Practice of antenatal clinical breast examination as a method of early detection of breast cancer by health care providers in a low resource setting

Purpose To promote a systems-based approach for the early detection and downstaging of breast cancer at presentation in the remote mountainous region of Gorno Badakhshan Autonomous Oblast (GBAO), Tajikistan, by introducing breast cancer awareness into the community and training health care professionals in clinical breast evaluation (CBE). Methods Through a public-private partnership between the Ministry of Health, the Aga Khan Health Services, Tajikistan, and the Aga Khan Health Board, we organized breast cancer screening in the community and trained family medicine doctors (FMDs) and family medicine nurses (FMNs) in CBE. We identified and trained CBE master trainers, who, in turn, systematically trained FMNs to conduct CBEs in each of the remote regional clinics. Results Between 2014 and 2017, 47 FMDs (85% of all FMDs in GBAO), 166 FMNs (55% of all FMNs in GBAO), and six master trainers were trained. Of 3,556 women who were screened, abnormal CBEs were noted in 696 of them (20%). Of the last 1,101 CBEs that were performed by trainee FMNs, with secondary CBEs by master trainers, the rate of abnormal CBEs plateaued at 9%. A total of 18 women were diagnosed with breast cancer—2.6% of abnormal CBEs and 0.5% of all screened women. Conclusion A dual-pronged approach of community awareness and CBE training of health care professionals, supported by CBE master trainers, offers a sustainable approach for the early detection of breast pathology. We observed anecdotal evidence of clinical early-stage detection over time with improved CBE proficiency and community acceptance. Sustaining this program will require advocacy by health care providers and a responsive public policy to support the early detection and treatment of breast cancer across the region.

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FAKTOR YANG BERHUBUNGAN DENGAN PERILAKU IBU RUMAH TANGGA MELAKUKAN PEMERIKSAAN PAYUDARA SENDIRI (SADARI)

The Indonesian Journal of Public Health ◽

10.20473/ijph.v12i2.2017.143-153 ◽

2018 ◽

Vol 12 (2) ◽

pp. 143

Author(s):

Alvita Brilliana R. Arafah ◽

Hari Basuki Notobroto

Keyword(s):

Breast Cancer ◽

Health Care ◽

Health Care Providers ◽

Early Stage ◽

Health Providers ◽

Care Providers ◽

Cross Sectional ◽

Information Accessibility ◽

Breast Examination ◽

Access Information

Breast cancer is cancer with the number of new cases and deaths highest in Indonesia. According to the Data Center and Information Ministry of a health Indonesia in the year 2013, the number of new cases of breast cancer of 819 and the number of deaths amounted to 217. In general, breast cancer known after stepping on an advanced stage. So the methods of early detection of breast cancer are focused on the detection of early stage tumors that are usually small with self-breast examination (SADARI). The purpose of this research is to predict the factors related to the behavior of self-breast examination (SADARI) the housewives aged 40–50 years. This research is an observational study with cross sectional approach. Sample research totaling 100 people housewife in Kelurahan Sidotopo Wetan Kenjeran Subdistrict Surabaya. The measurement was done by providing a questionnaire to obtain information about the research variables. Variable independent research is k nowledge, attitudes, information accessibility, support health providers and descent with breast cancer. The results of this research showed the variables that are associated with the SADARI behavior of the housewifes is attitude (p = 0.000), accessibility of information (p = 0.000), and health care providers support (p = 0.010). The majority of housewives in Kelurahan Sidotopo Wetan Kenjeran Sub-district Surabaya showed a good attitude and support toward SADARI. In the area surrounding the residence h ousewife get access information easily. There are no support for doing SADARI from health care providers.

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A Community-Based Clinical Breast Examination Program: Is it Feasible?

Journal of Global Oncology ◽

10.1200/jgo.18.10420 ◽

2018 ◽

Vol 4 (Supplement 3) ◽

pp. 36s-36s

Author(s):

Ranjit K. Pritam Singh ◽

Zainab Abdullah ◽

Salimah Saleh

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Conflicts Of Interest ◽

Clinical Breast Examination ◽

Outreach Program ◽

Breast Lump ◽

Community Based ◽

Breast Examination ◽

Clinical Breast ◽

Palpable Breast

Purpose Breast cancer presents in advanced stages in low- and middle-income countries where screening mammography is not available. In Malaysia, almost 60% of women, particularly in those the low socioeconomic group, present with stage III and IV breast cancer. We evaluated the feasibility of a community-based early detection program using clinical breast examination (CBE) carried out by the Breast Cancer Welfare Association, a nongovernmental organization. Methods Using a mobile clinic that was equipped to carry out CBE, a team of six health professionals trained in CBE techniques reached out to urban poor communities on the outskirts of the city and the rural population at the invitation of community leaders. At these events, breast self-awareness was taught to the community, with particular regard to the signs and symptoms of breast cancer and to breast self-examination. CBE was carried out in those women who agreed to be examined. Women who were found to have breast lumps were referred to the nearest public hospital and were observed for compliance. Women with anxiety were counseled. Results In 2016 to 2017, CBE was performed for 7,503 women, and 295 (3.9%) were found to have a palpable breast lump. These women were referred to the nearest hospital for additional assessment. Of these women, 156 (52.9%) consulted the doctor and sought additional examination. A total of 153 patients had no malignant findings, whereas three were found to have breast cancer. The mean age for women found to have a palpable breast lump was younger than 40 years—35 years in 2016 and 33 years in 2017—whereas the median age among the 295 women was 33 years in 2016 and 31 years in 2017 (range, 17 to 67 years). Conclusion A community outreach program using CBE as a method of early detection is feasible in Malaysia. Additional study is required to determine why 47% of those who were found to have a breast lump did not seek additional assessment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

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Knowledge, Attitude, and Practice Regarding Breast Cancer Early Detection Among Women in a Mountainous Area in Northern Vietnam

Cancer Control ◽

10.1177/1073274819863777 ◽

2019 ◽

Vol 26 (1) ◽

pp. 107327481986377

Author(s):

Do Thi Thanh Toan ◽

Dinh Thai Son ◽

Le Xuan Hung ◽

Luu Ngoc Minh ◽

Dinh Le Mai ◽

...

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Clinical Breast Examination ◽

Breast Self Examination ◽

Cancer Early Detection ◽

Attitude And Practice ◽

Breast Examination ◽

Clinical Breast ◽

Self Examination ◽

Knowledge Attitude And Practice

Breast cancer is the most common cancer in women all over the world, also in Vietnam. In recent years, the incidence of breast cancer has been increasing in Vietnam, and most cases are diagnosed at late stages, making treatment more difficult. More and better early detection could help more women to survive. The aim of this study was to identify the current knowledge, attitude and practice about early detection of breast cancer as well as potential predictors of breast cancer screening among women aged 20 to 49 year in a mountainous commune in Thanh Hoa Province, Vietnam, in a largely ethnic Muong population. Women aged 20 to 49 years were selected by systematic random sampling to participate in a cross sectional study in October 2017. They were interviewed with a closed questionnaire about their knowledge of breast cancer, its risk factors, and warning signs. A checklist for performance of breast self-examination was also applied. Three hundred six women agreed to participate in the study. More than half had a low level of knowledge, and were weak in attitude and practice about breast self-examination, clinical breast examination, breast ultrasound, and mamography. Among women who had practiced at least 1 screening method, 17.0% mentioned clinical breast examination, and only 13.8% reported practicing breast self-examination. Factors associated with practice included knowledge about breast cancer early detection (BCED), ethnicity, income, the BCED information approach, and the BCED screening programs approach. The finding of a very low proportion of women in the mountainous setting with good awareness and practice on early detection of breast cancer is important evidence to inform the BCED intervention program developers about where and how to target which information, especially to reach more ethnic minority women.

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Original Paper: Contribution of clinical breast examination to mammography screening in the early detection of breast cancer

Journal of Medical Screening ◽

10.1258/096914103321610761 ◽

2003 ◽

Vol 10 (1) ◽

pp. 16-21 ◽

Cited By ~ 47

Author(s):

C Bancej ◽

K Decker ◽

A Chiarelli ◽

M Harrison ◽

D Turner ◽

...

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Breast Cancer Mortality ◽

Clinical Breast Examination ◽

Screening Mammography ◽

Detection Rates ◽

Breast Examination ◽

Mode Of Detection ◽

Clinical Breast ◽

Interim Measures

Objectives: As the benefit of clinical breast examination (CBE) over that of screening mammography alone in reducing breast cancer mortality is uncertain, it is informative to monitor its contribution to interim measures of effectiveness of a screening programme. Here, the contribution of CBE to screening mammography in the early detection of breast cancer was evaluated. Setting: Four Canadian organised breast cancer screening programmes. Methods: Women aged 50-69 receiving dual screening (CBE and mammography) (n=300,303) between 1996 and 1998 were followed up between screen and diagnosis. Outcomes assessed by mode of detection (CBE alone, mammography alone, or both CBE and mammography) included referral rate, positive predictive value, pathological features of tumours (size, nodal status, morphology), and cancer detection rates overall and for small cancers (≤10 mm or node-negative). Heterogeneity in findings across programmes was also assessed. Results: On first versus subsequent screen, CBE alone resulted in 28.5-36.7% of referrals, and 4.6-5.9% of cancers compared with 52.6-60.1% of referrals and 60.0-64.3% of cancers for mammography alone. Among cancers detected by CBE, 83.6-88.6% were also detected by mammography, whereas for mammographically detected cancers only 31.7-37.2% were also detected by CBE. On average, CBE increased the rate of detection of small invasive cancers by 2-6% over rates if mammography was the sole detection method. Without CBE, programmes would be missing three cancers for every 10,000 screens and 3-10 small invasive cancers in every 100,000 screens. Conclusions: Inclusion of CBE in an organised programme contributes minimally to early detection.

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