Understanding Breast Health Awareness Among Nurses during conflict in Yemen

PURPOSE: The aim of this study was to determine the knowledge of risk factors and symptoms of breast cancer among Yemeni nurses during the conflict. METHODOLOGY: A cross-sectional design was carried out among 392 randomly selected participants. The instrument consists of 20 items, 12 general awareness statements, and 8 curability statements with a 0.711 reliability coefficient. Data analysis was performed using SPSS version 25. RESULTS: Most of the nurses were female (69.5%), with a mean age of 28.54, with monthly income less than 200 USD (54.3%). About 21.4% of the participants were smokers. Among all participants, the most frequently mentioned risk factor were breastfeeding, reducing the risk of breast development (86.2%), followed by physical activities lowers the developing risk of breast cancer (79.1%). Over time, the myth of the constant irritation due to the tight bra may cause breast cancer reported by women more than male nursing students. In this respect, men were better knowledgeable than women (P=0.001). Females, however, were more aware than males that women who bear their first child before 30 are more to develop breast cancer (P=0.017). Income is significantly associated with the level of knowledge among nurses. The most frequently mentioned breast symptoms among all participants were a pain in the breast (82.9%), followed by changes in the breast shape (79.1%). CONCLUSIONS: Income is significantly associated with the level of knowledge among nurses. The myth about breast cancer is dominant among nurses in Yemen. Therefore, there is an urgent need to educate nurses on breast health.

Joanne Knight Breast Health Cohort at Siteman Cancer Center: A model last cohort

PurposeThe Joanne Knight Breast Health Cohort was established to link breast cancer risk factors, mammographic breast density, benign breast biopsies and associated tissue markers, and blood markers in a diverse population of women undergoing routine mammographic screening.MethodsWomen were recruited from November 2008 to April 2012. Baseline questionnaire risk factors, blood, and screening mammograms were collected from 12,153 women. Of these, 1,672 were excluded for prior history of any cancer (except non-melanoma skin) or diagnosis of breast cancer within 6 months of blood draw/registration for the study, for a total of 10,481 women. Follow-up is through linking to electronic health records, tumor registry and death register. Routine screening mammograms are collected every 1 to 2 years and incident benign breast biopsies and cancers are identified through record linkage to pathology and tumor registries. Formal fixed tissue samples are retrieved and stored for analysis. County-level measures of structural inequality were derived from publicly available resources.ResultsCohort Composition: median age at entry was 54.8 years and 26.7% are African American. Through 2020, 74 percent of participants have had a medical center visit within the past year and 80% within the past 2 years representing an average of 9.7 person years of follow-up from date of blood draw per participant. 9,997 women continuing in follow-up. Data collected at baseline include breast cancer risk factors, baseline plasma and white blood cells, mammograms prior to baseline, at baseline, and during follow-up. ConclusionThis cohort assembled and followed in a routine clinical screening and care setting that serves a diverse population of women in the St Louis region, now provides opportunities to integrate study of questionnaire measures, plasma and DNA markers, benign and malignant tissue markers, and breast image features into prospective evaluation for breast cancer etiology and outcomes.

VITAMIN D AND THYROID HORMONES IN PATIENTS WITH BREAST BENIGN TUMOR

The Breast Benign tumor (BBT) is currently considered a significant breast health problem within women of all ages. In the present study, we aimed to investigate the Tumor markers CA125 and CA153, thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and vitamin D within benign breast tumor (BBT) during the reproduction ages. Twenty patients (ten patients in the control group and ten patients in cases (Breast Benign Tumor); Notably, the studies confirm the decrease in FT4 and FT3 and increase of the thyroid-stimulating hormone (TSH). In addition, the decreased level of Vitamin D is also revealed in BBT.

Development, Validation, and Implementation of a Short Breast Health Questionnaire

Background Health status and perception can be assessed by general or disease-specific questionnaires, the latter are more sensitive. Considering the importance of breast health in women’s lives and the lack of any pertinent questionnaire, we performed this study to develop a valid and reliable short BH questionnaire (BHQ); and then use it for the assessment of participants. Methods We first designed and developed the instrument, followed by measurement of inter-rater agreement IRA, content validity including content validity index (I-CVI) and scale content validity index (S-CVI), and reliability (through internal consistency and test-retest). We then included eligible women with normal breasts and benign breast disorders who attended our breast clinic. Results The IRA index (78.6%) showed optimal relevance and clarity of the questionnaire. The content validity was acceptable; with an S-CVI of 87.35 and 84.42 for clarity and relevance, respectively. One question was eliminated (I-CVI < 70%). The internal reliability was high (Cronbach’s alpha = 0.93). For external consistency, three questions were eliminated (intraclass correlation coefficient < 0.7), the rest of the questions showed good and excellent reliability. In the next step, BH in the 350 eligible participants showed an overall score of 55.86 ± 11.57. Among different variables, age was the only one that showed a significant direct relationship with BH. A history of breast surgery for benign lesions and a family history of breast cancer did not affect BH. Conclusion This study introduces a valid reliable 11-item BHQ. We propose its use in various conditions throughout breast cancer screening, diagnosis, and treatment; and in the assessment of BH in various physiologic and reproductive situations.

Breast Cancer Early Detection in Eswatini: Evaluation of a Training Curriculum and Patient Receipt of Recommended Follow-Up Care

PURPOSE Breast cancer (BC) is detected at late stages in sub-Saharan Africa. We piloted a BC early-detection program in Eswatini aimed at increasing breast health knowledge and clinical skills. We also aimed to determine the proportion of patients with breast abnormalities who completed referral to breast specialty clinics. METHODS Nurses and counselors from five human immunodeficiency virus and/or antiretroviral therapy clinics underwent training in BC and clinical breast examination (CBE). We compared knowledge and skill examinations completed before, immediately after, and 90 days after training. Nurses then screened female clinic patients ≥ 18 years for breast symptoms, examined those with symptoms, and referred women with CBE abnormalities to a surgeon or the national breast clinic. Consenting women were contacted at 30 and 60 days after screening to determine if they had completed referral. RESULTS In 2019, 44 nurses underwent training. Median scores (interquartile range) on pretraining, immediate post-training, and 90-day post-training knowledge examinations were 17.5 (16-19), 20 (19-21), and 20 (19-21), respectively. Median scores (interquartile range) on pretraining, immediate post-training, and 90-day post-training skills examinations were 10 (7-11), 23 (21.5-25), and 23 (22-24), respectively. Compared with pretraining scores, post-training scores were significantly improved ( P < .0001 for all comparisons). From June 2019 to April 2020, a total of 9,502 clinic patients were screened for breast symptoms: 150 (2%) underwent CBE, 93 (62%) were referred for further evaluation, and 88 (97%) were included in the study. Of those, 54 (61%) completed referral. Referral completion was not associated with age, employment, relationship status, or prior experiences related to BC. CONCLUSION The program's training curriculum improved breast health knowledge and clinical skills. Efforts are needed to improve patients' receipt of recommended evaluation for breast abnormalities.