Exploring the Landscape of Breast Cancer Prevention among Chinese Residents in Italy: An In-Depth Analysis of Screening Adherence, Breast Self-Examination (BSE) Practices, the Role of Technological Tools, and Misconceptions Surrounding Risk Factors and Symptoms.

BACKGROUND: Breast cancer remains a significant health concern among women globally. Despite advancements in awareness and diagnostic techniques, it persists as a leading cause of death, with profound impacts on affected individuals' quality of life. Primary and secondary prevention, including regular screenings and practices like breast self-examination (BSE), are pivotal in ensuring early diagnosis. The national health system (NHS) in Italy offers screenings for women aged 50-69 every two years, managed by the local health authority. However, the participation rates, especially among the Chinese female population residing in Italy, are not well understood. METHODS: Using a snowball method, we electronically disseminated a survey to investigate how Chinese women living in Italy engage with available NHS screening programs. The survey also explores their practice of BSE and the use and impact of technological tools on prevention. Furthermore, the study aims to understand the subjects' depth of knowledge and misconceptions about breast cancer. RESULTS: The data reveal a significant gap in breast cancer screening adherence and knowledge among Chinese women in Italy, with a notable discrepancy between the general population and those who have previously encountered cancer. CONCLUSIONS: The results highlight the urgent need for interventions that are culturally sensitive, stressing that these actions are not only desirable but essential.

Are rural women aware of breast cancer and do they practice breast self-examination? A cross-sectional study in a rural hospital in South India.

Background: Breast cancer is the most common cancer among Indian women. Breast self-examination (BSE) remains a feasible screening method in resource-poor settings, yet diagnosis in advanced stages remains common. We aimed to assess the awareness of breast cancer and the practice of BSE among women in a rural area of south India. Methods: A cross-sectional hospital-based study in rural Ramanagara district, Karnataka, with 416 adult women who were interviewed using the Breast Cancer Awareness Measure. Results: Less than one in ten women knew that lump in the breast is a symptom of breast cancer. Majority 338 (81.2%) were not able to state even a single symptom of breast cancer and 365 (87.7%) not able to state even one risk factor of breast cancer. Majority 354 (85.1%) of the women in the study had never heard of BSE. None of the women in the study performed monthly BSE. Only 40 (9.6%) of the women actually performed BSE within the last 6 months. Women with higher education and those who reported a history of a lump in the breast in self or family were significantly more likely to state at least one symptom of breast cancer and were more likely to practice BSE. Conclusion: The rural women in this study had poor awareness regarding breast cancer and poor practice of BSE. Awareness of at least one symptom of breast cancer was associated with an 18 fold increase in the practice of BSE. This study has revealed an urgent need to focus on health awareness regarding breast cancer and BSE among rural women.

BRCAR: herramienta de soporte en la evaluación del riesgo para cáncer de mama / BRCAR: Support Tools for Risk Evaluation of Breast Cancer

Introducción: El cáncer de mama es el tumor maligno más frecuente en el mundo, en Cuba, es la segunda causa de muerte en mujeres. La insuficiencia en el diagnóstico precoz y la existencia de novedosas estrategias de tratamiento plantean la necesidad de establecer formas eficaces para identificar el riesgo en personas sanas, sin embargo en nuestro país no se cuenta con un método eficaz para predecir el riesgo y direccionar las acciones preventivas y terapéuticas. Objetivo: Crear un estándar nacional orientado a la identificación del cáncer de mama como soporte a la práctica médica y como herramienta de apoyo en la evaluación del riesgo. Método: Se combinaron 28 variables (determinadas por los factores de riesgo de cáncer de mama) a las cuales se les atribuyeron parámetros de ponderación asociados al nivel de incidencia registrado en la literatura médica, utilizando un algoritmo de votación como elemento matemático central. Resultados: Se desarrolló un sistema computarizado para la evaluación del riesgo de cáncer de mama en personas sanas. Conclusiones: BRCAR es una herramienta de soporte para objetivar el riesgo del cáncer de mama, al determinar el impacto de determinados factores de riesgo, con el fin de direccionar los métodos de estudio para la detección precoz(AU)

Introduction: Breast cancer is the most frequent malignant tumour in the world; it is the second cause of women death in Cuba. The insufficiency in early diagnosis and the existence of novel treatment strategies raise the need to establish effective ways to identify risk in healthy people, however in our country there is no effective method to predict risk and direct preventive actions and therapeutic. Objective: To create a national standard aimed at identifying breast cancer as a support to medical practice and support tool in risk assessment. Method: 28 variables (determined by risk factors for breast cancer) were combined; assigning to those variables weighting parameters associated with the level of incidence recorded in the medical literature, using a voting algorithm as the central mathematical element. Results: A computerized system was developed to assess the risk of breast cancer in healthy people. Conclusions: BRCAR is a support tool to objectify the risk of breast cancer, by determining the impact of certain risk factors, in order to direct study methods for early detection(AU)

Linfoma primario no Hodgkin de mama / Primary Non-Hodgkin's Breast Lymphoma

Introducción: El cáncer de mama se ha convertido en un verdadero desafío a la calidad y expectativa de vida de la población mundial, con un aumento considerable en su incidencia y prevalencia. Cuba cuenta, desde 1987, con un Programa de Control de Cáncer Mamario. Objetivo: Ejemplificar el estudio de un caso con linfoma no Hodgkin primario de la mama, su cuadro clínico y los medios diagnósticos utilizados. Caso clínico: Paciente femenina de 70 años de edad, color de la piel negra, que acudió al Consultorio Médico de la Familia por presentar malestar general, molestias y aumento de volumen en la mama derecha. Se le remitió a consulta de cirugía y se le realizaron estudios complementarios. Se detectó nódulo de mediana densidad, contornos parcialmente definidos, distorsión del tejido vecino, otros nódulos de menos tamaño y densidad en el cuadrante inferior interno, calcificaciones vasculares en ambas mamas. Una biopsia corrobora linfoma no Hodgkin difuso de células grandes de alto grado. Conclusiones: El linfoma primario no Hodgkin de mama es muy raro y de difícil diagnóstico clínico porque no se dispone de signos, síntomas o criterios de imagen específicos para ello. El autoexamen de mama continúa siendo el principal método de diagnóstico del cáncer de mama y aunque el examen clínico, el ultrasonido de mama y la mamografía apoyan la presunción, es la biopsia quien solo brinda la confirmación diagnóstica precisa(AU)

Introduction: Breast cancer has become a real challenge to the quality of life and to life expectancy of the world population, with a considerable increase in its incidence and prevalence. Cuba has, since 1987, a breast cancer control program. Objective: To present a case with primary non-Hodgkin's lymphoma of the breast in a 70-year-old patient, its clinical picture and the diagnostic means used. Clinical case: 70-year-old female patient, with black skin, who came to the family medical office due to malaise, discomfort and increased volume in her right breast. She was referred to surgery and complementary studies were performed. Nodule of medium density was identified, with partially defined contours, distortion of the neighboring tissue, together with other nodules of less size and density in the lower internal quadrant, and vascular calcifications in both breasts. A biopsy confirms diffuse high-grade large-cell non-Hodgkin's lymphoma. Conclusions: Primary non-Hodgkin's lymphoma of the breast is very rare and difficult to diagnose clinically because there are no specific signs, symptoms or imaging criteria for it. Breast self-examination continues to be the main method of diagnosis for breast cancer and, although clinical examination, breast ultrasound and mammography support such diagnostic presumption, it is the biopsy that only provides the precise diagnostic confirmation(AU)

Breast Cancer Knowledge and Practice of Breast Self-Examination among Female University Students, Gaza.

Breast cancer is the highest public detected cancer among female population in the majority of countries worldwide. Breast self-examination (BSE) is a useful screening tool to empower women and raise awareness about their breast tissues and help detect any breast abnormalities when they occur. This study aimed to assess the level of female university students' knowledge and practice of BSE. A self-administered questionnaire was used to assess the knowledge about breast cancer and related items, and an observation checklist was used to test practicing BSE using a breast simulator. Eighty-six students participated in the study, 58.1% studying nursing and 41.9% studying clinical nutrition in the third (40.7%) or the fourth level (59.3%). Of them, 24.4% had previous family history of breast cancer. The majority of the students (80.2%) had previous information about breast cancer acquired from different sources, university studies (57%), the Internet (45%), and social media (41%). Findings showed good scores (≥70%) regarding signs and symptoms and risk factors of breast cancer; however, low knowledge scores (<70%) were detected regarding general knowledge about breast cancer disease, methods of early detection and management, and applying steps of practicing BSE. Roughly all the students (96.5%) have heard about BSE, and 69.8% knew the time to do BSE; however, only 31.4% practice it regularly. Three barriers to practice were dominant among students who do not have a breast problem (39.7%), do not know how to do it (37.9%), and being busy 31%. On the other hand, breast cancer early detection purpose and the presence of family history of breast cancer were considered facilitators to regular practice BSE. A statistically significant relationship existed between knowledge about the steps of applying the BSE and regular practicing. A training program should be implemented to increase the level of awareness about BC and practicing BSE.

Intervención educativa sobre cáncer de mama / Educative Intervention about Breast Cancer

Introducción: El cáncer de mama es una proliferación maligna de las células epiteliales que revisten los conductos o lobulillos mamarios. Objetivo: Evaluar la efectividad de una intervención educativa sobre cáncer de mama. Métodos: Se realizó un estudio cuasi-experimental de intervención educativa sobre cáncer de mama en mujeres mayores de 30 años pertenecientes al consultorio 13 del Policlínico Pedro del Toro; de Holguín durante el 2018. La población de estudio la constituyó el total de mujeres adultas mayores de 30 años de edad, 124 pertenecientes al consultorio en estudio. La muestra quedó conformada por 80 pacientes, seleccionadas mediante el muestreo aleatorio simple. Resultados: En cuanto a las necesidades identificadas, las 80 pacientes (100 por ciento) expresaron la necesidad de conocer acerca de los factores de riesgo del cáncer de mama. Antes del programa educativo predominaron las mujeres con conocimientos inadecuados sobre prevención del cáncer de mama, autoexamen de mama y factores de riesgo (80 por ciento, 65 por ciento y 80 por ciento, respectivamente). Luego de la intervención aumentaron a suficientes: en el primer caso al 85 por ciento, en el segundo y tercero a 100 por ciento. La aplicación de dicho programa resultó efectiva en 68 féminas, para un 85 por ciento. Conclusiones: La intervención educativa fue efectiva, porque demostró un incremento en el nivel de conocimiento sobre la prevención, los factores de riesgo y el autoexamen de mama(AU)

Introduction: Breast cancer is a malignant growth of epithelial cells that line the ducts or breast lobules. Objective: To assess the effectiveness of an educative intervention about breast cancer. Methods: A quasiexperimental study of an educative intervention about breast cancer was carried out, during 2018, with women over 30 years belonging to the family medical office 13 of Pedro del Toro Polyclinic of Holguín. The study population was made up of all women aged over 30 years: 124 women, who belonged to the medical office under study. The sample was made up of 80 patients, selected by simple random sampling. Results: Regarding the identified needs, all the patients expressed the need to know about the risk factors for breast cancer. Before the educative program, women with inadequate knowledge of breast cancer prevention, breast self-examination, and risk factors predominated (80 percent, 65 percent, and 80 percent, respectively). After the intervention, this amount increased to enough: in the first case, it increased to 85 percent; in the second and third cases, it increased to 100 percent. The application of this program was effective in 68 women, accounting for 85 percent. Conclusions: The educative intervention was effective because it showed an increase in the level of knowledge about prevention, risk factors and breast self-examination(AU)

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 .

Conocimiento del autoexamen de mama y testículo en estudiantes universitarios / Knowledge of university students on breasts and testicles self-examination

Introducción: El autoexamen de mama y el autoexamen de testículos son métodos de detección temprana sencillos, económicos, seguros, no invasivos, que no requieren ningún instrumento especial para su ejecución y que permiten una mayor conciencia y conocimiento del propio cuerpo. Objetivo: Determinar el conocimiento de la práctica del autoexamen de mama o testículo en un grupo de estudiantes universitarios. Métodos: Estudio descriptivo, transversal. Se aplicó un cuestionario sobre conocimientos de autoexamen de mama o testículo, consumo de tabaco, alcohol y variables sociodemográficas. El análisis de datos incluyó distribución de frecuencias, porcentajes y razones de prevalencia. Resultados: Del total de la muestra, el 43,9 por ciento eran hombres, de ellos el 30,7 por ciento manifestó conocer cómo se debía realizar el autoexamen de testículo. Los masculinos pertenecientes a estratos altos, los que se encontraban cursando tercer año y quienes tenían estudios afines con la facultad de salud mostraron las mayores tasas de conocimiento. De las mujeres, el 73,7 por ciento conocía cómo realizar el autoexamen de mama, demostrando tasas mayores de conocimientos las que cursaban cuarto año, las que pertenecían a estratos altos y las que tenían estudios afines con la facultad de salud. No se encontró asociación estadística con el conocimiento del autoexamen de testículo; mientras que ser mayor de 22 años y pertenecer a estratos altos fueron factores predisponentes para el autoexamen de mama. Conclusiones: Las mujeres tienen mayor percepción de la importancia del autocuidado para su salud, a la vez que manifiestan mayor conocimiento de los procedimientos para realizar el autoexamen. No obstante, existen hombres y mujeres que no saben aún como realizarlo, de ahí la importancia de desarrollar e implementar programas de educación, prevención y promoción del autoexamen en los estudiantes universitarios(AU)

Introduction: Breasts self-examination and testicles self-examination are simple, economic, safe, non-invasive early detection's methods that do not require any special tool for their performance and that foster a higher awareness and knowledge on your own body. Objective: To determine the knowledge of the breast or testicles self-examination practice in a group of university students. Methods: Descriptive, cross-sectional study. It was performed a questionnaire on the knowledge of the breast or testicles self-examination, tobacco and alcohol consumption, and socio-demographic variables. Data analysis included frequencies and percentages distribution, and prevalence ratios. Results: From the total of the sample, 43,9 percent were men, and 30,7 percent of them expressed to have knowledge on how to perform the testicles self-examination. Males corresponding to high strata, the ones that were in third year of the major, and those who had studies related to the Health's Faculty showed higher rates of knowledge. From women, 73,7 percent knew how to perform the breasts self-examination showing higher rates of knowledge the ones that were in the fourth year of the major, the ones that belonged to higher strata and the ones that had studies related with the Health's Faculty. There was not found statistic association with the knowledge on testicles self-examination; while being older than 22 years old and belonging to high strata were predisposing factors for breasts self-examination. Conclusions: Women have higher perception of the importance for health of self-care, while they show more knowledge on the procedures to perform self-examination. Nevertheless, there are men and women that do not know yet how to perform it, that is why it is important to develop and implement programs of education, prevention and promotion of the self-examination in university students(AU)

Analysis of the health situation of women referring to breast cancer screening in Poland.

PURPOSE: To analyze the health situation of women referring to breast cancer screening. METHODS: The study was conducted at "Certus" Medical Center in Myslenice (Malopolska Province). A total of 808 women aged 51-69 years were enrolled. The protocol of the study was approved by the administration of the medical center where it was conducted. The survey consisted of 24 descriptive and single/multiple choice questions referring to health behaviors related to breast cancer prevention. RESULTS: Most often the women received information about breast cancer prevention from specialist physicians [24%]. Only 14% of the participants reported radio, press and Internet as an important source of information. Only 12% of the respondents declared that they self-examined their breasts systematically every month, and 35% stated that their breasts had been examined by a physician during recent years. A statistically significant relationship was found between the primary source of information about breast cancer prevention and the educational level of the study participants (p=0.0008). CONCLUSIONS: Considering the Polish Central Statistical Office estimates, according to which the proportion of persons older than 65 years is projected to grow up to 22.3% by 2030, we may expect further increase in breast cancer incidence. Improvement of the epidemiological situation in Poland, which is worse than in other European countries, requires continuation of multidirectional activities, among them population-based education and active screening.

Awareness of Breast Cancer Risk Factors, Symptoms and Breast Self-Examination Among Omani Female Teachers: A cross-sectional study.

OBJECTIVES: This study aimed to assess knowledge of breast cancer (BC) risk factors, warning signs and symptoms and breast self-examination (BSE) practice among Omani female teachers in Al-Dhahira Governorate. METHODS: A cross-sectional sample of female teachers aged 20-50 years was collected from January to December 2018 from three wilayats (provinces) in Al-Dhahira-Ibri, Dhank and Yunqal. A questionnaire that included the Breast Cancer Awareness Scale and demographic characteristics was administered. Data were analysed using descriptive statistics, regression analysis and Pearson's Chi-square test. RESULTS: A total of 478 female teachers were included in the study (response rate: 72.4%). The majority of participants (60.5%) had good overall knowledge about BC while 19.9% of participants had excellent overall knowledge. Only 9% of participants demonstrating excellent knowledge of BC risk factors. More than half of the participants (56.1%) reported excellent knowledge in screening methods. Unfortunately, only 57% of the female teachers indicated practising BSE. Knowledge of BC symptoms was closely divided between excellent and good levels (45.8 and 42.5%, respectively). BSE practice was significantly (P <0.05) correlated with overall knowledge of BC and its symptoms and screening methods, but not with knowledge of BC risk factors. CONCLUSION: This study revealed unsatisfactory overall knowledge of BC risk factors, symptoms, screening methods and BSE practice among female Omani teachers in Al-Dhahira Governorate. These findings constitute a challenge to healthcare providers to continue developing awareness of BC and providing health information to the public.

Effectiveness of self-instructional module on awareness on screening regarding breast cancer with Intelligent Breast Examination among primary schoolteachers in Karad.

AIM: As Breast cancer is most common in developed and developing world. Despite of seriousness & importance of breast cancer the awareness is low. This Study highlights the primary screening of breast cancer with the device Intelligent Breast Examination. OBJECTIVES: The objectives of this study are to assess the knowledge regarding awareness on screening of breast cancer with Intelligent Breast Examination (IBE), to develop a self-instructional module (SIM) on awareness on screening regarding breast cancer with IBE, and to assess its effectiveness on awareness about screening breast cancer with IBE. MATERIALS AND METHODS: Evaluative research approach was used. The study used preexperimental research design. The samples (60 primary schoolteachers) were selected by the use of two sampling techniques, i.e., random sampling (for schools) and purposive sampling (study participants). Data were collected in two phases (pre and post) using structured questionnaire followed by the administration of SIM. RESULTS: The results revealed a significant increase in mean knowledge scores (mean pre 11.16 standard deviation [SD] = 2.631 to mean post 21.2 SD = 1.842) regarding awareness on screening of breast cancer with IBE. The calculated paired t value (23.902) is greater than the table value ( t = 1.67) at 0.05 level of significance. CONCLUSION: The study concluded that the SIM prepared proved to be effective in increasing the awareness regarding screening with IBE in breast cancer.

Time Interval between Self-Detection of Symptoms to Treatment of Breast Cancer.

BACKGROUND: In India breast cancer is the number one cancer among females with an incidence rate of 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. India continues to have a low 5-year survival rate of breast cancer with only 66.1% as compared to 90% in developed countries. The major reason for low survival is that patients are diagnosed with cancer at high stage. The present study attempts to delineate the time interval between self-detection of breast cancer symptoms and seeking care and to find the main reasons for delay in seeking care. METHODS: A cross sectional study was undertaken from October 2016 to March 2017 in a population based cancer registry (PBCR) and hospital based cancer registry (HBCR) located in south of India. Histologically confirmed breast cancer patients (N=181) were interviewed at hospital using a pre-tested semi structured questionnaire. RESULTS: The median time interval between the self-detection of breast cancer symptoms and first contact with general physician was 60 [IQR 30-180] days. The median time to diagnosis from the first contact was 30 [IQR 10 - 60] days and the overall median time span from self-detection of symptoms to treatment was 150 [IQR 95-265] days. The major reason given for not seeking medical care in time was lack of awareness in identifying the cancer symptoms both among patients and primary care providers. CONCLUSION: There was considerable delay from self-detection of symptoms to cancer specific primary treatment of breast cancer. We found lack of awareness among patients as well as in primary care providers to be the major concern for delay. Awareness among the target population and health care professionals would have to be improved for early diagnostics and access to care.
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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.

Factors Affecting Breast Self-examination Behavior Among Female Healthcare Workers in Iran: The Role of Social Support Theory.

OBJECTIVES: In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers. METHODS: This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2. RESULTS: The mean age of the participants was 37.1±8.3 years, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (ß=0.380, p<0.05), and protection motivation (ß=0.604, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (ß=0.202, p<0.05) had a significant positive effect on breast self-examination behavior. CONCLUSIONS: The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.

Evidence of promoting prevention and the early detection of breast cancer among women, a hospital-based education and screening interventions in low- and middle-income countries: a systematic review protocol.

BACKGROUND: Given the increasing burden of breast cancer in the low- and middle-income countries, cost-effective approaches are needed to improve the early detection of breast cancer in these continents. Global policies and guidelines are now placing much emphasis on promoting early detection of breast cancer through integrated education and screening interventions. The proposed systematic review aims to map evidence on hospital-based breast cancer education, breast self-examination, and clinical breast examination services for women in low- and middle-income countries. METHODS/DESIGN: We will conduct a systematic review of peer-reviewed studies on hospital-based breast cancer prevention intervention (breast cancer education, breast self-examination, and clinical breast examination) for women in low- and middle-income countries. An electronic search will be conducted in the following electronic databases CINAHL Plus with full text (EBSCOhost), MEDLINE with full-text (EBSCOhost) PsychINFO (EBSCOhost), and PubMed. Articles will also be searched through the "Cited by" search and citations included in the reference list of included articles. A two-stage mapping approach will be conducted. The first stage will involve screening studies through assessing their titles. Also, we will screen abstracts of identified studies descriptively and by focus and methods as dictated by the inclusion and exclusion criteria. The second stage will include extraction of data from eligible studies. A parallel screening and data extraction will be conducted by two reviewers. The quality of included studies will be assessed using the mixed methods appraisal tool (MMAT). A narrative account of the data extracted from the included studies will be analyzed using the thematic analysis. DISCUSSION: We hope to find relevant studies reporting evidence on promoting prevention and the early detection of breast cancer among women in a hospital-based education and screening interventions in low- and middle-income countries. The evidence obtained from the included studies when summarized will help guide future research. The study results will be disseminated electronically and in print. Also, it will be presented at conferences related to breast cancer. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered with PROSPERO, with registration number CRD42017077818.

Peer Leaders and Phone Prompts: Implications in the Practice of Breast Care among College Students

Background: Compliance with breast self-examination (BSE) guidelines helps detect breast cancer early while increasing physical activity decreases the risk of having breast cancer. Finding ways to early initiate and maintain such behavior among youth is therefore important. In this study we aimed to determine the effects of two health promotion education interventions on knowledge and attitude to breast care, as well as practice of BSE and physical activity by female college students. Materials and Methods: A total of 999 students from ten colleges underwent two kinds of health education strategies for three months, namely the traditional health education program (THEP) and tapping peer leaders using mobile phone prompts (PPHEP). Results: Improvement in knowledge and attitude was shown for both groups as compared to the control group. Both interventions equally increased the practice of BSE and maintenance of the recommended level of physical activity. Conclusion: There was an increase in the knowledge and positive attitude to breast care and practice of BSE with an improvement in the level of exercise when THEP and PPHEP interventions were used. Health education with peers using mobile phone prompts offers an alternative and effective way of promoting BSE and acceptable levels of exercise.

Conocimientos, actitudes y prácticas en cáncer de mama y el autoexamen para detección temprana / Knowledge, attitudes and practices about breast cancer and self-examination for early detection

Antecedentes: El cáncer de mama (CM) es causa frecuente de morbimortalidad en todo el mundo y Honduras no es excepción. Se ha hecho muchos esfuerzos por promover la detección y tratamiento temprano. Objetivo: Determinar los conocimien-tos, actitudes y prácticas en mujeres sobre el CM y su detección y tratamiento oportuno. Pacientes y métodos: Se realizó un estudio transversal descriptivo durante el primer trimestre del 2017. Se entrevistó a 100 pacientes consecutivas en las consultas externas de medicina general y ginecología en el Centro de Salud San Miguel, Hospital San Felipe de Tegucigalpa, Hospital General Santa Teresa de Comayagua. Las variables evaluadas fueron sociodemográicas, conceptos sobre cáncer de mama, práctica y método del autoexamen de mama y actitudes respecto a la importancia y la promoción del autoexamen. RESULTADOS: Todas las personas encuestadas han escuchado de cáncer de mama, su diagnóstico y tratamiento, pero cerca de un cuarto de ellas tenían conceptos incompletos sobre la importancia y método del autoexamen, sobredimensionando la importancia de los métodos de imagen. El 91% de entrevistadas tenia entre 21 y 50 años de edad y 92% airmó que se practica el eautoexamen al menos una vez al año. El método de tratamiento más conocido fue la cirugía (78%). Las entrevistadas opinaron que los médicos promocionan poco el autoexamen. Conclusión: La educación sobre CM y autoexamen de mama debería actualizarse en Honduras en base a los conocimientos, acti-tudes y prácticas entre nuestras mujeres, según la medicina basada en evidencia. Se propone un estudio línea base multicéntrico.

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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