scholarly journals Different Routes, Similar Destination: Building Breast Care Models in Tanzania, Zambia, and Colombia

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 7s-7s
Author(s):  
Anna Cabanes ◽  
Mary Rose Giattas ◽  
Mavalynne Orozco-Urdaneta ◽  
Groesbeck Parham ◽  
Leeya Pinder ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Research Funding ◽  
Conflicts Of Interest ◽  
Cancer Education ◽  
Noncommunicable Diseases ◽  
Breast Health ◽  
Implementation Framework ◽  
Country Ownership ◽  
Care Assessment

Purpose Cancer is becoming an urgent problem in low- and middle-income countries as the global burden of disease shifts from infectious to noncommunicable diseases. Whereas cervical cancer and breast cancer are preventable and treatable, these diseases are the leading causes of women’s cancer deaths in low-resource settings, mostly because of late-stage presentation and limited diagnostic and treatment capacities. Methods Using the Breast Health Global Initiative resource-stratified guidelines and a phased implementation approach, countries with resource constraints have designed and implemented breast cancer interventions that allow for a balanced, efficient, and equitable use of limited resources. Results Tanzania, Zambia, and a rural area of Colombia serve as examples of evidence-based approaches to the implementation of breast cancer control programs, leveraging the successes and experiences of existing care platforms—mostly cervical cancer and HIV—while creating a solid foundation for country ownership and sustainability. Tanzania used a top-down approach, investing in understanding the needs through a breast health care assessment to inform policy and practice, as well as building a national policy framework. Zambia analyzed the successes and experiences of their public Cervical Cancer Prevention Program to introduce breast cancer education, detection, and surgical treatment, and to improve the time of diagnosis for breast cancer using the single-visit approach recommended by WHO for cervical cancer. A rural community in Colombia has focused on mitigating some of the most common barriers that women face during their cancer journey by improving the cancer education of medical personnel, providing technology for early diagnosis, and implementing an outreach and navigation program that has significantly reduced waiting times from screening through diagnosis and treatment. Conclusion What are key characteristics that guarantee success? Country ownership is crucial, with political, institutional, and community ownership; capabilities; and accountability. Under these four dimensions and a phased implementation framework, we explain the approach that civil society, ministries of health, and stakeholders have taken to implement these programs. 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 . Anna Cabanes Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, Astra Zeneca Mary Rose Giattas Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, Astra Zeneca Mavalynne Orozco Urdaneta Stock or Other Ownership: Celgene, Johnson and Johnson Armando Sardi Stock or Other Ownership: Celgene, Johnson and Johnson

Effects of an Art-Based Curriculum on Clinical Trials Attitudes and Breast Cancer Prevention Knowledge

2006 ◽  
Vol 33 (5) ◽  
pp. 664-676 ◽  
Author(s):  
Patricia M. Herman ◽  
Linda K. Larkey
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Education Program ◽  
Cancer Education ◽  
Controlled Study ◽  
Breast Health ◽  
Breast Cancer Education ◽  
The Difference ◽  
The U.S

Although Latinos now comprise the largest minority in the U.S. population, they continue to be seriously underrepresented in clinical trials. A nonrandomized controlled study of an innovative community-developed clinical trial and breast cancer education program targeting Latinas tested whether use of an art-based curriculum could increase willingness to enroll in six clinical trial scenarios and increase breast health and clinical trial knowledge. The art-based curriculum resulted in a larger increase in stated willingness to enroll across all clinical trial scenarios, and the difference was statistically significant ( p < .05) in three. Breast health and clinical trials knowledge increased similarly and significantly for both groups. The results of this study show promise for the use of a community-developed art-based curriculum in the Latina population to increase willingness to enroll in clinical trials.

scholarly journals Characteristics of Screen-Detected Breast Cancer of Turkish Bahcesehir (Istanbul) Screening Project

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 9s-9s
Author(s):  
Neslihan Cabıoğlu ◽  
Sibel Ozkan-Gurdal ◽  
Arda Kayhan ◽  
Ayse Nilufer Ozaydın ◽  
Cennet Şahin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Research Funding ◽  
Conflicts Of Interest ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Multivariable Logistic Regression Analysis ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Ki 67 ◽  
Screening Programs

Purpose The Turkish Bahcesehir Breast Cancer Screening Project is a 10-year organized population-based screening program carried out in one of the largest counties of Istanbul, Turkey. The aim of the current study was to examine the biologic features of screen-detected and interval breast cancers for the first 9-year study period. Methods Between January 2009 and January 2018, 26,040 mammographies were performed with 2-year intervals for 8,408 women age 40 to 69 years. Clinicopathologic and biologic tumor characteristics—estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2-neu, and protein encoded by the MKI67 gene (Ki-67) —were analyzed for those patients who were diagnosed with breast cancer. Interval cancer was defined as symptomatic cancer diagnosed within 24 months of a negative screening. Ki-67 level > 20% was considered a high score. Results Median age was 52.5 years, and 37% were younger than age 50 years. Of 8,408 women, 113 breast cancers (1.3%) were detected. There were 14 ductal carcinoma in situ (12.4%) and 99 invasive cancers (87.6%). The majority of patients with invasive cancer had stage 1 (49.1%) or stage 2 (31.8%) disease. The majority of patients underwent breast-conserving therapy (83%) with sentinel lymph node biopsy alone (74.1%). Interval cancers (n = 11) were more likely to have multifocality or multicentricity ( P = .002) and high Ki-67 score ( P = .05). Furthermore, diagnosis with interval cancer was associated with more advanced disease, including stage II to IV disease and axillary positivity, and patients were more likely to have nonluminal cancers or tumors with lymphovascular invasion. However, these associations did not reach statistical significance. Multivariable logistic regression analysis identified multifocality or multicentricity as the only significant factor to be associated with interval cancers (odds ratio, 5.94; 95% CI, 1.4 to 25.4; P = .016). Conclusion Our findings suggest that the majority of screen-detected breast cancers exhibit either luminal A or B subtype with low Ki-67 scores and unifocal tumors. However, interval cancers were more likely to have aggressive biology and multicentricity that was less likely to be detected by mammographic screening programs and that required more aggressive surgical and systemic therapies. 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 . Neslihan Cabioğlu Research Funding: Roche (Inst) Travel, Accommodations, Expenses: Genomic Health Sibel Ozkan-Gurdal Research Funding: Roche (Inst) Arda Kayhan Research Funding: Roche (Inst) Ayse Nilufer Ozaydin Research Funding: Roche (Inst) Cennet Şahin Research Funding: Roche (Inst) Beyza Ozcinar Research Funding: Roche (Inst) Erkin Aribal Employment: Nutricia – Danone and TRPharm (I) Leadership: Nutricia – Danone and TRPharm (I) Stock or Other Ownership: Roche (I) Honoraria: GE Healthcare, Fuji, Roche Travel, Accommodations, Expenses: Bayer Vahit Ozmen Honoraria: Pfizer, Roche Research Funding: Roche (Inst), Genekor, Roche Travel, Accommodations, Expenses: Pfizer

scholarly journals Opportunistic Breast Cancer Education and Screening in Rural Honduras

2016 ◽  
Vol 2 (4) ◽  
pp. 174-180 ◽  
Author(s):  
Linda S. Kennedy ◽  
Suyapa A. Bejarano ◽  
Tracy L. Onega ◽  
Derek S. Stenquist ◽  
Mary D. Chamberlin
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Health Services ◽  
Women's Health ◽  
Cervical Cancer Screening ◽  
Cancer Education ◽  
Breast Cancer Education ◽  
Women’S Health Services

Purpose In Honduras, the breast cancer burden is high, and access to women’s health services is low. This project tested the connection of community-based breast cancer detection with clinical diagnosis and treatment in a tightly linked and quickly facilitated format. Methods The Norris Cotton Cancer Center at Dartmouth College partnered with the Honduran cancer hospital La Liga Contra el Cancer to expand a cervical cancer screening program, which included self-breast exam (SBE) education and clinical breast exams (CBEs), to assess patient attitudes about and uptake of breast cancer education and screening services. The cervical cancer screening event was held in Honduras in 2013; 476 women from 31 villages attended. Results Half of the women attending elected to receive a CBE; most had concerns about lactation. Clinicians referred 12 women with abnormal CBEs to La Liga Contra el Cancer for additional evaluation at no cost. All referred patients were compliant with the recommendation and received follow-up care. One abnormal follow-up mammogram/ultrasound result was negative on biopsy. One woman with an aggressive phyllodes tumor had a mastectomy within 60 days. Multimodal education about breast cancer screening maximized delivery of women’s health services in a low-tech rural setting. Conclusion The addition of opportunistic breast cancer education and screening to a cervical cancer screening event resulted in high uptake of services at low additional cost to program sponsors. Such novel strategies to maximize delivery of women’s health services in low-resource settings, where there is no access to mammography, may result in earlier detection of breast cancer. Close follow-up of positive results with referral to appropriate treatment is essential.

scholarly journals MEMBANGUN KESADARAN DAN PERILAKU HIDUP SEHAT MAHASISWI GUNA MENCEGAH KANKER PAYUDARA

2021 ◽  
Vol 2 (2) ◽  
pp. 107
Author(s):  
Ni Luh Nyoman Kebayantini ◽  
I Nengah Punia ◽  
Nazrina Zuryani ◽  
Wahyu Budi Nugroho ◽  
Gede Kamajaya ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Adolescent Girls ◽  
Young Women ◽  
Breast Tumors ◽  
Develop Breast Cancer ◽  
Daily Routine ◽  
Breast Health ◽  
History Of ◽  
Keywords Breast

Breast cancer is the second highest prevalence after cervical cancer. In recent years cases of breast tumors that are at risk of becoming cancer are found in women aged 25 years and under. This risk will increase in adolescent girls who have a history of tumors, so there is a 4.37 times more risk of developing breast cancer. Similarly, young women who experience menarche (first menstruation) at the age of <12 years are more likely to develop breast cancer than those who experience menarche aged> 12 years. Busyness undergoing daily routine is also one of the causes of teenagers / young women paying less attention to the health of their breasts. Based on this there have been many campaigns and movements to foster women's awareness of breast cancer such as the BSE movement (Breast Self-Check) and SADANIS (aware of clinical examination). It is unfortunate that this campaign has not been able to touch all circles, especially among students who are very busy with campus life and do not have the awareness to take care of their health. This dedication activity is carried out to increase the awareness of students / young women to maintain breast health. Keywords: breast cancer, health, increase student awareness.

scholarly journals Student Midwives’ Perspective on Improving Early Diagnosis in Breast Cancer During Antenatal Care

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 24s-24s
Author(s):  
Judy Mella
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Antenatal Care ◽  
Access To Health Care ◽  
Conflicts Of Interest ◽  
Cancer Education ◽  
Breast Cancers ◽  
Breast Lump ◽  
Female Population ◽  
Child Bearing

Purpose The incidence of breast cancer in Uganda is estimated at approximately 32.3 per 100,000, with a 5-year survival rate of 56%. Breast cancers present later and have a higher incidence in patients in the child-bearing age group compared with those in high-income countries. Uganda has an ongoing program to train degree-level midwives for extended midwifery roles that are exclusive to practice in Uganda. These midwives are highly motivated and have intimate local knowledge and effective access to the female population with the highest incidence of breast cancers. This work assesses their views on the key reasons women present so late and ideas for system-strengthening measures that will target these reasons, effectively combining antenatal care with breast lump education and diagnosis. Methods Midwifery students in years at Lira University were invited to fill out a questionnaire—with two open and seven structured questions—that was handed out at the ends of lectures and collected the next day. Results One hundred fifty-three questionnaires were returned. In the open question, midwifery students indicated overwhelmingly that the main reason women present late is ignorance. Finance was perceived to be the second factor. Analysis of the stratified question demonstrated that, even with knowledge of breast cancer, women would still be likely to think that a breast lump does not matter, and this factor scored higher than finances, culture, or access to health care. Of respondents, 73% felt that a facility for diagnosis in the community would definitely help women come for treatment. As midwives, 94% would definitely refer a breast lump to a specialist breast clinic if one was available, and on a background of limited health care funding, 90% still felt that time and money should be prioritized toward breast cancer education diagnosis and treatment because of its impact on the community. Conclusion Community midwives are well placed to educate women on breast care in antenatal clinics. This questionnaire demonstrates their perspective on the overriding significance of educating the child-bearing population about breast lumps in addition to cancer education. Therefore, breast lump examination and diagnosis is being taught to the students, community diagnostic facilities are being developed alongside antenatal care (ultrasound and cytology), and a breast lump referral clinic is planned for the new hospital. AUTHOR’S 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 author.

scholarly journals Breast Cancer Downstaging Practices and Breast Health Messaging Preferences Among a Community Sample of Urban and Rural Ugandan Women

2017 ◽  
Vol 3 (2) ◽  
pp. 105-113 ◽  
Author(s):  
John R. Scheel ◽  
Yamile Molina ◽  
Donald L. Patrick ◽  
Benjamin O. Anderson ◽  
Gertrude Nakigudde ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Center ◽  
Cancer Education ◽  
Community Sample ◽  
Breast Health ◽  
Breast Cancer Education ◽  
Regular Source ◽  
Source Of Care ◽  
Self Examination ◽  
Health Messaging

Purpose Among a community sample of Ugandan women, we provide information about breast cancer downstaging practices (breast self-examination, clinical breast examination [CBE]) and breast health messaging preferences across sociodemographic, health care access, and prior breast cancer exposure factors. Methods Convenience-based sampling was conducted to recruit Ugandan women age 25 years and older to assess breast cancer downstaging practices as well as breast health messaging preferences to present early for a CBE in the theoretical scenario of self-detection of a palpable lump (breast health messaging preferences). Results The 401 Ugandan women who participated in this survey were mostly poor with less than a primary school education. Of these women, 27% had engaged in breast self-examination, and 15% had undergone a CBE. Greater breast cancer downstaging practices were associated with an urban location, higher education, having a health center as a regular source of care, and receiving breast cancer education ( P < .05). Women indicated a greater breast health messaging preference from their provider (66%). This preference was associated with a rural location, having a health center as a regular source of care, and receiving breast cancer education ( P < .05). Conclusion Most Ugandan women do not participate in breast cancer downstaging practices despite receipt of breast cancer education. However, such education increases downstaging practices and preference for messaging from their providers. Therefore, efforts to downstage breast cancer in Uganda should simultaneously raise awareness in providers and support improved education efforts in the community.

scholarly journals Leveraging HIV Research and Implementation for Cancer and Noncommunicable Diseases in Malawi

2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 27s-28s
Author(s):  
Mwapatsa Mipando ◽  
Nyengo Mkandawire ◽  
Jones Masiye ◽  
Emily Wroe ◽  
Luckson Dullie ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Conflicts Of Interest ◽  
Political Stability ◽  
Hiv Treatment ◽  
National Institutes Of Health ◽  
Noncommunicable Diseases ◽  
International Agency ◽  
Hiv Positive ◽  
Global Leader ◽  
Hiv Research

Abstract 33 Background: Enabled by collaboration and political stability, Malawi is a global leader for HIV research and implementation. We undertook this work to identify ways to leverage successes in HIV treatment and research for cancer and noncommunicable diseases (NCDs). Methods: Over more than two decades, investment from the National Institutes of Health (NIH) and other funders has allowed Malawi participation in international HIV networks. As these sought to address HIV-positive cancer, investment occurred to increase pathology, improve cancer registration, scale up cervical cancer screening, and improve nursing and pharmacy skills for chemotherapy administration. This allowed Malawi to participate in multinational clinical trials for HIV-positive Kaposi sarcoma treatment and cervical cancer prevention. Building on this, Malawi was one of six countries in 2014 to receive an NIH U54 consortium award for HIV-positive malignancies and was one of six countries added to the National Cancer Institute (NCI) AIDS Malignancy Consortium. In 2016, expanding beyond HIV-positive cancer, Malawi was one of three countries invited to join a new NCI–International Agency for Research on Cancer esophageal cancer consortium, one of five recipients of a new NCI Burkitt lymphoma award, and one of six recipients of a new NCI P20 grant for a regional center of research excellence for NCDs. Malawi is also one of 11 countries to convene a Lancet noncommunicable diseases and injury poverty commission for NCDs and injury. Finally, partners have improved surveillance and treatment for hypertension, diabetes, injury, and sickle cell anemia, in part, through a national Knowledge Translation Platform for HIV-NCD integration. With this support and funding, career development opportunities are embedded for Malawian NCD researchers. Results: Building on successes in HIV treatment and research, Malawi has become a global leader for cancer and NCD research and implementation. Conclusion: Continue developing a multilateral national platform for NCD research and implementation that is globally impactful and can lead to measurable outputs for individual cancer and NCD focus areas. Funding: National Institutes of Health. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

scholarly journals Leverage of an Existing Cervical Cancer Prevention Service Platform to Initiate Breast Cancer Control Services in Zambia: Experiences and Early Outcomes

2018 ◽  
pp. 1-8 ◽  
Author(s):  
Leeya F. Pinder ◽  
Ronda Henry-Tillman ◽  
David Linyama ◽  
Victor Kusweje ◽  
Jean-Baptiste Nzayisenga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Detection ◽  
Needle Biopsy ◽  
Cervical Cancer Prevention ◽  
Breast Health ◽  
Breast Cancer Care ◽  
Core Needle

Purpose In 2005, the Cervical Cancer Prevention Program in Zambia (CCPPZ) was implemented and has since provided cervical cancer screen-and-treat services to more than 500,000 women. By leveraging the successes and experiences of the CCPPZ, we intended to build capacity for the early detection and surgical treatment of breast cancer. Methods Our initiative sought to build capacity for breast cancer care through the (1) formation of a breast cancer advocacy alliance to raise awareness, (2) creation of resource-appropriate breast cancer care training curricula for mid- and high-level providers, and (3) implementation of early detection and treatment capacity within two major health care facilities. Results Six months after the completion of the initiative, the following outcomes were documented: Breast health education and clinical breast examination (CBE) services were successfully integrated into the service platforms of four CCPPZ clinics. Two new breast diagnostic centers were opened, which provided access to breast ultrasound, ultrasound-guided core needle biopsy, and needle aspiration. Breast health education and CBE were provided to 1,955 clients, 167 of whom were evaluated at the two diagnostic centers; 55 of those evaluated underwent core-needle biopsy, of which 17 were diagnosed with invasive cancer. Newly trained surgeons performed six sentinel lymph node mappings, eight sentinel lymph node dissections, and 10 breast conservation surgeries (lumpectomies). Conclusion This initiative successfully established clinical services in Zambia that are critical for the early detection and surgical management of breast cancer.

scholarly journals “You Can Breast Health Club” Empowering Healthy Women of Myanmar to Enhance Breast Cancer Awareness and Take Action

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 126s-126s
Author(s):  
Y. Shwe Yee Soe ◽  
Z.N. Win ◽  
T. Aung ◽  
T. Win ◽  
Y.Y. Htun
Keyword(s):  
Breast Cancer ◽  
Cancer Education ◽  
Breast Health ◽  
Breast Cancer Patients ◽  
Cancer Awareness ◽  
Education Programs ◽  
Healthy Women ◽  
Health Club ◽  
Breast Cancer Education ◽  
Breast Cancer Awareness

Background and context: Pun Hlaing Siloam Hospital (PHSH), the only Joint Commission International (JCI) accredited hospital in Myanmar, is committed to provide comprehensive breast health services through “You Can Breast Health Club” in accordance with its vision; international quality, reach, scale and compassion. A free of charge membership-based club led by a dedicated medical oncology team that includes health care personnel, family members of breast cancer patients and healthy women of all walks of life. Aim: To promote awareness and take action on breast health and breast cancer so as to empower women to commit to lifelong breast health. Strategy/Tactics: The club executed its strategy through three pillars: 1) hospital-based comprehensive breast cancer care services, 2) community-based breast cancer education programs and 3) partnership with local and international organizations. The theme is “You can prevent the preventable; you can check for early detection; you can survive with effective treatment” with an aim to encourage women to play an active role in their own health. Program/Policy process: As part of a comprehensive approach to breast health, “one stop” hospital-based program provides breast health education on basic breast health and breast cancer facts, teaching breast self-exam, personal risk assessment and advise on risk reduction and to make healthy life choices. Interdisciplinary breast clinic provides clinical breast exam, state-of-the art breast imaging, diagnostic evaluation, referral for surgical and treatment options and patient family education. A training-of-trainers workshop on breast health was conducted for the hospital staff to facilitate program participants in turn to educate other club members and women in the local community. The club was launched in October Breast Cancer Awareness Month campaign held in October 2017 at PHSH. As a strategic partnership supported Shwe Yaung Hnin Si Cancer Foundation to host the World Cancer Day 2018 Community Cancer Awareness campaign held in Yangon. Outcomes: The number of club members increased to (282) within five months. Among the members, (204) women are from the community including family members of breast cancer patients, office staff, industry workers, and housewives reflecting the various socioeconomic status. The outcome was encouraging given that 60% of members are below the age of 40. What was learned: Community outreach breast cancer education programs combined with access to hospital-based services at affordable prices enhanced interest in club membership. The hospital-based strategy readily provides healthy women the facilities for early diagnosis and prompt access to quality care without any delays. Partnership with other advocacy groups accelerated the club process.

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