Assessment of breast cancer risk perception, knowledge, and breast self-examination practices among market women in Owo, Ondo State, Nigeria.

BACKGROUND: Breast cancer (BC) is the leading cause of cancer death among women worldwide, and its incidence is increasing, particularly in low-medium-income countries (LMICs). Evidence shows that breast self-examination (BSE) is culturally acceptable, religiously friendly and inexpensive. This study assessed BC risk perception, knowledge and breast self-examination practices among market women in Ondo State, Nigeria. METHODS: A descriptive cross-sectional survey was conducted among market women in 3 selected markets in Owo. A semi-structured interview-based questionnaire was used to collect data. The instrument consisted of five sections based on the objective of the study. Selection of the study participants was done using a multistage sampling technique. The test-retest method was used to determine the reliability of the instrument. Participants knowledge and practices were categorised into good (≥ 50% total score) and poor (< 50% total score) while risk perception was grouped into high (≥ 50% total score) and low (< 50% total score).Data were analysed using descriptive and inferential statistics at a p value < 0.05 for determining statistical significance. RESULTS: A total of 335 respondents completed the study and the mean age ± S.D. was 37.19 ± 9.19 years (range: 18-65 years). 47.5% of respondents were Christian while 60.0% of the respondents were married. 15.5% had tertiary education, and more than two-thirds were from the Yoruba tribe. More than two-thirds (78.5%) of the participants stated that they practiced breast self-examination, while 58.5% reported to have been taught how to perform BSE. 75.8% agreed that the use of injectable contraception or oral pills can result in BC, while 75.8% also agreed that women of reproductive age are at risk of BC. Less than 50% mentioned that they were uncomfortable taking off clothes in front of health professionals during the examination. The perceived risk of BC showed that 221 (65.97%), and 114 (34.03%) of respondents had high, and low levels of perceived risk of BC, respectively. However, 184 (54.93%) and 151 (45.07%) of the respondents had good and poor knowledge. The majority (139, 41.49%) of the respondents had poor BSE practice. Age (p = 0.023), educational qualifications (p < 0.001), average income per month (p < 0.001) and ethnicity (p = < 0.001) were statistically associated with knowledge of breast self-examination while religion (p = 0.02), marital status (p = 0.01), educational qualification (p = 0.001) and distance from facility (p = 0.009) were statistically associated with perceived risk of BC. Participants' educational qualification (p = 0.006) and ethnicity (p = 0.013) were statistically associated with practice of BSE. Good knowledge was also identified as a significant predictor of good practice of participants among the women (95%CI: 4.574 (2.841-7.365), p < 0.001). CONCLUSION: This study identified high level of perception, good knowledge and good practice of BSE among majority of the market women in Owo Town. Interventions and extensive health education on BSE with the aim of creating positive awareness and understanding of BSE among the population should be encouraged.

Assessment of knowledge and practice of mammography and breast self-examination among the general female population in Asir region of KSA.

OBJECTIVE: Breast cancer is the most common malignancy in Kingdom of Saudi Arabia (KSA) and an increasing burden in terms of incidence, morbidity and mortality. It accounts for about 28.7% of all new cancers in women. In 2015, the Saudi cancer registry shows that breast cancer was graded first among women and it accounts for 16.7% of all cancers reported among Saudi nationals. This study was designed to assess breast cancer screening knowledge and practices among women in the Asir region, Kingdom of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study recruiting 1,021 female participants was performed. The variables included breast cancer knowledge, socio-demographic features, breast self-examination knowledge and practice. Descriptive statistics was used to compare and analyze the collected data while chi-square test was used to check the statistical significance among the selected variables. Saudi married women from Asir region were the participants of this cross-sectional study. RESULTS: Our findings suggested that participants had a satisfactory level of knowledge about breast self-examination and mammograms at a rate of > 90% and 44.76% respectively. Over 90% of participants had good breast self-exam knowledge, however, only 6.37% was always performed breast self-examination. Similarly, nearly 40% of participants performed mammograms, while 40.5% were unaware. Leaflets and doctors were the primary sources of information for participants regarding the information of breast cancer screening. CONCLUSIONS: Breast self-examination is a crucial approach to the timely detection of breast cancer and is subsequently critical for effective treatment. From the findings of this study we concluded that most women in the Asir region have a good awareness of breast cancer screening methods. However, either screening of self-examination or mammogram for breast cancer was not carried out thoroughly and regularly. This means that we must continue to emphasize the importance of primary health care in the earliest stages of breast cancer.

The first BGICC consensus and recommendations for breast cancer awareness, early detection and risk reduction in low- and middle-income countries and the MENA region.

In low-middle income countries (LMICs) and the Middle East and North Africa (MENA) region, there is an unmet need to establish and improve breast cancer (BC) awareness, early diagnosis and risk reduction programs. During the 12th Breast, Gynecological & Immuno-oncology International Cancer Conference - Egypt 2020, 26 experts from 7 countries worldwide voted to establish the first consensus for BC awareness, early detection and risk reduction in LMICs/MENA region. The panel advised that there is an extreme necessity for a well-developed BC data registries and prospective clinical studies that address alternative modalities/modified BC screening programs in areas of limited resources. The most important recommendations of the panel were: (a) BC awareness campaigns should be promoted to public and all adult age groups; (b) early detection programs should combine geographically distributed mammographic facilities with clinical breast examination (CBE); (c) breast awareness should be encouraged; and (d) intensive surveillance and chemoprevention strategies should be fostered for high-risk women. The panel defined some areas for future clinical research, which included the role of CBE and breast self-examination as an alternative to radiological screening in areas of limited resources, the interval and methodology of BC surveillance in women with increased risk of BC and the use of low dose tamoxifen in BC risk reduction. In LMICs/MENA region, BC awareness and early detection campaigns should take into consideration the specific disease criteria and the socioeconomic status of the target population. The statements with no consensus reached should serve as potential catalyst for future clinical research.

Assessment of knowledge, attitude and practice regarding breast self examination among females in Karachi.

OBJECTIVE: To assess the knowledge, attitude and practice regarding breast self-examination among women in an urban setting. METHODS: The Knowledge, Attitude and Practice study was conducted from May to July 2018 at the Department of Gynaecology and Obstetrics at Naseer Hussain Shaheed Hospital and the Institute of Infectious Disease, Karachi, and comprised women aged 15 years or above who were attending the outpatient department. Data was collected using a pre-designed questionnaire and was analysed using SPSS 23. RESULTS: There were 385 women with a mean age of 30.09±7.09 years. Overall, 259 (67.3%) subjects had adequate knowledge about breast self-examination, 123 (31.9%) had appropriate practices and 187 (48.6%) had positive attitude. CONCLUSIONS: Overall knowledge level regarding breast self-examination was found to be inadequate.

Knowledge, awareness, and practice of breast self-examination among females in Mosul city, Iraq.

AIMS: This study is carried out to report on the knowledge and practice regarding breast self-examination (BSE) among women from the city of Mosul in Iraq and to evaluate the prevalence of performing clinical breast examination (CBE) and mammography among them. SETTINGS AND DESIGN: A descriptive, cross-sectional survey carried out among females working in the University of Mosul, as a sample of the female population of Mosul city. SUBJECTS AND METHODS: The sample was collected conveniently, and the data were collected from July to November 2018. Data were collected by interviews with 405 participants. Knowledge answers were scored and categorized into two groups: good and poor level of knowledge. RESULTS: A final sample of 384 participants were included in the analysis, with a mean age of 42.58 ± 8.9. Only 39 (10.1%) and 37 (9.6%) participants performed mammographic examination and CBE of their breasts, respectively. Just 100 (30.3%) of the 330 females who knew BSE performed BSE routinely or intermittently. The mean knowledge score was 4.22 ± 1.66, and only 141 females (42.7%) were found to have a good level of knowledge. A statistically significant association of knowledge level with marital status (P = 0.015), perceived benefit of BSE (P = 0.001), previous gain of instructions of BSE (P < 0.05), and the provider (P < 0.05) was found. CONCLUSIONS: The performance results of BSE were poor as well as for CBE and mammography among the study participants. There is a need for educational programs to create awareness and improve knowledge about routine breast cancer screening behavior.

Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews.

BACKGROUND: There is uncertainty about the effectiveness of clinical breast examination (CBE) and conflicting recommendations regarding its usefulness as a screening tool for breast cancer. This paper provides an overview of systematic reviews that assessed the effectiveness of CBE as a 'stand-alone' screening modality for breast cancer compared to no screening and focused on its value in low- and middle-income countries (LMICs). METHODS: We searched MEDLINE, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for systematic reviews reporting the effectiveness of CBE published prior to October 29, 2019. The main outcomes assessed were mortality and down staging. The AMSTAR 2 checklist was used to assess the methodological quality of the reviews including risk of bias. RESULTS: Eleven systematic reviews published between 1993 and 2019 were identified. There was no direct evidence that CBE reduced breast cancer mortality. Indirect evidence suggested that a well-performed CBE achieved the same effect as mammography regarding mortality despite its apparently lower sensitivity (40-69% for CBE vs 77-95% for mammography). Greater sensitivity was recorded among younger and Asian women. Moreover, CBE contributed between 17 and 47% of the shift from advanced to early stage cancer. CONCLUSIONS: CBE merits attention from health system and service planners in LMICs where a national screening programme based on mammography would be prohibitively expensive. In particular, it is likely that considerable value would be gained from conducting implementation scientific research in countries with large numbers of Asian women and/or where younger women are at higher risk. REGISTRATION: PROSPERO, registration number CRD42019126798 .

Self-reported breast and cervical cancer screening practices among women in Ghana: predictive factors and reproductive health policy implications from the WHO study on global AGEing and adult health.

BACKGROUND: Breast and cervical cancers constitute the two leading causes of cancer deaths among women in Ghana. This study examined breast and cervical screening practices among adult and older women in Ghana. METHODS: Data from a population-based cross-sectional study with a sample of 2749 women were analyzed from the study on global AGEing and adult health conducted in Ghana between 2007 and 2008. Binary and multivariable ordinal logistic regression analyses were performed to assess the association between socio-demographic factors, breast and cervical screening practices. RESULTS: We found that 12.0 and 3.4% of adult women had ever had pelvic screening and mammography respectively. Also, 12.0% of adult women had either one of the screenings while only 1.8% had both screening practices. Age, ever schooled, ethnicity, income quantile, father's education, mother's employment and chronic disease status were associated with the uptake of both screening practices. CONCLUSION: Nationwide cancer awareness campaigns and education should target women to improve health seeking behaviours regarding cancer screening, diagnosis and treatment. Incorporating cancer screening as a benefit package under the National Health Insurance Scheme can reduce financial barriers for breast and cervical screening.

Practice and Barriers toward Breast Self-Examination among Palestinian Women in Gaza City, Palestine.

Breast self-examination (BSE) is one of many first-line screening practices aimed at early detection and prevention of fatal outcomes of breast cancer. The present study aimed to identify Palestinian women's practices, awareness, and barriers to BSE. Using descriptive-analytical methods, a previously validated questionnaire was administered to a conveniently selected sample of women. The study was conducted among women who visited primary health clinics (PHCs) in Gaza City. A total of 390 participants who met the selection criteria answered the self-administered questionnaires. We used SPSS version 24.0 to analyze the data. The findings suggest that the practice of BSE among women in Gaza is low, with only 40% of the study participants reporting that they never practiced BSE before, even though 76.7% reported that they were aware of BSE. In general, the main barriers to BSE practices were that participants had wrong perceptions and lacked knowledge about BSE. Others also reported fear of detecting breast cancer as a barrier. The practice of BSE among Palestinian women in the Gaza Strip is low and marred with trivial issues as barriers that could be eliminated with dedicated and extensive educational campaigns in the area.

Socioeconomic Inequalities in Uptake of Breast Cancer Screening among Saudi Women: A Cross-Sectional Analysis of a National Survey.

Timely and adequate screening for breast cancer could improve health outcomes and reduce health costs. However, the utilization of free breast cancer screening services among Saudi women is very low. This study aims to investigate socioeconomic inequalities in breast cancer screening among Saudi women. The data of this study were extracted from the nationally representative Saudi Health Interview Survey, conducted in 2013; the study included 2786 Saudi women. Multivariate logistic regression, the concentration curve, and the concentration index were used to examine, illustrate, and quantify income- and education-related inequalities in three outcomes: Knowledge about self-breast examination (SBE), clinical breast examination (CBE) received in the last year, and mammography, that has ever been previously carried out. Results showed a marked socioeconomic gradient in breast cancer screening services. The concentration index by income was 0.229 (SBE), 0.171 (CBE), and 0.163 (mammography). The concentration index by education was 0.292 (SBE), 0.149 (CBE), and 0.138 (mammography). Therefore, knowledge about breast cancer screening, and the utilization of screening services, were more concentrated among richer and better-educated women. Poorer and less educated women had less knowledge about self-breast examination, and had considerably less adherence to clinical breast examination and mammography. The findings are helpful for policy makers to devise and implement strategies to promote equity in breast cancer screening among Saudi women.

Socioeconomic Status Moderates the Effects of Health Cognitions on Health Behaviors within Participants: Two Multibehavior Studies.

BACKGROUND: Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate. PURPOSE: Current research on SES as moderator of the health cognitions-health behavior relation is inconsistent. Previous studies are limited by diverse operationalizations of SES and health behaviors, demographically narrow samples, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models. METHODS: Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1; Amazon MTurk; USA only) and 1,273 participants (Study 2; Prolific; international). Self-reports of multiple SES indicators (education, income, occupation status; ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES. RESULTS: Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated individuals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES. CONCLUSIONS: Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.

Assessment of knowledge and practice of breast self-examination among reproductive age women in Akatsi South district of Volta region of Ghana.

BACKGROUND: Breast cancer is the primary cause of cancer death among women globally, responsible for about 425,000 deaths in 2010. This study assessed the awareness, knowledge and practices of breast self-examination as a method of prevention and early diagnosis of breast cancer among reproductive aged women in Akatsi South district in Volta region of Ghana. METHODS: This study was a cross-sectional study involving 385 women between the ages of 15-49 years. Data were collected with a structured questionnaire and variables included socio-demographic characteristics, breast cancer knowledge, breast self-examination knowledge and practice. Descriptive statistics were used to analyze and present the data and chi square test of significance was used to determine association between socio-demographic variable and practice of breast self-examination. RESULTS: The mean age of the women was 24.54±7.19. Only 3.1% of women had no formal education and 58.9% were single. Although 88.3% of the respondents were aware of breast cancer, 64.9% of the respondents had good or sufficient knowledge of breast cancer and only 94(37.6%) practice BSE. Over 50% of the respondents did not know how to perform BSE. There was a significant association between knowledge on breast cancer and practice of BSE (χ2 = 36.218 p = 0.000). The higher the age of a participant, the lower practice of breast self-examination and this was significant (χ2 = 11.324, p = 0.003). CONCLUSION: Breast self-examination is a key strategy to early detection of breast cancer and subsequently critical for effective treatment and cure of the disease. The findings in this study have shown significant low levels of awareness and practice of breast self-examination among women in Akatsi South district of the Volta region. This pattern may be similar to other rural communities across the region. The need to create awareness and to educate women, especially rural women, on importance of breast self-examination as preventive measure for breast cancer is paramount.

Assessment of breast self- examination practice and associated factors among female workers in Debre Tabor Town public health facilities, North West Ethiopia, 2018: Cross- sectional study.

BACKGROUND: Although breast Self-Examination is no longer tenable as a standard method to detect early breast cancer, world health organization recommends breast self -examination for raising awareness of women about breast cancer. Secondary prevention through monthly breast self-examination is the best option to tackle the rising incidence of breast cancer. Therefore, the aim of this study was to assess breast self -examination practice and associated factors. METHODS: This cross-sectional study was conducted from April 23 to May 23, 2018. A total of 421 female workers in Debre Tabor Town public health facilities were included. The study participants were selected using simple random sampling technique from the study population. The collected data were checked for completeness. The data were entered and cleaned using EpiData version 3.1 then exported to SPSS version 20 for analysis. Crude odd ratio and probability value were identified for each independent variable and all independent variables with probability value of less than 0.2 were entered into multivariables logistic regression. Statistically significant associated factors were identified based on probability value (p-value) less than 0.05 and adjusted odd ratio with 95% confidence interval. RESULT: The mean age of participants was 25.2 (S.D = 4.12) and 137 (32.5%) of the participants had practiced breast self -examination and 64 (15.2%) of them performed it monthly. Family history of breast cancer (adjusted OR = 6.5, CI = 1.54-21.4), Knowledge about breast -self examination (adjusted OR = 5.74, CI = 2.3-14.4) and self- efficacy in practicing breast self -examination (adjusted OR = 4.7, CI = 1.84-12.11) were significantly associated with breast self -examination practice. CONCLUSIONS: The study showed that the prevalence of breast self-examination was low. Family history of breast cancer, knowledge about breast self -examination and self- efficacy in practicing breast self- examination did have statistically significant association with breast self-examination practice.

Integration of breast cancer prevention and early detection into cancer palliative care model.

BACKGROUND: Breast cancer is common among Ghanaian women. Late stage presentation has been credited to knowledge deficit and lack of breast cancer prevention and early detection services for women. OBJECTIVE: This study aimed to develop a model to facilitate the integration of breast cancer prevention and early detection into cancer palliative care. METHOD: This study used synthesized concepts emerging from a single case study research. The case was a tertiary health care facility, embedded with sub-units of analysis. Mixed-method approach was used to collect data from 102 participants. The study examined the experiences and views of the participants on breast cancer and screening pathways in Ghana. Thematic analysis and descriptive statistics ware used to analyze the qualitative and quantitative data respectively. This was followed with a cross-case analysis across the sub-units of analysis. A theory development approach was further used towards the development of a model, following three steps: concept analysis, statement synthesis and theory synthesis. RESULTS: Six key concepts synthesized from the data were used to develop the model: initiate and sustain breast cancer prevention and early detection program, collaboration of health professionals, patients, families and micro-communities, conducive environment of the health care facility and needed resources, actions, services, and lastly diffusing innovation into the community through agents. CONCLUSION: A model has been developed based on the experiences shared by women diagnosed with advanced breast cancer, their first degree relatives, micro-communities as well as clinicians working in a palliative care setting. This model will aid clinicians to provide breast cancer education, teach breast self-examination and offer clinical breast examination to families and micro-communities of advanced breast cancer patients receiving supportive care in a resource-limited setting.

Predictors of practice of breast self-examination: A study among female undergraduates of Ebonyi State University, Abakaliki, Nigeria.

BACKGROUND: Breast cancer is the most common female cancer in both developed and developing countries. This study was designed to determine the predictors of practice of breast self-examination among female undergraduate students of Ebonyi State University, Abakaliki, Nigeria. METHODOLOGY: This was a descriptive cross-sectional study. A three-stage sampling design was used to select 365 female students of the university. Data were collected using a pretested self-administered questionnaire. Completion of one academic year qualified students for inclusion. Good knowledge of breast self-examination was determined by proportion of respondents who scored 50% and above of 15 variables used to assess knowledge. RESULTS: The mean age of the students was 22.1 ± 2.5 years. Majority (76.4%) were aware of breast self-examination and health workers; 37.0% were the major source of information. A minor proportion (5.8%) have had their close relatives diagnosed with breast cancer. Majority (55.3%) had good knowledge of breast self-examination. Majority (63.6%) have ever-practiced breast self-examination; however, only 15.9% of the respondents examined their breasts on a monthly basis. Predictors of ever-practiced breast self-examination included having good knowledge of breast self-examination (adjusted odds ratios [AOR] =6.4, 95% CI: 3.9-10.4), having a close relative diagnosed with breast cancer (AOR = 4.0, 95% CI: 1.1-15.1), and mother of respondent being self-employed (AOR = 0.5, 95% CI: 0.5-1.5). CONCLUSIONS: Awareness of breast self-examination and practice were high among the respondents; however, only a minor proportion practiced breast self-examination every month. Having good knowledge of breast self-examination was associated with its practice. Having a close relative diagnosed with breast cancer encouraged the respondents to prevent the occurrence of breast cancer, thus enabling the practice of breast self-examination. Moreover, the practitioners of breast self-examination taught and encouraged others to examine their breasts. There is a need to increase knowledge of breast self-examination through public health education using the media.

Sustainable and cost-effective teenage breast awareness campaigns: Insights from a Nigerian high school intervention study.

BACKGROUND: With limited government-sponsored breast screening programmes in developing countries, breast awareness remains the only realistic survival hope for millions. Poor levels of knowledge and preventive practices remain in these countries, and early enlightenment to empower teenage high school girls has been advocated for, recently. This study evaluates ways to ensure sustainability for such an approach. METHOD: A 6-month longitudinal, interventional cohort study of 432 high school female students in South-eastern Nigeria. The efficacies of a video-assisted face-to-face intervention, as well as the use of printed handouts, were evaluated. RESULTS: A total of 317 (73.4%) and 301 (69.7%) valid responses were received from the pre-intervention (16.8 ± 1.5 years) and post-intervention (17.2 ± 1.6 years) surveys, respectively. Logistic regression revealed that participants who were "engaged" with the campaigns, either through symposium attendance or by reading handouts, showed significant improvements on most aspects of knowledge regarding the cancer's early symptoms and risk factors, as well as breast self-examination (BSE). However, the monthly practice of BSE was not significantly increased (Attendees: OR = 1.44, P = 0.18; Handout-readers: OR = 1.52; P = 0.17). Also, when "engagement" to the respective empowerment activities was disregarded, a chi-squared analysis comparing the pre-intervention and post-intervention groups showed significant improvements on specific knowledge regarding risk factors and early symptoms of breast cancer, as well as BSE techniques and regular monthly practice: χ2 (1, N = 596) = 46.703, P < 0.001. Across multiple parameters, the impact of exclusive face-to-face participation was not different to that from the reading of handouts. CONCLUSION: Face-to-face and handout were both effective and of similar impact. However, sustained impact on monthly BSE is doubtful. To surmount this, strategies to ensure ongoing engagements are vital. Perhaps adjusting existing high school curricula to allow repeated yearly teachings on breast cancer and BSE, along with in-built-in evaluation systems like examinations and quizzes, are ways of ensuring engagement.

Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours.

OBJECTIVES: Breast cancer contributes substantially to morbidity and mortality in Namibia as is the case in most countries in Sub-Saharan Africa (SSA). However, there is a dearth of nationally representative studies that examine the odds of screening for breast cancer in Namibia and SSA at large. This paper aims to fill this gap by examining the determinants of breast cancer screening guided by the Health Belief Model. METHODS: We applied hierarchical binary logit regression models to explore the determinants of breast cancer screening using the 2013 Namibia Demography and Health Survey (NDHS). We accounted for the effect of unobserved heterogeneity that may affect breast cancer, testing behaviours among women cluster level. The NDHS is a nationally representative dataset that has recently started to collect information on cancer screening. RESULTS: The results show that women who have health insurance coverage (odds ratio (OR) = 1.62, p ≤ 0.01), maintain contact with health professionals (OR = 1.47, p = 0.01), and who have secondary (OR = 1.38, p = 0.01) and higher (OR = 1.77, p ≤ 0.01) education were more likely to be screened for breast cancer. Factors that influence women's perception of their susceptibility to breast cancer such as birthing experience, age, region and place of residence were associated with screening in this context. CONCLUSIONS: Overall, the health belief model predicted women's testing behaviours and also revealed the absence of relevant risk factors in the NDHS data that might influence screening. Overall, our results show that strategies for early diagnosis of breast cancer should be given major priority by cancer control boards as well as ministries of health in SSA. These strategies should centre on early screening and may involve reducing or eliminating barriers to health care, access to relevant health information and encouraging breast self-examination.

Patologías mamarias en pacientes atendidas en el hospital "Carlos Andrade Marín". Enero-octubre 2013 / Mammary pathologies in patients treated at the "Carlos Andrade Marín" hospital. January-October 2013

Se realizó una investigación con enfoque mixto, de tipo observacional descriptiva, de corte transversal; con el propósito de caracterizar las patologías mamarias, así como los factores de riesgo en las pacientes atendidas en la consulta de Mastología del Hospital del Instituto Ecua-toriano del Seguro Social "Carlos Andrade Marín", en la ciudad de Quito, durante el período enero-octubre de 2013. La totalidad de la población (326 pacientes de sexo femenino) fue incluida en el estudio; en las que predominó el rango de 40 a 60 años, y el antecedente fami-liar de cáncer de mamas; la presencia de nódulos resultó la principal causa por la que las pacientes asistieron a la consulta de Mastología; el 88,9 % en el caso de las diagnosticadas con lesiones benignas y el 80,1 % para las malignas. Las presentaciones anátomo-patológicas más frecuentes en las pacientes diagnosticadas con LMB estuvieron dadas por los cambios fibroquísticos (39 %) y los fibroadenomas, con un 30 %. En estudio ecográfico se apreció contornos irregulares en las imágenes de los diagnósticos malignos contrariamente a lo ocurrido en los benignos. El diagnóstico de certeza de lesiones mamarias malignas resultó mayoritariamente en estadíos tempranos, posibilitando la adopción de medidas terapéuticas más efectivas.

A research with a mixed approach, of a descriptive observational type, of a cross-sectional nature was carried out in order to characterize the mammary pathologies, as well as the risk factors in the patients treated in the Mastology consultation of Ecuadorian Social Security Institute "Carlos Andrade Marín" Hospital, in the city of Quito, during the period January-October of 2013. The entire population (326 female patients) was included in the study; in which the range of 40 to 60 years of age prevailed, and the family history of breast cancer. Patients mainly attended the consultation of Mastology because of the presence of nodules. 88.9% of cases were diagnosed with benign lesions and 80.1% with malignant ones. The most frequent anatomical-pathological presentations in patients diagnosed with LMB were given due to fibrocystic changes 39% and fibroadenomas with 30%. Irregular contours were seen in the images of the malignant diagnoses in an ultrasound study, contrary to what happened in the benign ones. The diagnosis of certainty of malignant mammary lesions was mainly in the early stages by allowing the adoption of more effective therapeutic measures.

Breast self-exam and patient interval associate with advanced breast cancer and treatment delay in Mexican women.

PURPOSE: The objective of this study was to compare treatment intervals in breast cancer patients according to the detection method (breast self-exam vs screening). PATIENTS AND METHODS: We conducted a retrospective analysis including 291 breast cancer patients at a Mexican tertiary referral hospital. RESULTS: Breast cancer detection method was mostly breast self-exam (60%). The median patient interval was 60.5 days, and was associated with marital status and socioeconomic level. Differences between the two groups were statistically significant for global interval, p = 0.002; however, health system interval was not statistically different. CONCLUSION: In our country, breast cancer screening is opportunistic, with several weaknesses within its management and quality systems. Our study showed that even in specialized health care centers, breast cancer is detected by self-exam in up to 2/3 of patients, which can explain the advanced stages at diagnosis in our country. In developing countries, the immediate health care access for breast cancer patients should be prioritized as an initial step to reduce the global treatment initiation interval in order to reduce mortality.

Assessment of Breast Cancer Knowledge among Health Workers in Bangui, Central African Republic: a Cross-sectional Study.

BACKGROUND: Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. MATERIALS AND METHODS: This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's χ 2 test and ANOVA were applied to examine associations between variables with <0.05 being considered significant. RESULTS: Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in the Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. CONCLUSIONS: There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.

Marketing communication in the area of breast and cervical cancer prevention.

BACKGROUND/AIM: Innovative marketing campaigns and promotional activities can successfully contribute to the improvement of public health by raising the level of general knowledge about health issues and benefits that the change of habits, eradication of undesirable behaviour and regular medical controls have. The focus should be on continuous marketing communication through various mass media or direct communication between medical staff and patients. The aim of this paper was to define the role that various communication channels have in the process of informing and educating the target group in case of breast and cervical cancer prevention. METHODS: The survey based on polling a sample of 2,100 female patients of the Serbian Railways Medical Centre was conducted in the period October- December 2013. The questionnaire included questions about demographic characteristics, prevention habits of women, their level of information on that topic and communication channels they prefer. RESULTS: There is a difference among respondents' awareness level about preventive measures depending on demographic and geographical criteria. The results indicate the existence of variations in frequency of performing gynaecological examinations and Pap tests depending on different age, educational and residential groups. Although the largest percentage of women stated familiarity with the way of performing breast self-examination (78%), the majority of them had never performed mammography or ultrasonography (67%). The greatest number of women were informed about the possibility of preventing breast and cervical cancer by posters or brochures in health institutions (71%) and mass media--television on the first place (74%), then specialized magazines about health (48%), radio (48%), web sites about health (42%), and daily newspapers (34%). The respondents consider the Ministry of Health and health institutions as the most responsible subjects for education of women about cancer prevention, while the self-initiative was given the least importance. CONCLUSION: Determined informing habits of the target group, their prevention habits and attitudes on the subject should be used as the basis for planning and implementation of prevention marketing campaigns that would be the most effective.