Breast cancer risk-factor and screening awareness among women nurses and teachers in Amman,Jordan

Breast cancer awareness studies of women in Jordan do not exist. This study used data from 163 nurses and 178 teachers surveyed in Amman to determine 2 dimensions of breast cancer awareness: general breast cancer awareness, defined as knowledge of risk factors associated with the disease and breast cancer screening awareness, defined as knowledge of breast self-examination and mammography. The survey instrument was based on 2 previously validated knowledge-based questionnaires in the literature (Breast Cancer Knowledge Test and the Comprehensive Breast Cancer Questionnaire). Analysis of covariance indicated that family history was associated with general breast cancer awareness. Profession, age, and family history significantly influenced breast cancer screening awareness. The average percentage of correct responses to general breast cancer awareness was adjusted for select covariates (adjusted means). The adjusted mean general awareness score for nurses was not significantly different from that of teachers (P =.8470). Nurses were more aware than teachers of the importance of breast cancer screening and its techniques. The adjusted mean screening awareness score for nurses was 88.3%, compared with 73.1% for teachers (P <.0001). These results provide important information about the level of breast cancer awareness among women nurses and teachers in Jordan and may be useful for developing future prevention and screening education programs.     

Preventing Breast Cancer Through Identification and Pharmacologic Management of High-Risk Patients

Breast cancer remains the most common cancer in women in the United States. For certain women at high risk for breast cancer, endocrine therapy (ET) can greatly decrease the risk. Tools such as the Breast Cancer Risk Assessment Tool (or Gail Model) and the International Breast Cancer Intervention Study risk calculator are available to help identify women at increased risk for breast cancer. Physician awareness of family history, reproductive and lifestyle factors, dense breast tissue, and history of benign proliferative breast disease are important when identifying high-risk women. The updated US Preventive Services Task Force and American Society of Clinical Oncology guidelines encourage primary care providers to identify at-risk women and offer risk-reducing medications. Among the various ETs, which include tamoxifen, raloxifene, anastrozole, and exemestane, tamoxifen is the only one available for premenopausal women aged 35 years and older. A shared decision-making process should be used to increase the usage of ET and must be individualized. This individualized approach must account for each woman’s medical history and weigh the benefits and risks of ET in combination with the personal values of the patient.     

Promoting breast health: older women's perceptions of an innovative intervention to enhance screening

Aims and objectives. This study is a continuation of prior funded research in which we tested the use of age and ethnically sensitive video breast health kits to increase knowledge about breast cancer and enhance the screening practices of breast self‐examination and mammography among older Caucasian and African‐American women. Background. Breast cancer is the most frequent cancer in women worldwide and accounts for 23% of all cancers. Mammography is currently the best procedure available for mass screening of breast cancer. However, underutilization of mammography is a problem among older women in the United States. Elders are at the greatest risk for developing and dying from breast cancer but they are the least likely group to be screened routinely with mammograms or to practice breast self‐examination, particularly if they are African‐American. Design. Participatory qualitative evaluation focus groups were used to assess the overall impact of the video kit intervention programme and to elucidate the quantitative findings of the original study. Methods. Four focus groups were conducted in two diverse settings with a purposive sample of 23 participants (N = 23). The overall sample was predominantly African‐American (87%) with mean age of 71 ± 7.9 years and mean education completed of 12 ± 3.4 years. Results. Five major themes emerged from group discussions: usability and appeal of the intervention, fear and empowerment, personal relevance and intergenerational sharing, impact on screening behaviours, and story telling. Conclusions. Analyses suggest that customized media materials constructed especially for older African‐American women empowered participants in this sample to action regarding their own breast health. Relevance to clinical practice. These findings may translate to global populations where risk is increasing but screening programmes are not widely available. Given that older women are historically difficult to access and impact, further design and evaluation of innovative and sensitive educational programmes such as the one described here are recommended.     

Secondary lymphoedema after breast cancer surgery: A survival analysis

This study explores the time of occurrence and risk factors of secondary lymphoedema after breast cancer surgery. A cross‐sectional study of women with breast cancer (n = 230) recruited from Chongqing Breast Cancer Center from July 2009 to June 2010 provided data. A self‐reported questionnaire was used to evaluate the lymphoedema by telephone interview at 6 monthly intervals between 12 and 24 months after breast cancer surgery. The Kaplan–Meier method and Cox proportional hazards regression were used to analyse the collected data. The mean time reported by women who had lymphoedema after breast cancer surgery was 18 months; body mass index and preoperative chemotherapy associated with lymphoedema development were identified in the present study. Given these findings, oncologists and nurses should provide sufficient knowledge to patients to recognize the symptoms, risk factors of lymphoedema and know‐how to use interventions to prevent it.     

African American women's breast memories, cancer beliefs, and screening behaviors

African American women experience higher breast cancer mortality and lower survival rates compared with white women of comparable age and cancer stage. The literature is lacking in studies that address the influence of past events on current health behaviors among women of diverse cultural groups. This qualitative exploratory study used participant narratives to examine associations between women's memories and feelings concerning their breasts and current breast cancer screening behaviors. Twelve professional African American women, aged 42 to 64 years, shared stories about memories and feelings regarding their breasts. Codes grouped together with related patterns and recurrences revealed categories that encompassed the language and culture of the participants. The categories identified were Seasons of Breast Awareness, Womanhood, Self-Portraits, Breast Cancer and Cancer Beliefs, Breast Cancer Screening Experiences, and Participants' Advice for Change. These categories provide direction for further exploration of barriers to health promotion practices among African American women and women in general.     

Breast cancer risk factor knowledge among nurses in teaching hospitals of Karachi, Pakistan: a cross-sectional study

Background  

Breast cancer is the most common cancer among women in both the developed and the developing world. The incidence of breast cancer in Karachi, Pakistan is 69.1 per 100,000 with breast cancer presentation in stages III and IV being common (≥ 50%). The most pragmatic solution to early detection lies in breast cancer education of women. Nurses constitute a special group having characteristics most suited for disseminating breast cancer information to the women. We assessed the level of knowledge of breast cancer risk factors among registered female nurses in teaching hospitals of Karachi. We also identified whether selected factors among nurses were associated with their knowledge of breast cancer risk factors, so that relevant measures to improve knowledge of nurses could be implemented.     

Leitlinie zur Pr?vention und Früherkennung von Brust- und Eierstockkrebs bei Hochrisikopatientinnen, insbesondere bei Frauen aus HBOC (Hereditary Breast and Ovarian Cancer) Familien

The Austrian guideline for prevention and early detection of breast and ovarian cancer in high risk patients--particularly in women from hereditary breast and ovarian cancer families--were established with particular consideration of the most recent position paper of the European Society of Breast Cancer Specialists (EUSOMA) by the authors mentioned above. The guideline is aimed at facilitating and standardizing the care and early detection strategies in women with an elevated life time risk for breast and ovarian cancer.     

Impact of breast cancer patients' awareness on attendance at screening

SHIEH S.-H., CHEN H.-C., TSAI W.-C., KUO S.-Y., TSAI Y.-F. & LU C.-H. (2012) Impact of breast cancer patients' awareness on attendance at screening. International Nursing Review59, 353-361 Aim: The purpose of this study is to investigate the impact of breast cancer awareness on the attendance for screening among women with breast cancer prior to diagnoses of breast cancer. Background: Breast cancer is the most commonly diagnosed cancer for women in Taiwan and its incidence rate continues to increase. However, screening for breast cancer is still not common even if the incidence rate has topped the list from 2003 to 2010. Methods: A cross-sectional study was conducted among women diagnosed with breast cancer. Subjects (535 women) were recruited from two medical centres in central Taiwan. Information on attendance for breast cancer screening was collected by self-report. Chi-square test and logistic regression were utilized to analyse the relationships between awareness of breast cancer and attendance at screening. Findings: The results indicated that pre-diagnostic awareness of 'the concept of early treatment relating to higher cure rate'[odds ratio (OR): 4.09; 95% confidence interval (CI): 1.12-14.9], 'various breast cancer screening methods' (OR:3.00; 95% CI: 1.23-7.30), 'the coverage of breast cancer screening programme in the National Health Insurance' (OR:1.76; 95% CI: 1.03-3.02) and 'breast self-examination after each menstrual cycle' (OR:3.42; 95% CI: 1.99-5.87) were all significantly associated with the screening procedures performed. Conclusions: Findings of this study indicated that particular attention should be paid towards enhancement of women's knowledge for prevention and early detection of breast cancer through educational efforts by nurse professionals, medical institutions and/or civil organizations.     

Breast cancer chemoprevention: current clinical practice and future direction.

With the unblinding of the Breast Cancer Prevention Trial (BCPT) in 1998, the clinical management of breast cancer prevention patients has expanded from the time-honored triad of breast cancer screening to include breast cancer risk assessment and risk reduction. With a proven 49% reduction in the incidence of breast cancer, tamoxifen is now the gold standard in chemoprevention for breast cancer risk reduction for women at increased risk of the disease. The suggested 74% reduction in the incidence of breast cancer seen with raloxifene in the Multiple Outcomes of Raloxifene Evaluation (MORE) trial is the basis of the now ongoing Study of Tamoxifen and Raloxifene (STAR) for the Prevention of Breast Cancer. Findings are anticipated in 2006.     

Breast self-examination and breast awareness: a literature review

Aim. To explore the literature on breast self‐examination and breast awareness. Objectives. To clarify the confusion surrounding breast awareness and breast self‐examination. To critique the evidence for breast awareness as a health promotion tool. Background. Over 41 000 women are diagnosed with breast cancer each year in the United Kingdom. Compared with other European countries, women in England have poor survival prospects, for breast cancer, due in part to advanced disease at first presentation. In the United Kingdom, women are encouraged to be breast aware from the age of 18. However, the evidence suggests that women do not engage in breast awareness and are frightened and confused about their role in breast health promotion. Methodology. Four databases were used: Medline, Ebsco including CINAHL and Sociological Abstracts and the Cochrane Database of Systematic Reviews. The search terms ‘breast awareness’ and ‘breast self‐examination’ were used and combined with ‘breast cancer’, ‘breast screening’ and ‘health promotion’. Conclusion. The evidence on breast self‐examination is clear, there is no benefit to breast cancer mortality and results suggest that breast self‐examination may do more harm than good. Breast awareness provides women with some acknowledgement of the part they can play in being empowered to fight breast disease, not in terms of statistics used for mortality but on the qualitative effects of reductions in morbidity. Relevance to clinical practice. The Royal College of Nursing of The United Kingdom is actively encouraging all nurses to promote breast awareness along with clear guidelines for doing so. The United Kingdom National Health Service Cancer Plan: a plan for investment, a plan for reform, encourages preventive care, information giving, good communication as well as evidence‐based practice. In breast care this can reduce confusion for women and encourage empowerment in breast health promotion.     

Knowledge, practice, and risk of breast cancer among rural women in Korea

Abstract Breast cancer is the third leading cause of death among Korean women after stomach and cervical cancer. Furthermore, the incidence of breast cancer is increasing in contrast to decreasing trends of those two cancers described above. According to the Korean Ministry of Health and Welfare, in 1998, 6.1% of all cancers and 14.1% of cancers in women were breast cancers. Early detection of breast cancer can be achieved by performing periodic breast self-examinations (BSE), clinical breast examinations, and/or mammography. Women should perform early detection procedures such as BSE or mammography on a regular basis to detect breast cancer earlier. For the cost effectiveness of the program, the identification of high-risk groups should be conducted, and the provision of community programs for the early detection of breast cancers should be focused on high-risk groups. The present study was designed to classify the high-risk groups of breast cancer among rural women in Korea, to provide early detection of breast cancer programs. Breast cancer risk of each participant, aged 35–65 years and who reside in the Korean rural community including Kyungki-Do and Chungchongbuk-Do, was assessed utilizing the breast cancer risk appraisal instruments. The tool estimates the six risk factors including age, family history, personal breast disease history, breast-feeding experience, number of children, and frequency of fat intakes. Breast cancer-related knowledge and practices were also assessed. The study results identified a 1.5% high-risk group, 3.8% moderate-risk group, and 24.0% borderline-risk group. Approximately 30% of the respondents were above the borderline-risk groups, which indicate the need for systematic approach for breast cancer prevention and early detection in the community.     

A technology‐based information and coaching/support program and self‐efficacy of Asian American breast cancer survivors

Women's self‐efficacy for coping with breast cancer is one of the key factors that lead to successful breast cancer survivorship. Due to the cultural stigma linked to breast cancer (e.g., breast cancer is a genetic disease), Asian Americans are known as a high‐risk group within breast cancer survivors. However, healthcare providers are challenged to promote women's self‐efficacy while considering their cultural beliefs and attitudes. In this study, the efficacy of a technology‐based information and coaching/support program was examined in improving self‐efficacy for coping with breast cancer among Asian American survivors. A randomized repeated measures control group study was conducted with 67 Asian American breast cancer survivors. The questions on background characteristics, the Personal Resource Questionnaire, the Perceived Isolation Scale, the Supportive Care Needs Survey Short Form 34, and the Cancer Behavior Inventory were used. The data were analyzed using repeated measurement analyses, χ² tests, and decision tree analyses. There were significant increases in the self‐efficacy scores of both control and intervention groups over time (p = .017). However, the increase in the control group's self‐efficacy scores was only up to post 1 month, and there was a decrease in the scores by post 3 months. When the participants were divided into high and low‐change groups based on the changes in their self‐efficacy scores for 3 months, the intervention group had more participants who belonged to the high‐change group (p = .036). The technology‐based intervention was effective in improving self‐efficacy for coping with breast cancer among Asian American breast cancer survivors.