Breast Cancer Screening Research Articles (Page 6)

The expert eye - Navigating ambiguity in clinical breast radiology.

BackgroundBreast cancer has a high health and economic burden in Europe. Screening is an effective intervention, enabling cancer prevention. Trend analysis provides insights for public health planning, particularly for understanding the impact of disruptive events such as the COVID-19 pandemic and then adopting strategies to increase adherence.MethodsData on breast cancer screening adherence from EU and EFTA countries were collected from Eurostat. Seventeen countries with ≥15 years of data between 2000 and 2022 (last data available) were included. Joinpoint regression was used to identify the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) over time.ResultsOverall, 12 countries had declining screening adherence; 10 had significant reductions (Finland, Germany, Hungary, Iceland, Ireland, Italy, Luxembourg, Netherlands, Norway, Slovakia; AAPC -0.25 to -0.97). Considering the pandemic years, all but two countries (Iceland and Ireland) reported a decrease (between -1.35% and -15.98%). Three trend patterns emerged. Group 1 (Finland, Norway) showed a decline in 2020 (APC -1.3, -12.29) followed by an increase in 2021-2022. Group 2 (Cyprus, Hungary, Netherlands) exhibited accelerated negative trends during the pandemic period. Group 3 (Belgium, Croatia, Czech Republic, Estonia, France, Germany, Iceland, Ireland, Italy, Lithuania, Luxembourg, Slovakia) displayed no statistically significant trend changes.ConclusionsOverall, most of the countries reported a decrease in screening adherence. The COVID-19 pandemic coincided with abrupt disruptions in uptake in 5 European countries, while in others it aligned with pre-existing patterns. These heterogeneous impacts highlight the need for research into the factors influencing different healthcare system responses. Strengthening monitoring and adaptability of preventive programs will be critical to sustain equitable access during future health crises.Key messages• Analyzing trends in breast screening uptake provides crucial insights for public health planning, particularly in understanding the impact of major disruptive events.• COVID-19 caused varying impacts on breast cancer screening trends across European countries; understanding health system responses is key to strengthening resilience of screening programs.

Abstract Background With the advent of personalised medicine, risk prediction models that incorporate personal and genetic factors now enable individualised breast cancer risk assessment. These innovations have sparked global interest in risk-stratified screening, which may improve early detection in high-risk women, reduce overdiagnosis in low-risk women, and enhance the cost-effectiveness of screening programmes. The aim of this study was to assess the acceptability and perceptions of personalised, risk-based breast cancer screening among Cypriot women. Methods A cross-sectional survey was conducted between November 2024 and March 2025 across all 5 mammography centers operating in Cyprus. Women attending routine screening appointments were invited to complete a structured five-question questionnaire. Descriptive statistics were performed using Stata 18. Results A total of 503 Cypriot women aged 45-74 years participated in the study (98.2% participation rate). Only 31% of respondents were aware of personalised, risk-stratified breast cancer screening. However, 90% expressed interest in knowing their personal breast cancer risk, and 78% were willing to participate in a risk-based screening programme. Hesitancy was primarily attributed to anxiety, fear of results, time constraints, and satisfaction with the current screening system. While 62% of women reported feeling anxious about being categorised as “high-risk” for breast cancer, only 51% felt reassured by a potential “low-risk” classification. Conclusions Cypriot women appear broadly supportive of personalised, risk-based breast cancer screening, although overall awareness is limited. Addressing this gap will require a coordinated approach involving public education, effective communication strategies, and collaboration with healthcare professionals to improve understanding and facilitate future implementation. Key messages • Most Cypriot women support personalised, risk-based breast cancer screening. • Public awareness is essential for the successful implementation of risk-stratified breast screening.

Evaluation of breast cancer screening programmes: Candidate performance indicators and their association with breast cancer mortality.

ABSTRACTBackground and AimsBreast cancer is a leading cause of cancer‐related deaths among women worldwide. This study compares the effectiveness of the Pink Luminous Breast LED‐based Technology Device with traditional Breast Self‐Examination (BSE) among nursing students.MethodsA comparative cross‐sectional study was conducted with 191 nursing students aged 20 years and above. Data was collected using socio‐demographic characteristics, knowledge of breast screening, and feedback on screening methods. Statistical analyses were performed using SPSS version 28.0, employing Chi‐square tests and thematic analysis.Results63.4% (121/191) of participants preferred Pink Luminous over BSE. Significant associations were observed between preference for Pink Luminous and marital status (88.9% [16/18] vs. 60.7% [105/173], p < 0.001), contraceptive use (85.7% [12/14] vs. 100% [9/9], p < 0.001), and year of study (e.g., 89.3% [50/56] among fourth‐year students, p < 0.001). Participants with good breast cancer screening knowledge (132/191) had a 75% (99/132) preference for Pink Luminous versus 33.3% (20/60) among those with poor knowledge (p < 0.001).ConclusionThe Pink Luminous Device demonstrates promise as an effective tool for breast cancer screening among nursing students. Integrating advanced screening technologies into nursing education could enhance awareness and early detection of breast cancer.

Abstract Health and well-being are understood as multidimensional, shaped by social, cultural, and emotional factors as well as healthcare services. In contexts marked by vulnerability, marginalisation, or structural exclusion, populations such as people in prison (PIP), refugees, and youth in under-resourced settings often face overlapping barriers to health equity and remain underrepresented in the design of health interventions. In this context, participatory methods that incorporate creative expression - such as storytelling, active techniques, photography, and collective future thinking - offer tools to engage individuals in articulating their experiences of distress, resilience, and well-being. These methods encourage individuals to express themselves, their needs and their experiences, which are essential to culturally sensitive, contextually relevant and responsive interventions for structurally marginalised populations. This workshop explores how these methods contribute to health, well-being and inclusion in diverse vulnerable settings. The objective is to share experiences, reflect on methodological and ethical considerations, and to discuss the potential of these approaches. The added value of this workshop lies in its focus on tools that facilitate the interpretation of participants’ own realities and inner worlds. These methodologies improve psychological well-being and support socio-emotional learning. They also uncover experiences of groups often excluded from standardised health interventions, enriching the understanding of health needs and broadening the scope of public health. The workshop presents four case studies applying participatory methodologies in contexts of structural vulnerability. The first explores the use of psychodrama with adolescents and young adults in Beira, Mozambique, through a project by Doctors with Africa-CUAMM. This approach uses collective enactment to foster emotional expression, build resilience, and strengthen group dynamics. The second draws on the Erasmus+ funded PARTNER project, which applies participatory futures thinking in prison settings. Through co-creative laboratories, PIP reimagine life trajectories and reflect critically on time, agency, and care. The third focuses on a photography project implemented by RedLab with adolescent refugees in Iraqi Kurdistan. The workshops facilitated self-narration and group dialogue, promoting emotional awareness and community connection. The fourth discusses participatory methods used in a project with Roma women in Greece to promote cervical and breast cancer screening and HPV vaccination, alongside health education. The session will conclude with a reflective exercise, inviting participants to respond to a shared prompt on applying expressive methods in their own contexts. This exchange will surface common challenges, tensions, and enablers, and support the co-development of insights for integrating participatory approaches into public health strategies. Key messages • Participatory methods amplify voices often excluded from public health and foster culturally responsive, equity-oriented interventions. • Creative expression strengthens mental well-being, collective reflection, and community-driven solutions in vulnerable contexts.

Abstract Roma people remain one of the most vulnerable groups in Europe and in Greece, as they continue to face difficult living conditions and discrimination in access to health, social protection, employment and adequate housing. The health of Roma women is highly vulnerable, with high rates of pregnancy and maternal complications, chronic conditions and mental health problems reported. In response, a comprehensive health promotion and disease prevention programme has been implemented in different Roma settlements across Greece, with a focus on rural and isolated areas. The project aims to strengthen women's agency over their health and improve health literacy, health-related behaviours and outcomes by combining culturally sensitive education with access to preventive services, including cervical and breast cancer screening and HPV vaccination. Participatory methods are embedded throughout the project cycle. Focus groups were used to inform the development of training materials and communication tools, ensuring cultural relevance and alignment with the community's needs and concerns. These methods have also been central to process evaluation throughout the project implementation. The real-time process evaluation using participatory tools has guided important adaptations to recruitment strategies, service delivery approaches, and communication methods, especially around cancer screening and vaccination. These adjustments have significantly improved outreach and participation, demonstrating the value of incorporating community feedback into health intervention delivery. Projects targeting vulnerable groups are often challenging, as real-life and on-site conditions influence implementation. Integrating participatory methods into process evaluation helps ensure that approaches remain responsive and adapted to evolving needs.

Women with severe mental disorders (SMD) experience premature mortality, with disparities in healthcare access and quality contributing to this trend. This study aimed to analyze breast cancer screening rates in women with schizophrenia, major depressive disorder, and bipolar disorder, compared to women without SMD. A systematic review and meta-analysis were conducted using PubMed, Embase, PsycINFO, Cochrane, and Web of Science databases. Studies were included if they examined women with SMD (schizophrenia, major depressive disorder, or bipolar disorder) who were within the age range eligible for participation in breast cancer screening programs, according to the guidelines in effect at the time and in the country where the study was conducted, and if they also reported screening rates. Odds ratios were calculated, and meta-analyses were performed using random-effects models. The review included 22 studies. Women with SMD showed significantly lower odds of mammography screening compared to women without SMD (pooled OR=0.66, 95% CI: 0.65-0.80, p-val =<0.0001). Subgroup meta-analyses revealed significantly reduced screening rates in women with schizophrenia (OR=0.58, 95% CI: 0.38 - 0.88, p-val=0.005) and major depressive disorder (OR=0.41, 95% CI: 0.17 - 0.97, p-val =<0.0001), but no significant difference for bipolar disorder. Women with SMD, particularly schizophrenia and major depressive disorder, have lower mammography screening rates than women without a SMD diagnosis. Addressing this disparity requires targeted interventions and increased healthcare provider awareness to improve screening rates and ensure equitable access to preventive care.

Provider effects and racial inequities in breast cancer risk-management adoption: Findings from a community-based study of high-risk women.

With over 2 million cases annually, breast cancer (BC) remains a major cause of cancer mortality. In Flanders, Belgium, the BC screening program (BCSP) reduces BC-specific mortality by 51%. Yet, participation remains low among previous non-responders, an issue that particularly affects underserved groups such as low-income individuals and minorities. A participatory approach was used to develop a tailored reminder letter, specifically addressing participation barriers faced by underserved groups. The co-creation process included 33 underserved women - mostly non-native Dutch speakers - and refined with stakeholder input. Compared to the official invitation letter, the reminder incorporated culturally tailored, simplified text and visuals and a QR code with 12-language translations. A randomized controlled trial (RCT) assessed the effectiveness of the reminder from April to June 2024. Participants were non-responders who previously received invitations but never participated. In total, 7922 individuals were randomized 1:1 to receive either the standard invitation alone (control) or with the tailored reminder (intervention). Participation rates were compared using the χ² test. Overall, 643 (12.1%) attended screening within 40 days. Intention-to-treat analysis showed a 6.5% absolute increase in participation in the intervention group (16.2% vs. 9.7%; OR 1.81 [95%CI 1.58-2.07], p < 0.001). The intervention improved participation across all age groups, provinces, and radiologic units. The largest gains occurred among participants aged 51-54 (+9.7%), residents of Limburg (+10.3%), and appointments at private radiologists (+8.7%). Preliminary cost-effectiveness data is promising and will inform decisions regarding implementation. The intervention significantly increased BC screening participation among previous non-responders, indicating potential to reduce disparities in screening access. Ongoing discussions with health authorities aim to assess its integration into the BCSP.Key messages• A simplified reminder letter tailored for a low-literate audience significantly increased mammography screening among previous non-responders.• Co-created health communications tailored to underserved groups are effective and a scalable public health strategy to reduce disparities in access to breast cancer screening.

160 Background: Health insurance status impacts access to mammography services and downstream diagnostic follow-up. Mobile Mammography units (MMU) are a valuable tool for improving access for under- and uninsured women. This study aims to evaluate the impact of insurance status on diagnostic resolution in women receiving breast cancer screening in a MMU compared to an urban, hospital-based site. Methods: This retrospective study analyzed all screening mammography examinations with BI-RADS 0 assessments performed during two-week periods in 2022 and 2023 at a MMU and our hospital-based sites. All patients screened at the MMU received diagnostic follow-up at the hospital-based sites included in the study. Sociodemographic variables were obtained. The primary endpoint was time to diagnostic resolution, defined as time from abnormal screening mammogram to completion of diagnostic mammogram or biopsy, if indicated. Statistical analyses performed: chi-square, analysis of variance (ANOVA), and Kruskall-Wallis tests. Cox regression analysis was utilized to measure the effects between type of insurance and diagnostic resolution. Results: Compared to the hospital-based cohort (n = 236), more MMU patients (n = 97) were uninsured (71% vs. 2.1%, p &lt; 0.001) and less had private insurance (15% vs. 60%, p &lt; 0.001). The MMU cohort had longer time to diagnostic resolution (median 29 days, IQR 16-52) versus the hospital-screened cohort (median 14 days, IQR 7-29; p &lt; 0.001). Uninsured women had longer median time to diagnostic resolution than women with private insurance (30 vs. 14 days, p &lt; 0.001, Table 1) in both cohorts. Patients with no insurance had a lower rate of diagnostic resolution compared to patients with private insurance (HR 0.43, 95%CI [0.26, 0.71], p &lt; 0.001). Conclusions: Women screened in a MMU were less likely to have health insurance and more likely to experience delayed and incomplete diagnostic work-up. Furthermore, insurance status impacts diagnostic resolution irrespective of site of care. This study highlights the importance of insurance status on timely and complete diagnostic resolution in all patients receiving screening mammography, regardless of screening site, and the need for robust navigation services in patients screened at a MMU. Median days to diagnostic resolution based on type of insurance. Overall Mobile Facility p-value N = 333 N = 97 N = 236 Median Days to Diagnostic Resolution (IQR) Medicaid (N = 42) 24 (36.5) 63 (61.8) 14.5 (23.3) &lt; 0.001 Medicare (N = 60) 18 (22.8) 16 (7.5) 18 (25) 0.43 Private (N = 157) 14 (19.5) 19 (27.5) 13 (15.5) 0.02 Uninsured (N = 74) 30 (35.5) 30 (60.3) 22 (60.3) 0.49 Overall 17 (8,34) 14 (7,29) 29 (16,52) &lt;0.001 Type of Insurance by Site (n, %) &lt; 0.001 Medicaid (N = 42) 42 (13%) 10 (10%) 32 (14%) Medicare (N = 60) 60 (18%) 3 (3%) 57 (24%) Private (N = 157) 157 (47%) 15 (16%) 142 (60%) Uninsured (N = 74) 74 (22%) 69 (71%) 5 (2%)

Artificial intelligence as treatment support in breast cancer: current perspectives.

Breast cancer represents a significant burden of disease for women across the globe. Screening has been demonstrated to decrease breast cancer-related mortality. However, many nations do not have population breast cancer screening programs, which are key to early detection and can decrease mortality rates. In 2024, the International Federation of Gynecology and Obstetrics (FIGO) established the Committee on Breast Health to raise awareness about breast disease, advocate for improved prevention and treatment, and promote best practices. This manuscript aims to review national policies in screening and early detection across 7 of the countries represented in the FIGO Committee on Breast Health: Chile, Germany, India, Mexico, the Philippines, Senegal, and the United States. Policies for population screening for breast cancer are reviewed and compared across countries, as well as efforts in risk stratification. A framework for addressing population screening for breast cancer is also proposed that acknowledges resource and infrastructure limitations across nations. These efforts represent a critical step in addressing breast cancer-related mortality worldwide.

Transgender and gender-diverse (TGD) people have increased cancer morbidity and mortality relative to cisgender individuals. Existing breast cancer prevention guidelines fail to adequately address gender-affirming care implications, especially in the context of gender-affirming mastectomies (top surgery). Evaluation of familial and germline genetic risk before top surgery is recommended by some transgender health guidelines. This evaluation can facilitate shared surgical decision making regarding breast tissue resection extent. In this study, we use in-depth interviews with TGD people planning or having recently undergone top surgery. We aimed to understand barriers and facilitators to pre- and post-top surgery breast cancer risk assessment and screening, and the perceived utility and acceptability of presurgical genetic evaluation. We conducted qualitative community-engaged research through interviews with 16 TGD adults who had or were considering top surgery. Through a social constructivist lens, we used reflexive thematic analysis to generate themes. We conceptualized six key themes: (1) post-top surgery cancer screening uncertainty, (2) lack of provider knowledge hindering appropriate care, (3) the experience of breast health spaces as heavily feminized, (4) the balance of aesthetic goals with cancer risk reduction, (5) increased comfort with postsurgical screening because of reduced dysphoria and greater body confidence, and (6) the desire for cancer genetics integration with top surgery care navigation. From these themes, we derived actionable guidance to address breast cancer health equity in this population. Enhancing patient education, increasing provider awareness, and developing inclusive clinical practice guidelines are crucial steps in effectively addressing breast cancer risk in individuals receiving surgery. It is vital to degender health spaces to promote inclusion and accessibility of breast cancer prevention. Integrating genetics professionals and cancer risk assessment into transgender health clinics and the top surgery process is paramount for delivering personalized care and facilitating informed surgical decision making.

Effective breast cancer (BC) screening relies on shared decision-making and clear communication to help patients understand their risk and choose strategies aligned with that risk. The CanRisk tool was used to estimate BC risk in healthy women with a familial history of BC and the absence of a pathogenic variant in BC genes. Results were disclosed to patients using different formats, and data were collected to analyze the association between patient characteristics and risk communication preferences. Participants preferred their risk explained by percentages (59%) over fractions (15%), icon arrays (13%) or risk groups (13%) and 10-year risk estimation was favored to remaining lifetime risk (71% vs. 22%). Participants highlighted the use of positive and negative formats and comparison with the population's risk formats, and line graphic (61%) was selected over numerical table or a color-graph (19% each). However, participants with lower numeracy preferred color graphics (OR: 1.42; 95% CI 1.15-1.77 p = 0.001). The use of percentages, line graphics, and 10-year risk formats are highly accepted for healthy participants with a family history of BC, although adaptation may be needed for those with lower numeracy skills.

164 Background: TRAP laws impose unnecessary rules on abortion providers, hindering care like cancer screening for low-income women. This study examines TRAP laws' impact on breast and cervical cancer screening (BCS and CCS) rates in this group. Methods: We identified low-income women (≤$35,000 annual income) from the 2012-2018 Behavioral Risk Factor Surveillance System survey. States were grouped by TRAP law status: 1) existing, 2) new in 2017, 3) without. Outcomes were self-reported BCS via mammography for women aged 40 and above, and CCS via Pap test for women aged 21-65 without a history of hysterectomy, in the past year. Multivariate logistic regression estimated adjusted screening prevalence (aSP) and adjusted prevalence ratios (aPR), comparing 2012-2016 and 2018 screening rates by TRAP law. We also performed difference-in-difference (DiD) analysis on screening rates in TRAP vs. non-TRAP states between 2012-2016 and 2018. Results: From 2012 to 2016, BCS and CCS prevalence rates were similar between states with TRAP laws (BCS: 56.44%, CCS: 54.26%) and those without (BCS: 56.77%, CCS: 54.12%), with aPR of 1.08 for BCS and 0.91 for CCS. In 2018, BCS rates increased in states with existing TRAP laws (56.44% to 56.98%) but decreased in states with new TRAP laws (56.96% to 55.02%) and states without TRAP laws (56.77% to 54.36%). The aPR for BCS and CCS in states with new 2017 TRAP laws were 0.95 and 1.04, while states without TRAP laws had aPRs of 0.93 for BCS and 0.88 for CCS. All results were statistically significant at alpha = 0.05. The DiD analysis indicated a significant BCS increase in TRAP states compared to non-TRAP states from 2012-2016 to 2018, with a DID estimate of 0.0288 (p-value &lt;0.001). The DID estimate for CCS was 0.0158 (p-value 0.126), indicating no significant change. Conclusions: Overall, BCS rates increased in states with longstanding TRAP laws but decreased in states with new or no TRAP laws, suggesting a positive association between TRAP laws and BCS. However, no significant impact was observed for CCS, highlighting a more definite effect of TRAP laws on BCS among low-income women. Targeted restriction on abortion provider (TRAP) laws and breast and cervical cancer screening in low-income women. aSP* aPR* 2012-2016 2018 2012-2016 vs 2018 States with existing TRAP law Breast 56.44% 56.98% 1.08 Cervical 54.26% 48.44% 0.91 States with new TRAP law in 2017 Breast 56.96% 55.02% 0.95 Cervical 54.79% 56.51% 1.04 States without TRAP laws Breast 56.77% 54.36% 0.93 Cervical 54.12% 50.89% 0.88 Models adjusted for age, race, body mass index, marital status, education, insurance status, general health status, state, and year. *All results were statistically significant at alpha = 0.05.

Breast cancer remains a leading cause of mortality among women globally especially women of child bearing age in low and medium income countries thereby constituting serious public health concern. Awareness and screening practices for early detection and prompt intervention is of immense benefit. Objective: This study was done to assess the level of awareness and screening practices for breast cancer among women of child bearing age who presented at the General Outpatient Clinic (GOPC) of a secondary health facility in south-south Nigeria. Materials and Methods: It was a cross-sectional study done among 168 women of child bearing age selected conveniently at the GOPC of General Hospital, Ikot Ekpene, Akwa Ibom State, South South Nigeria. Data were obtained using interviewer-administered questionnaire and analysed with EPI-INFO Version 3.1 Results: Majority of the respondents, 73.81%, had heard of breast cancer and their source of information was mostly from health workers, 72.02%. On screening practices, only 9.52% and 7.74% had ever done self-breast examination (SBE) and radiological screening, mammography, respectively. Breast self-examination was significantly associated with age (P=0.001), educational status (P=0.01), marital status (P=0.001) and parity (P=0.01). Conclusion: While the awareness of breast cancer was high, screening practices for early detection and prompt treatment was poor. This calls for a more intense public awareness sensitization on the existence of breast cancer and the imperative of screening for early detection. Moreover, considering the cost implication of mammography, it is recommended that this modality of screening should be highly subsidized or made free for the population at risk, especially at the low income setting.

99 Background: Socioeconomic inequities limit access to cancer screening, undermining the benefits of early detection. While neighborhood-level financial exclusion, such as home loan denial rates (HLDRs) for conventional mortgages, may reflect broader access barriers, its relationship to screening uptake is poorly understood. We examined how HLDRs impact cancer screening utilization across American neighborhoods. Methods: We obtained cancer screening data from CDC PLACES, which utilizes BRFSS data and small-area estimation to generate census tract-level data. Outcomes included mammography among women 50–74y (2018, 2020, 2022), cervical cancer screening among women 21–65y (2018, 2020), and colorectal cancer screening among adults 45–75y (2018, 2020, 2022). Utilizing the Home Mortgage Disclosure Act database, we calculated HLDRs by census tract, matched to the same time period described for each screening outcome (2017-2018, 2019-2020, 2021-2022). HLDRs and census tract median income for corresponding years (from ACS 5-year estimates) were categorized into quintiles. We used univariable and multivariable beta generalized linear mixed models to examine the association between HLDRs and screening, adjusting for tract-level age, race, income, rurality, insurance status, and routine care access. Reported statistics include adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results: Cohort included &gt;82,000 census tracts across the US. Individuals residing in census tracts with higher mortgage denials rate were more likely to be younger (&lt;40y), have higher proportions of Black/AA residents, lower household income (&lt;$40k), no health insurance, and living in an urban center. In fully adjusted models (Table), odds of colorectal screening was 8.5% lower in the highest HLDR quintile (≥21.9%) compared to the lowest HLDR (&lt;10.6%). Similar patterns were seen for breast (4.8% lower odds) and cervical cancer screening (3.8% lower odds). Notably, this relationship between HLDR and cancer screening persisted across all income levels: within each income stratum (≤40k, 40-49k, 50-62k ≥63k), neighborhoods with higher HLDR were consistently associated with lower odds of each cancer screening (p &lt; 0.001 for all). Conclusions: Neighborhood-level financial exclusion, reflected in mortgage denials, is a novel and consistent predictor of lower cancer screening at all income levels. Federal policy efforts should integrate financial access measures to guide screening outreach and tackle structural cancer disparities. Multivariable analysis (aOR and 95% CI) of cancer screening and HLDR. HLDR Colorectal Breast Cervical ≥21.9% 0.92 (0.91, 0.92) 0.95 (0.95, 0.96) 0.95 (0.95, 0.96) 16.7% - 21.8% 0.95 (0.94, 0.95) 0.97 (0.97, 0.97) 0.97 (0.96, 0.97) 13.5% - 16.6% 0.96 (0.96, 0.96) 0.97 (0.97, 0.98) 0.98 (0.98, 0.98) 10.6% - 13.4% 0.98 (0.97, 0.98) 0.98 (0.98, 0.99) 0.99 (0.99, 0.99) &lt;10.6% Ref Ref Ref

The “Hand-as-Foot” teaching method in X-ray screening of breast cancer

Breast cancer continues to be a leading cause of morbidity and mortality worldwide, demanding timely diagnosis, comprehensive treatment, and coordinated care. Nurses play a critical role in bridging the gap between patients, healthcare teams, and the wider healthcare system. Their contributions span clinical management, psychosocial support, patient education, and public health initiatives, making them indispensable to high-quality breast cancer care [1, 2]. Specialist nurses provide targeted support throughout the cancer journey, addressing both physical and emotional needs. Patients consistently report that nurses offer clear communication, practical guidance, reassurance, and continuous availability, which reduces anxiety and improves overall well-being [3,4]. Beyond patient interaction, nurses contribute significantly to multi-disciplinary teams, coordinating planning, facilitating communication, and guiding the management of complex cases. They often introduce innovative solutions to navigate bureaucratic barriers and respond to patients’ and families’ immediate needs, demonstrating leadership and expertise within the clinical team. Primary care nurses further enhance breast cancer control by promoting early detection and health education at the community level. Evidence from Brazil shows that nurses in primary health care programs conduct clinical breast examinations, recommend mammography, and provide educational activities, though gaps exist in alignment with official guidelines due to high workloads and limited training [5]. Ensuring nurses receive continuous professional development and structured guidance enables them to perform effective screening, follow-up, and patient counselling, thereby reducing delays in diagnosis and treatment. Integrating specialist and primary care nursing roles is essential for delivering patient-centered breast cancer care. Nurses act as clinicians, educators, advocates, and coordinators, improving both individual patient outcomes and the efficiency of healthcare delivery. Studies consistently show that nurse-led interventions positively impact patient quality of life, promote early detection, and enhance team functioning [1,4]. Healthcare systems must recognize the value of nurses by providing structured protocols, ongoing training, and supportive working conditions. Positioning nurses at the core of breast cancer care enables the delivery of holistic, effective, and equitable services, ultimately improving survival rates and patient experiences. Investing in nursing roles not only strengthens clinical practice but also reinforces public health strategies, making nurses pivotal to advancing breast cancer care globally.