Performance of Clinical Breast Examination of a Breast Care Nurse

Abstract 11 Background: System-level barriers to care and low levels of awareness lead to late-stage presentation of breast disorders in resource-constrained environments. Simulating Zambia’s successful screen and treat approach to cervical cancer prevention, we designed and implemented an algorithm to improve breast care efficiency. Methods: In collaboration with the Zambian Ministry of Health and with support from the Susan G. Komen Breast Cancer Foundation, we initially expanded breast care capacity in Zambia through on-site training of mid- and high-level health care providers by international experts. By using this cadre of local experts, we then implemented a rural breast care camp of 1-week duration, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided breast biopsy, histologic analysis of biopsy specimens, and treatment were offered to participants in a single-visit format. Results: Four hundred seventy-five women were evaluated during the camp. The mean age of participants was 34.5 (± 13.0) years. The majority of women were multiparous (81.9%), breast-fed (78.5%), and reported hormone use (54.1%). Abnormalities were detected on clinical breast examination in 33 women, 27 of which required ultrasound. Lesions were confirmed in 17 and evaluated by using ultrasound-guided core needle biopsy (12) or fine-needle aspiration (five). On-site imprint cytology was performed on all specimens and later confirmed by histology, with a concordance of 100%. Two cancers were detected. Three women with benign lesions underwent same-day surgery after histologic confirmation. Conclusion: Similar to the see-and-treat approach for cervical cancer prevention, the single-visit algorithm has the potential to vastly improve breast care efficiency in low-resource environments ( Fig 1 ). [Figure: see text] Funding: Susan G. Komen Breast Cancer Foundation. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Leeya F. Pinder No relationship to disclose Aaron Shibemba No relationship to disclose Victor Kusweje No relationship to disclose Jean-Baptiste Nzayisenga No relationship to disclose Hector Chiboola No relationship to disclose Mary Amuyunzu-Nyamongo No relationship to disclose Catherine Mwaba Research Funding: Mylan (Inst) Travel, Accommodations, Expenses: Fresenius Susan Citonje Msadabwe Travel, Accommodations, Expenses: AstraZeneca Pavlo Lermontov No relationship to disclose Edgar Chikontwe No relationship to disclose Groesbeck P. Parham No relationship to disclose

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Clinical breast examination: An illustrated educational review and update

Clinical Excellence for Nurse Practitioners ◽

10.1054/xc.2001.24219 ◽

2001 ◽

Vol 5 (4) ◽

pp. 197-204 ◽

Cited By ~ 3

Author(s):

Elizabeth Ann Coleman ◽

Jeanne K. Heard

Keyword(s):

Clinical Breast Examination ◽

Breast Examination ◽

Clinical Breast

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4186 POSTER The Experiences of Breast Cancer Patients With the Care of the Breast Care Nurse

European Journal of Cancer ◽

10.1016/s0959-8049(11)71352-1 ◽

2011 ◽

Vol 47 ◽

pp. S304-S305

Author(s):

E. Decoene ◽

C. Verschueren ◽

M. Daem ◽

M. Grypdonck

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Care Nurse ◽

Breast Care Nurse ◽

Breast Care

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Financial Anxiety is Associated With Cancer Screening Adherence in Women at High Risk of Breast Cancer

Annals of Behavioral Medicine ◽

10.1093/abm/kaab010 ◽

2021 ◽

Author(s):

Salene M W Jones ◽

Tammy A Schuler ◽

Tasleem J Padamsee ◽

M Robyn Andersen

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

High Risk ◽

Pap Smear ◽

Clinical Breast Examination ◽

Lower Odds ◽

Breast Examination ◽

Clinical Breast ◽

Financial Anxiety ◽

Screening Adherence

Abstract Background Previous studies have examined the impact of material financial hardship on cancer screening but without focusing on the psychological aspects of financial hardship. Purpose This study examined the effects of different types of financial anxiety on adherence to breast cancer screening in women at high risk of breast cancer. Adherence to cervical cancer screening was also examined to determine whether associations between financial anxiety and screening adherence were unique to breast cancer screening or more general. Methods Women (n = 324) aged 30–50 and at high risk for inherited breast cancer completed a survey on general financial anxiety, worry about affording healthcare, financial stigma due to cancer risk, and adherence to cancer screening. Multivariate analyses controlled for poverty, age, and race. Results More financial anxiety was associated with lower odds of mammogram adherence (odds ratio [OR] = 0.97, confidence interval [CI] = 0.94, 0.99), Pap smear adherence (OR = 0.98, CI = 0.96, 0.996), and clinical breast examination adherence (OR = 0.98, CI = 0.96, 0.995). More worry about affording healthcare was associated with lower odds of clinical breast examination adherence (OR = 0.95, CI = 0.91, 0.9992) but not mammogram or Pap smear adherence (p > .05). Financial stigma due to cancer risk was associated with lower odds of Pap smear adherence (OR = 0.87, CI = 0.77, 0.97) but no other cancer screenings (p > .07). Conclusions Financial anxiety may impede cancer screening, even for high-risk women aware of their risk status. Clinical interventions focused on social determinants of health may also need to address financial anxiety for women at high risk of breast cancer.

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Efficacy of clinical breast examination in chest-irradiated female survivors of childhood Hodgkin lymphoma (HL).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10028 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10028-10028

Author(s):

Florence Lennie Wong ◽

Janie M. Lee ◽

Wendy M. Leisenring ◽

Joseph Philip Neglia ◽

Rebecca M. Howell ◽

...

Keyword(s):

Clinical Breast Examination ◽

Female Survivors ◽

Breast Examination ◽

Life Years ◽

The Us ◽

Clinical Breast ◽

Childhood Cancer Survivor Study ◽

Magnetic Resonance Imaging Mri ◽

Simulated Cohort

10028 Background: Female survivors of childhood HL treated with ≥10 Gy of chest radiation are at high risk for breast cancer (BC). The Children’s Oncology Group (COG) guidelines recommend CBE annually starting at puberty and then semiannually from age 25, plus lifetime annual mammography (MAM) and breast Magnetic Resonance Imaging (MRI) starting 8y after chest radiation or age 25, whichever is later. While imaging-based screening recommendations are largely consistent with US guidelines for women at high BC risk, only the COG guidelines recommend CBE. The benefits of lifetime CBE starting from puberty for life in chest-irradiated HL survivors is unknown. Methods: Life-years (LYs) and lifetime BC mortality risk were estimated from a simulated cohort of 5-million HL survivors using the data from 5y female survivors of HL in the Childhood Cancer Survivor Study (CCSS) treated with ≥10 Gy of chest radiation. The simulated cohort underwent annual MAM+MRI from age 25 for life, with and without annual CBE from age 11 (presumed age of puberty) to age 24 and with and without semiannual CBE from age 25 for life with 100% adherence. BC included in-situ and invasive BC. Treatment-related BC incidence and non-BC mortality risks were estimated from the CCSS data. Risks at age <25 were extrapolated from the CCSS estimates while risks beyond age 50 were extrapolated additionally using the US population rates. CBE sensitivity (17.8%, in-situ and invasive BC) and specificity (98%) and MAM+MRI sensitivity (84.2-86.0%, in-situ; 96.7-97.1%, invasive) and specificity (75.3%) were obtained from the medical literature. Results: The CCSS cohort included 1057 female HL survivors. BC (all invasive) developed in three patients at age <25 (ages: 23, 24, 24). In the simulated cohort receiving no screening, lifetime BC risk was 40.8% and BC mortality was 17.5%. HL survivors around age 50 were at a 7.4-fold higher risk of developing BC and a 5.2-fold higher risk of non-BC mortality when compared with the general population. Compared to no annual CBE for ages 11-24y, undergoing annual CBE did not increase gains in LYs or reduce lifetime BC mortality relative to no screening (Table). Among those who survived to age ≥25, undergoing semiannual CBE from age 25 for life compared to no semiannual CBE also resulted in little gain in LYs or reduction in lifetime BC mortality relative to no screening. Conclusions: Lifetime CBE starting at puberty in conjunction with MAM+MRI appears to add little survival benefits compared with no CBE, suggesting that COG guidelines may be revised without adverse effect on long-term outcomes for chest-irradiated female survivors of childhood HL.[Table: see text]

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