Breast Self-Examination Proficiency: Attitudinal, Demographic, and Behavioral Characteristics

Abstract

Despite public efforts to promote breast self-examination (BSE), few data exist that identify the skill level that women possess after formal BSE training. This investigation assessed BSE skill deterioration and identified critical factors that may contribute to BSE proficiency level. Data were collected on 57 women who voluntarily participated in a free BSE training program. The subjects completed a 68-item questionnaire and returned for a 30-min reevaluation of self-modeling BSE and examination of a breast model. Proficiency scores were obtained as they related to a woman's weeks posttraining, psychosocial, attitudinal, and behavior profile, and knowledge of breast cancer and BSE. A woman's BSE proficiency level deteriorates after initial training (r = −0.353, p = 0.004). Educational level (r = 0.253, p = 0.029) and age (r = −0.4094, p = 0.001) were significantly related to level of BSE proficiency. Approximately 17 weeks was determined as a critical time period posttraining for skill deterioration. Self-reported data collected from the questionnaire that had been used in previous studies to determine BSE proficiency were inaccurate in predicting observed BSE proficiency. Women should be taught proficiency of BSE by self-modeling and one-on-one training, and they should be reevaluated at 3-4 months. Special emphasis should be directed at offering BSE training to older women, women less educated, and those women at higher risk for developing breast cancer. Self-reported data appear to be unreliable in predicting a women's BSE proficiency. To address the true effect of BSE on cancer morbidity and mortality, an observed evaluation of a women's BSE proficiency should be defined and reevaluated at critical time periods posttraining.