al médico especialista ante posibles dudas de cambios en las mismas, etc(AU)

Breast cancer is the most common malignancy in women. Breast self-examination stands out as the main preventive measure, since almost 95% of breast tumours are detected by the woman herself through this technique. Nursing is the group most closely related to health education appropriate guidelines to perform the technique correctly: monthly technical realization, recognition of abnormalities in the breast, go to the doctor for possible doubt about changes in them, etc(AU)

Un bulto en la mama. Tú eliges cómo abordarlo / A lump in the breast

Las estadísticas parecen indicar que en algún momento de su vida, una de cada nueve mujeres deberá afrontar un cáncer de mama. La autora relata su manera personal de hacerle frente, compartiendo las preguntas y respuestas que ha ido hallando en este camino. Es autora del libro de igual título que su artículo(AU)

The statistics seem to indicate that at some point in their lives, one in nine women must face breast cancer. The author recounts his personal way of moving forward and sharing the questions and answers that have been found in this way. She is the author of the book with the same title that his article(AU)

Conocimiento y práctica del autoexamen de mamas por usuarias de la Unidad de Salud de la Familia / Knowledge and practice of the breast self examination by the users of the Family Health Unit / Conhecimento e prática do auto-exame das mamas por usuárias de Unidade de Saúde da Família / studo transversal com 116 usuárias, de 40 a 59 anos, de uma Unidade de Saúde da Família, no sudoeste baiano, a fim de avaliar o conhecimento e prática das mesmas acerca do auto-exame das mamas (AEM). Foi utilizado formulário estruturado, analisado pela regressão de Poisson. 75,9 % das mulheres relataram conhecer o AEM e 65,5%, praticá-lo; A razão de prevalência para o conhecimento do AEM foi 1,40 vezes maior entre as mulheres com mais escolaridade; 2,85 vezes maior entre as que conheciam o câncer de mama e 15% maior para as que acham importante descobrir cedo a doença. A prática mostrou-se maior entre as economicamente ativas; com mais de 2 filhos; não tabagistas; que freqüentam a unidade mais de 2 anos, que conhecem e acham importante descobrir o câncer de mama precocemente. Depreende-se que é preciso investir mais em atividades de educação para evitar agravos à saúde da mulher

Estudio transversal con 116 usuarios, de 40 a 59 años, de una Unidad de Salud de la Familia en el suroeste de Bahía, con el fin de evaluar el conocimiento y la práctica de las mismas sobre el autoexamen de mamas (AEM). Se utilizó formulario estructurado, analizado por regresión de Poisson. 75,9% de las mujeres reportaron conocer el AEM y el 65,5% lo practica. La razón de prevalencia para el conocimiento del AEM fue 1,40 veces mayor entre las mujeres con mayor escolaridad, 2,85 veces mayor entre las que conocían el cáncer de mama y más del 15% para aquellas que consideran que es importante detectar la enfermedad temprano. La práctica fue más alta entre la población económicamente activa, con más de 2 hijos, no fumadoras, que asisten a la unidad durante más de 2 años, que conocen y sienten importante detectar el cáncer de mama precozmente. De ello se desprende que es preciso invertir más en actividades de educación para prevenir riesgos para la salud de la mujer (AU)

Transversal study with 116 users, from 40 to 50 years old, of a Family Health Unit in the southwest of Bahia, in order to assess the knowledge and the practice of themselves about the breast self examination (BSE). A structured form was used, analyzed by Poisson regression , the 75.9% of the women reported on knowing the BSE and the 65.5% of the women put it into practice.the prevalence reason for knowing the BSE was 1.4 times higher among women with higher scolarship, 2.85 times higher among those who know the breast cancer and more than 15% for those who consider that it is important to detect the disease early. The practice was higher among the economical active population, with more than 2 children, non-smoking, who attend to the unit for more tan 2 years, who know and feel that detecting the breast cancer early is important. From that can be deduced that it is necessary to invest more in education activities to prevent risks for the health of the women (AU)

Identifying women's knowledge about risk factors of breast cancer and reasons for having mammography.

The aim of this study was to identify breast cancer risk factors and reasons for having mammography of the women who applied for mammography, as well as to determine their level of knowledge about risk factors and level of risk perception, and anxiety concerning breast cancer. This cross-sectional descriptive study was conducted from June 15, 2010 through September 10, 2010, in a university hospital in Ankara, Turkey. A questionnaire prepared by the researchers was used to collect the data. The mean age of the women was 52.1 ± 9.98 years. Sixteen percent of the women had a family history of breast cancer. The majority of participants had mammograms (75.8%) before and had gained knowledge about breast cancer and its screening (73.7%). The leading source of information about breast cancer was physicians (46.2%). Physician recommendations, having breast-related complaints, and family history of breast cancer were important reasons to obtain mammography. The mean knowledge score about risk factors of breast cancer was 4.15 ± 2.73 and the mean anxiety score was 1.65 ± 1.61. It was found that some socio-demographic and obstetrical characteristics of women, their family history, and risk perceptions about breast cancer affect their knowledge and anxiety scores about breast cancer. In conclusion, the present study identified a number of factors affecting mammography participation for women. The results of this study can be helpful in promoting screening for breast cancer.

Practice and barriers of mammography among Malaysian women in the general population.

OBJECTIVE: The objective of this study was to determine the practice and barriers of mammography and associated factors among Malaysian women in the general population. METHODOLOGY: A cross-sectional study was conducted among 200 women in Shah Alam, Selangor; Malaysia. The questionnaire contained 27 questions and was comprised of two sections; socio-demographic characteristics and practices, knowledge and barriers of mammography. All the data were analyzed using the Statistical Package for the Social Sciences (SPSS) 13.0. RESULTS: Of the 200 Malaysian women who participated in this study, the majority were under the age of 50 years (65.5%), Malay (86%), and married (94.5%). Regarding any family history of cancer in general, the majority of the participants had none (78%). However, some did report a close relative with breast cancer (16.5%). While the majority of them knew about mammography (68%), 15% had had a mammogram once in their life and only 2% had the procedure every two or three years. Univariate analysis showed that age, family history of cancer, family history of breast cancer, regular supplement intake, regular medical check-up and knowledge about mammogram were significantly associated with mammogram practice among the general population (p=0.007, p=0.043, P=0.015, p=0.01, p=0.001, p<0.001; respectively). Multivariate analysis using multiple linear regression test showed that age, regular medical check-up and knowledge about mammography testing were statistically associated with the practice of mammography among the general population in Malaysia (p=0.035, p=0.015 and p<0.001; respectively). Lack of time, lack of knowledge, not knowing where to go for the test and a fear of the test result were the most important barriers (42.5%, 32%, 21%, 20%; respectively). CONCLUSION: The practice of mammogram screening is low among Malaysian women.

Practice of breast self-examination among women in Malaysia.

OBJECTIVES: The objective of this study was to examine the practice and associated factors of breast self- examination (BSE) among Malaysian women. METHODS: For this cross-sectional study 250 women were selected by a simple random sampling technique. The questionnaire was consisted of three parts: socio-demographic characteristics, knowledge about BSE, and practice of BSE. Obtained data was analyzed using SPSS version 13. T-test and ANOVA test were used to explore the relation between socio-demographic characteristics and the practice of BSE. RESULTS: About 32% of the participants reported that they have had family history of cancer and about 20% of the participants reported that they have had family history of breast cancer. The majority of the participants (88.8%) have heard about breast cancer and 78.4% of the participants have heard about BSE. Race, marital status, residency, regular exercise, awareness about breast cancer, belief that breast cancer can be detected early, belief that early detection improves the chance of survival, family history of cancer, family history of breast cancer, awareness about BSE, and belief that BSE is necessary, significantly influenced the practice of BSE among women. Practice of BSE on monthly basis was found to be 47.2% among the study participants. CONCLUSION: The socio-demographic characteristics significantly influence the practice of BSA among women in Malaysia. The findings of this study might not only influence the planning of specific screening interventions and strategies in Malaysia but might also be important for the relevant international communities, interested in the peculiarities of BSE incidence in different countries.

Literacy and breast cancer prevention: a population-based study from Iran.

Breast cancer is the most common cancer in women worldwide and the leading cause of death from cancer among women. Evidence suggests that early diagnosis and screening interventions might help to improve outcomes. This population-based study was conducted to determine breast cancer awareness and screening behavior among Iranian women and to examine its association with women's literacy. The study was carried out in two provinces, with 1,477,045 population, located in central and eastern part of Iran. Overall, 770 women were studied. Of these, 482 (62.7%) were literate and 287 (37.3%) were not. The results obtained from the data analysis indicated that there was a significant difference between literate and illiterate women. Further analysis of the data using logistic regression showed that literacy was an important contributing factor for breast cancer prevention behavior. The findings suggest that in order to improve women's health and breast cancer outcomes providing equal educational opportunities for women seems necessary.

Mujeres con alta probabilidad de padecer cáncer de mama. Luces, sombras y muchos puntos oscuros / No disponible

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Practice and barriers toward breast self-examination among young Malaysian women.

INTRODUCTION: The etiology of breast cancer is still unknown and adequate primary prevention strategies or interventions are still not possible. Therefore, early detection remains the first priority and regular practice of breast self-examination (BSE) influences treatment, quality of life, survival, and prognosis of breast cancer patients. OBJECTIVES: The objective of this study was to determine the practices and barriers towards breast self-examination among young Malaysian women. METHODOLOGY: Cross-sectional study was conducted among 251 female students at the Management and Science University, Shah Alam, Selangor, Malaysia. Questionnaires were distributed at gathering places such as the university cafeteria, the university plaza, the Islamic center, and at the library. In addition, questionnaires were distributed in the lecture halls. The proposal of this study was approved by the Ethics and Research Committee of Management and Science University. Data was analysis using SPSS version 13, t-test was used to analyze the associated factors toward the practice of BSE. RESULTS: A total number of 251 students participated in this study. The majority of them were older than 20 years old,of Malay racial origin, single and from urban areas (66.5%; 63.7%; 96%; 70.9% respectively). Regarding their lifestyle practices, the majority of participants do exercise, are non-smokers and do not drink alcohol (71.3%; 98.4%; 94.4% respectively). More than half of the study participants mentioned that they have practiced BSE (55.4%). Regarding the sources of information about BSE, the majority mentioned that radio and TV were their main sources of information (38.2%). Age, exercise and family history of cancer significantly influenced the practice of BSE (p = 0.045; p=0.002; p=0.017 respectively). Regarding the barriers to BSE, the majority who never practiced BSE mentioned that lack of knowledge, not having any symptoms, and being afraid of being diagnosed with breast cancer were the main barriers to practicing BSE (20.3%; 14.3%; 4.4% respectively). CONCLUSION: More than half of the participants practiced BSE. Age, exercise and family history of cancer significantly influenced the practice of the BSE. Lack of knowledge, not having any symptoms and being afraid of being diagnosed with breast cancer were the main barriers to practicing BSE. There is an urgent need to develop a continuous awareness campaign among university students on the importance of performing BSE.

Knowledge, attitudes, beliefs, and practices regarding breast and cervical cancer screening in selected ethnocultural groups in Northwestern Ontario.

PURPOSE/OBJECTIVES: To examine the knowledge, attitudes, beliefs, and practices regarding breast and cervical cancer screening in selected ethnocultural groups (i.e., Italian, Ukranian, Finnish, and the native population) in Northwestern Ontario, Canada. DESIGN: Descriptive, exploratory. SETTING: Rural and urban settings in Northwestern Ontario. SAMPLE: 105 women aged 40 and older who were residents of Northwestern Ontario and members of selected ethnic groups, including Italian, Ukranian, Finnish, Ojibwa, and Oji-Cree. METHODS: An interview guide was designed specifically for this study to gather information regarding knowledge, attitudes, beliefs, and practices about breast self-examination (BSE), clinical breast examination (CBE), mammography, and cervical cancer screening procedures. Data were obtained through face-to-face interviews (two or three hours) in English or the language spoken. Interviews in other languages were transcribed into English. FINDINGS: Ojibwa and Oji-Cree women were more likely than any other group to not have practiced BSE, to have refused CBE or mammogram, to not have been told how to perform BSE, to not have received written information about breast examination, and to be uncomfortable and fearful about cervical cancer screening procedures (33% refused internal examination as compared to 0-8% in the other ethnic groups). Four issues emerged from the findings: (a) using multimedia sources to inform women about screening programs, (b) educating women regarding breast and cervical cancer screening, (c) reminding women when they are due for screening, and (d) identifying that Pap tests are uncomfortable and frightening. CONCLUSIONS: Cultural beliefs, attitudes, and practices of marginal populations (e.g., native women) are important to consider when developing strategies to address barriers to effective breast and cervical screening. IMPLICATIONS FOR NURSING: Educational programs that are culturally sensitive to participants are imperative.

Racial differences in breast cancer screening, knowledge and compliance.

BACKGROUND: Breast cancer is the second leading cause of cancer death among women in the United States. Although the incidence of breast cancer is 13% higher in white women, mortality in black women is 28% higher, due to histological and socioeconomic factors. Existing research regarding racial differences in compliance with breast cancer screening recommendations has found conflicting results. METHODS: Data on more than 4,500 women were taken from the 1992 National Health Interview Survey, a nationally representative, population-based sample survey. Logistic regression was used to estimate the relative odds of knowledge of breast self-exam (BSE) and mammograms, and compliance with BSE, clinical breast exams (CBE), and mammograms. RESULTS: Black women were less likely than white women to be aware of and use breast cancer screening tests. However, among women who were aware of screening tests, compliance was higher among black women. Women with low educational attainment, low cancer knowledge, and no usual source of care were less likely to be CBE or mammogram compliant. Socioeconomic differences were larger for the two clinical tests than for BSE. CONCLUSIONS: Programs should inform women about cancer screening tests and remove barriers that hinder women from receiving clinical screening exams.

Breast cancer screening.

Achieving and maintaining a high rate of attendance for screening and two-yearly re-screening is essential for the success of the BreastScreen Australia program. A low participation rate will result in fewer breast cancer-related deaths being prevented. Results of two recent large randomised trials do not show that a systematic approach to breast self examination finds breast cancers early or impacts on survival. "Breast awareness" and the prompt reporting of breast symptoms are important early detection messages for women of all ages. General practitioners have a key role in the promotion and provision of information about effective public-health initiatives for the early detection of breast cancer.

Breast health educational interventions. Changes in beliefs and practices of working women.

Health education programs supported by women's groups or workplaces have been successful in reaching large populations and changing intentions to perform breast health behaviors. This study examined the responses women working in the automotive industry had to two health education interventions, mailed pamphlets, and a combination of mailed material and classes at the worksite compared to a control group. A quasi-experimental design was used. Of the 948 women completing the pre-test, 437 also completed the post-test and were highly representative of the initial sample. The findings suggest that although the mailed information produced some change in practices and intentions, the classes in combination with the mailed pamphlets produced greater change. In addition, confidence in breast self examination as a method of detecting an existing breast lump increased from pre-test to post-test across all age groups. The reported influences on the women's decisions related to breast health varied across the life span. The results of this study can be used to support the development of effective health promotion programs for use at workplaces to increase the likelihood of women engaging in healthy breast practices.

Comparison of breast screening outcomes from a cancer control intervention for African-American and white women in western New York.

This study's purpose was to compare breast screening outcomes, health practices, and risk factors for low-income African-American and white women who participated in a multistrategy cancer control intervention. Subjects were recruited from their communities to participate in breast screening activities (clinical breast examination and mammography testing). Data were collected via a screening intake form for a 2-year period (mid- 1994 to mid- 1996). As a result of the recruitment. 1444 women enrolled for breast screening services. They included 282 African Americans. 1079 whites, and 83 other minorities. African-American and white women alike reported deficiencies in monthly breast self-examination practices and previous mammography use. However, more African-American women than white women reported monthly breast self-examination practice (P < 001). More white than African-American women reported having had a previous mammogram (P < .002). Examination of selected risk factors showed that both African-American women and white women had minimum family history. A comparison of breast screening outcomes showed that African-American women presented with slightly more abnormalities than did white women after undergoing clinical breast exams and mammography. However, no significant difference was found when comparing these variables. Overall, African-American women were as likely as white women to participate in screening activities. There was little difference between these groups when comparing screening outcomes, health practices, and risk factors.