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 (AU)

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Mujer con patología mamaria. ¿qué factores se asocian a la práctica de la autoexploración? / Profile of women with breast disease wich does self-exploration. Which are the factors associated with this practice?

Antecedentes. En las últimas décadas la lucha contra el cáncer de mama se ha centrado, básicamente, en el tratamiento y en la prevención secundaria (fundamentalmente la detección precoz). La autoexploración mamaria, aunque no se ha demostrado que reduzca la mortalidad, sí es importante respecto a los casos detectados por la propia mujer (se estima que un 90% del total) y principalmente en los cánceres de intervalo. Objetivos. Identificar entre mujeres con cáncer de mama, cuántas realizan la autoexploración y los factores asociados. Describir las características clínico-patológicas de los cánceres en las mujeres que sí realizan la autoexploración. Metodología. En mujeres diagnosticadas de cáncer de mama, en un hospital de la provincia de Cádiz, España, se reconstruye de manera retrospectiva la historia relacionada con el proceso del cáncer, es decir, sintomatología, factores psicosociales que determinan el contacto con el sistema sanitario, realización de prácticas preventivas (participación en el Programa de Detección Precoz del Cáncer de Mama –PDPCM–, autoexploración mamaria,...). Se realiza una descripción clínico-patológica del tumor: síntoma de presentación, tamaño tumoral, ganglios negativos, grado de diferenciación histológica. Resultados. Se estudiaron 149 mujeres con cáncer de mama, de las cuales el 52% realizaba autoexploración. Las mujeres que realizan autoexploración son más jóvenes (54,78 años frente a 65,63), están casadas (66,2%), se encuentran laboralmente activas y tienen un nivel de estudios mayor. La valoración de la aparición del primer síntoma como algo importante se correlaciona positivamente con aquellas mujeres que practican la autoexploración. En cuanto a otras prácticas preventivas, las que se autoexploran son también las que más acuden al programa de detección precoz (74,4% frente a 29,5% en las que no se autoexploran). En cuanto a las características clínico-patológicas del tumor en las mujeres que se autoexploran: el tamaño tumoral medio es de 2,5 cm; el 50,7% se halla bien diferenciado, y en un 59,1% de los casos los ganglios son negativos. Conclusiones. Las mujeres que se autoexploran son más jóvenes, tienen un nivel educativo mayor, están casadas, se encuentran laboralmente activas y suelen participar en otras prácticas preventivas. En ellas, los tumores diagnosticados presentan un menor tamaño, se diagnostican en estadios más precoces y por lo general presentan mejor grado de diferenciación(AU)

Background/Aims: In recent decades the fight against breast cancer has focused primarily on the treatment and secondary prevention (early detection mainly). In the case of breast self-examination, althought it has not been prove to reduce mortality, it is important in cases detected by women themselves (it is estimated 90% of total), mainly in the interval cancers. Objectives: To identify within women with breast cancer, how many do self-examination and identify associated factors. Describe the clinical and pathological features of cancers in women who do perform self-examination. Methodology: In women diagnosed with breast cancer during 2007 in a hospital in the province of Cadiz, Spain, is reconstructed in retrospect the story related the cancer process: symptoms, psychosocial factors that determine the contact with the health system, preventive practices (self-examination, mammography screening). A description of the pathological tumor: presenting symptom, tumor size, node negative, grade of differentiation… Results: We studied 149 women with breast cancer, from whom 52% did self-exploration. Women who performed self-examination were younger (54.78 years) against the women who did not (65.63 years), married (66.2%), active workers and have a higher educational level. The assessment of the first symptoms in these women as «important» is positively correlated with those women who practice self-examination. For other preventive practices, women who does self-examination are also the most actives in early detection programs (74.4% against 29.5% which didn’t do self-examination). For the pathologic characteristics of tumor in women who did self-examination: the tumor size was 2.5 cm, 50.7 / are well differentiated, and 59.1% of cases the nodes are negative. Conclusions: Women who does self-examination are younger, have higher educational level, are married, are active workers and are often involved in other preventive practices. On them, the tumors diagnosed have a smaller size, are diagnosed at earlier stages and usually present better degree of differentiation(AU)

La autoexploración mamaria como principal técnica de prevención del cáncer de mama / Breast self-examination as main technique for breast cancer prevention

El cáncer de mama es la neoplasia más frecuente en la mujer. Como principal medida preventiva destaca la autoexploración mamaria, ya que casi el 95% de los tumores mamarios es detectado por la propia mujer a través de esta técnica. La enfermería constituye el grupo sanitario más relacionado con la enseñanza de las pautas adecuadas para realizar la técnica de forma correcta: práctica mensual, reconocimiento de anomalías en la mama, acudir al médico especialista ante posibles dudas de cambios en las mismas, etc(AU)

Breast cancer is the most common malignancy in women. Breast self-examination stands out as the main preventive measure, since almost 95% of breast tumours are detected by the woman herself through this technique. Nursing is the group most closely related to health education appropriate guidelines to perform the technique correctly: monthly technical realization, recognition of abnormalities in the breast, go to the doctor for possible doubt about changes in them, etc(AU)

Un bulto en la mama. Tú eliges cómo abordarlo / A lump in the breast

Las estadísticas parecen indicar que en algún momento de su vida, una de cada nueve mujeres deberá afrontar un cáncer de mama. La autora relata su manera personal de hacerle frente, compartiendo las preguntas y respuestas que ha ido hallando en este camino. Es autora del libro de igual título que su artículo(AU)

The statistics seem to indicate that at some point in their lives, one in nine women must face breast cancer. The author recounts his personal way of moving forward and sharing the questions and answers that have been found in this way. She is the author of the book with the same title that his article(AU)

Evaluation of breast cancer awareness among female university students in Malaysia / Evaluación del conocimiento sobre cáncer de mama entre estudiantes universitarias en Malasia

Breast cancer is the most common cancer and the leading cause of cancer death among women of all ethnic and age groups in Malaysia. Objective: The objectives of this study were to evaluate the knowledge of breast cancer risk factors, symptoms and methods of screening among female university students and their perception towards the disease treatment outcomes. Methods: A cross-sectional survey was conducted from February to March 2008 at University Sains Malaysia. Two hundred participants from 10 randomly selected faculties were interviewed face to face by a trained pharmacist using a validated questionnaire. In addition to their demographic characteristics, participants were required to answer 22 questions concerning knowledge of breast cancer and five questions related to their perception of breast cancer management and treatment outcomes. Data were analyzed using SPSS version 15. Results: The mean age of the respondents was 26.7 (SD=1.9) years. The results showed that the vast majority of the female university students had inadequate knowledge of breast cancer. The mean total knowledge score of the students was 60.7%. Indian students had significantly less knowledge of breast cancer compared to their Chinese and Malay counterparts (p<0.05). However, more than two third of the students were aware of breast self examination (BSE) and clinical breast examination (CBE) recommendations. Furthermore, the students had positive perceptions towards the treatment outcomes of breast cancer. Conclusion: This study has highlighted the need of a breast cancer awareness campaign, which should also stress the importance of early detection and reporting of breast cancer (AU)

El cáncer de mama es el cáncer más común y la mayor causa de muerte entre jóvenes de todos los grupos étnicos y edad en Malasia. Objetivo: Los objetivos de este estudio fueron evaluar el conocimiento sobre los factores de riesgo de cáncer de mama, los síntomas y los métodos de rastreo entre estudiantes universitarias y su percepción hacia los resultados del tratamiento de la enfermedad. Métodos: Se realizó un estudio transversal de febrero a marzo e 2008 en la Universidad Sains Malaysia. Un farmacéutico entrenado entrevistó cara a cara a 200 participantes entre las 10 facultades aleatoriamente seleccionadas utilizando un cuestionario validado. Además, de sus características demográficas e les pidió que respondiesen 22 preguntas relativas al conocimiento del cáncer de mama y 5 relativas a su percepción sobre los resultados de su gestión y tratamiento. Los datos se analizaron utilizando el SPSS versión 15. Resultados: La media de edad de los respondentes era de 26,7 (DE=1,9) años. Los resultados mostraron que la gran mayoría de las estudiantes universitarias tenían conocimientos inadecuados sobre el cáncer de mama. La media de puntuación total fue del 60,7%. Las estudiantes indias tenían significativamente menos conocimiento que sus colegas chinas y malayas (p<0,05). Sin embargo, más de dos tercios de las estudiantes conocían las recomendaciones de auto-exámenes de cáncer de mama y de exámenes clínicos de mama. Incluso, las estudiantes tenían una percepción positiva sobre los resultados del tratamiento del cáncer de mama. Conclusión: Este estudio indicó la necesidad de una campaña de concienciación sobre el cáncer de mama, que también debería remarcar la importancia de la detección temprana y la comunicación del cáncer de mama (AU)

Devices for home evaluation of women's health concerns.

PURPOSE: Devices used for home evaluation of fertility, pregnancy, menopause, colon cancer, breast cancer, and urinary-tract and vaginal yeast infections are discussed. SUMMARY: Ovulation-prediction devices monitor natural changes in a woman's body during the menstrual cycle, including changes in basal body temperature, urinary luteinizing hormone, and urinary estrone-3-glucuronide concentrations. Also available are devices that identify changes in the content of sodium chloride and other electrolytes in saliva and cervical-vaginal mucus. Home pregnancy tests are designed to detect human chorionic gonadotropin in the urine. Both urine and saliva tests are available for home evaluation of menopause; the most common devices use urine to measure follicle-stimulating hormone. The saliva tests measure estradiol, progesterone, and testosterone. Devices for home screening for colon cancer use either the guaiac test or the fecal immunochemical test. For aid in breast self-examination, patients may use a simulated-breast product designed to train them to detect lumps or a thin, silicone-containing pad intended to increase the sensitivity of the fingers to abnormalities. Urine-dipstick tests can be used to screen for urinary-tract infection, and a swab or panty liner can be used to detect vaginal pH changes indicative of vaginal yeast infection. Home-based tests may be convenient and economical but also have limitations; pharmacists can help educate patients and clinicians. CONCLUSION: Many devices are available to help evaluate women's health concerns at home.

Evaluation of a breast examination facilitation device.

Breast self-examination (BSE) is recommended in order to help women detect possible breast cancer early in its development. Correct BSE performance has been shown to be positively associated with breast lump detection ability. Few women, however, report practising BSE, citing reasons such as: dislike of touching one's own breasts, fear of finding a lump, lack of confidence in their ability to perform BSE. The purpose of this study was to test a breast examination facilitation device (BEFD) for women, which would provide a teaching/screening tool, as well as a shield between breast and fingers for women who are reluctant to touch their breasts. A sample of 36 registered nurses in the United States was asked to perform BSE on three separate occasions using a BEFD made of latex, paper or cloth on which a wedge pattern for BSE had been imprinted. Subjects found the BEFD to be a useful tool for teaching/learning BSE, and expressed a clear preference for the latex material. One size of BEFD is not adequate for all women. A smaller size for women who wear A and B cup-size bras, and a larger size for women who wear C cup size and above, would be more acceptable.

Aplicación piloto de programa educativo en autoexamen de mama / Pilot application of an educative program in breast self-examination

Se trata de la experiencia vivida con un grupo de alumnas de un colegio del gran Santiago, donde a partir de un diagnóstico aplicando el Modelo Precede se implementa y aplica un programa de educación sobre autoexámen de mama. Se visualiza esta experiencia como una forma de poder influir en el diagnóstico precoz del cáncer de mamas a través del autocuidado