Breast Examination Research Articles

Knowledge and Practices of Breast Self-Examination among Female Students of Bahria University of Health Sciences Karachi

Breast Self-Examination is an efficient approach for investigating physical and visual abnormalities in breast tissue. Objective: To evaluate the awareness, knowledge, practice of breast self-examination among female university students in five colleges of Bahria University Health Sciences Karachi. Methods: A cross-sectional study at Bahria University Health Sciences Campus Karachi with random sampling among female students from the Dental, Medical, Doctor of Physical Therapy, Nursing sections and Medical Laboratory Technicians. The data were collected using a self-administered google questionnaire form distributed online via WhatsApp. The questionnaire encompassed sections on the socio-demographic characteristics of the participants, as well as their awareness, knowledge, attitude, and practice towards BSE. For data analysis SPSS Software version 25.0 was used. Results: 240 female participants were enrolled in study, 77.5% knew the meaning of BSE, while 31.7% had complete knowledge. 5.4% BDS students did it in routine practice, 63% believed, it helps in cancer monitoring, 22.8% performed to detect nodules and 8.7% carried out because of family history. Out of 110 participants from nursing section, 7.3% followed BSE in routine practice, 65.5% believed it’s beneficial in the detection of cancer. However, the main reason for performing was detection of cancer 62.9%. Several barriers were encountered such as time constraint, lack of knowledge 46.7%, uncomfortable 6.7%, fear 30.4% and misconception. Conclusions: Participants had understanding of BSE but they lacked complete knowledge of breast self-examination due to limited access to health care resources and insufficient understanding about the technique also encounter significant barriers during practicing.

Comparison of knowledge, attitudes, and behaviors regarding breast self-examination among health and non-health students

Comparison of knowledge, attitudes, and behaviors regarding breast self-examination among health and non-health students

From Awareness to Action: Assessment of Breast Cancer, Self-Examination, and Mammography Knowledge with Subsequent Screening Among Urban Women

From Awareness to Action: Assessment of Breast Cancer, Self-Examination, and Mammography Knowledge with Subsequent Screening Among Urban Women

Approach to: the Patient with a Palpable Breast Mass

Palpable breast masses are common reasons for presenting to the primary care or emergency clinic setting. Although most palpable masses are benign in etiology, the possibility of malignancy exists and may be anxiety-inducing to patients. A systematic approach to history-taking, to clinical breast examination and to imaging is important for the adequate evaluation of a palpable breast mass. This article aims to provide medical students with a stepwise approach to the evaluation and diagnosis of palpable breast masses. Given the wide spectrum of diseases associated with palpable masses, the differential diagnosis and management is out of the scope of this paper. However, we will touch upon the breast cancers most commonly associated with breast masses and briefly mention their respective treatments.

Epidemio-Clinical Profile and Management of Carcinoma in Situ of the Breast in the Department of Obstetrics and Gynecology II of the CHU HASSAN II of Fès: 2000-2024

Breast cancer is the most common cancer in women and is, therefore, a major public health problem. Among the different types of breast cancer, breast carcinoma in situ occupies a special place because of its pre-invasive nature. Ductal carcinoma in situ (DCIS) accounts for 85% to 90% of in situ breast cancers. Their incidence is increasing as a result of widespread screening. Lobular carcinoma in situ remains a rare lesion and is considered to be a cancer risk factor. Diagnosis of this cancer is quite difficult, and treatment is team-dependent, ranging from conservative treatment to mastectomy. The aim of our study was to describe the epidemiological and clinical characteristics of patients with carcinoma in situ isolated within the gyneco-obstetrics II department in Fez, as well as the therapeutic modalities. 19 patients were included; the mean age of our patients was 56 years, with extremes ranging from 34 to 88 years. The average consultation time was seven months; the mode of discovery was dominated by the discovery of a nodule on a breast self-exam in 13 patients (72%), followed by a pathological nipple discharge in 5 and a combination of two in one patient. The average tumor size was 3 cm, with extremes ranging from 1 cm to 5 cm. Combined screening with mammography and breast ultrasound was carried out in all our patients (100%), supplemented by MRI in 4 patients (high breast density) with a view to conservative treatment. Histology was dominated by ductal carcinoma in 17 patients (92%). The surgical procedure was conservative in 5 patients (28%) and radical in 13 (72%). 3 out of the 5 patients who had undergone conservative surgery underwent revision surgery (mastectomy) due to positive surgical margins (60%). 11 (61%) patients benefited from an axillary procedure essentially by sentinel lymph node biopsy which was negative (100%).

Optimization of health promotion through audiovisual media and leaflets to increase adolescents' awareness of breast self-examination

Optimization of health promotion through audiovisual media and leaflets to increase adolescents' awareness of breast self-examination

Multifaceted barriers associated with clinical breast examination in sub-Saharan Africa: A multilevel analytical approach.

Clinical breast examination (CBE) open the pathway to early detection and diagnosis of breast cancer. This study examined barriers to CBE uptake in seven sub-Saharan African (SSA) countries. Data from the most current Demographic and Health Surveys of Burkina Faso, Cote d'Ivoire, Ghana, and Kenya Mozambique, Senegal and Tanzania was used. A weighted sample size of 65,486 women aged 25-49 years was used to estimate the pooled prevalence of CBE. We employed a multilevel logistic regression modelling technique, with results presented in adjusted odds ratios (aOR) along with a 95% confidence interval (CI). The pooled prevalence of CBE uptake in the studied SSA countries is low at 19.2% [95%CI: 18.5-19.8]. Screening uptake was significantly low among women reporting difficulty in getting permission (aOR = 0.88, 95% CI: 0.82-0.95), and distance (aOR = 0.95, 95% CI: 0.89-0.99), as well as those who reported financial constraints (aOR = 0.92, 95% CI: 0.88-0.97), as barriers to access healthcare facilities. However, surprisingly, women who faced travel-alone barriers were 1.19 times (95%CI: 1.10-1.28) more likely to utilise CBE than those who did not face this barrier. We conclude that barriers such as difficulties in obtaining permission, long distances to healthcare facilities, and financial constraints significantly reduce the likelihood of women undergoing CBE. The study underscores a need to improve access to healthcare facilities. Practically, this can be achieved by expanding mobile health services and integrating CBE into primary healthcare will help overcome distance-related challenges. Additionally, targeted outreach and transportation initiatives are necessary to support women facing travel barriers.

Predictors of breast self-examination practices among female undergraduates in selected tertiary institutions in Ogun State, Nigeria: The Health Belief Model Approach

Predictors of breast self-examination practices among female undergraduates in selected tertiary institutions in Ogun State, Nigeria: The Health Belief Model Approach

Assessment of Knowledge, Attitudes and Needs of Accredited Social Health Activist (ASHA) in Community based Cancer Awareness and Screening Programme: A Mixed Method Study from a Rural Area in Central Kerala, Southern India

Introduction: Cancer is the leading cause of death worldwide. Primary prevention through health education and secondary prevention through early detection and treatment can alter cancer burden and outcomes. The current study focuses on the possibility of establishing Accredited Social Health Activist (ASHAs) as facilitators in cancer awareness generation and screening. Aim: To assess the knowledge and attitudes of ASHAs in awareness generation and encouraging screening for cancers, and to explore their needs as facilitators in cancer control. Materials and Methods: A mixed-method study was conducted in Kuzhalmannam Panchayath in Palakkad district of Kerala, India, among 30 ASHAs, for two-months from 15th August 2022 to 14th October 2022 in two phases. In phase 1, data regarding knowledge about common cancers, risk factors, danger signs, and screening methods, along with attitudes toward functioning as facilitators, were collected (cross-sectional). Phase 2 comprised Focus Group Discussions (FGDs) for exploring needs. Data were analysed using Statistical Packages for Social Sciences (SPSS) version 20.0 (phase 1). Thematic analysis followed in phase 2. Quantitative and qual itative variables were summarised as means and percentages. Results: The mean age of the ASHAs surveyed was 44.73±5 years. All ASHAs were aware that cancer did not transmit through contact, and 27 (90%) participants knew about the existence of risk factors. Knowledge about family history and the human papillomavirus as risk factors for cancers of the breast and cervix was inadequate. Breast lumps 6 (20%) and blood loss 5 (16.67%) were the common danger signs known. Though 26 (87.67%) participants knew that screening could detect cancers early, knowledge about PAPs smear 6 (20%) and breast self-examination 5 (16.6%) was inadequate. All ASHAs had positive attitudes to raise awareness and encourage screening. For 10 (33.33%) participants, incomplete knowledge created anxiety. Their needs as facilitators emerged under two global themes: functional and aspirational. The quantitative data showed a gap in specific knowledge areas, which was also echoed in FGDs, where ASHAs requested more training and supervision. Conclusion: The ASHAs had a positive attitude to serve as advocates for cancer control. Knowledge gaps created anxiety. Interventions including training, supervision, and better payment are required to address their needs.

Artificial intelligence for breast cancer detection and its health technology assessment: A scoping review.

Recent healthcare advancements highlight the potential of Artificial Intelligence (AI) - and especially, among its subfields, Machine Learning (ML) - in enhancing Breast Cancer (BC) clinical care, leading to improved patient outcomes and increased radiologists' efficiency. While medical imaging techniques have significantly contributed to BC detection and diagnosis, their synergy with AI algorithms has consistently demonstrated superior diagnostic accuracy, reduced False Positives (FPs), and enabled personalized treatment strategies. Despite the burgeoning enthusiasm for leveraging AI for early and effective BC clinical care, its widespread integration into clinical practice is yet to be realized, and the evaluation of AI-based health technologies in terms of health and economic outcomes remains an ongoing endeavor. This scoping review aims to investigate AI (and especially ML) applications that have been implemented and evaluated across diverse clinical tasks or decisions in breast imaging and to explore the current state of evidence concerning the assessment of AI-based technologies for BC clinical care within the context of Health Technology Assessment (HTA). We conducted a systematic literature search following the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist in PubMed and Scopus to identify relevant studies on AI (and particularly ML) applications in BC detection and diagnosis. We limited our search to studies published from January 2015 to October 2023. The Minimum Information about CLinical Artificial Intelligence Modeling (MI-CLAIM) checklist was used to assess the quality of AI algorithms development, evaluation, and reporting quality in the reviewed articles. The HTA Core Model® was also used to analyze the comprehensiveness, robustness, and reliability of the reported results and evidence in AI-systems' evaluations to ensure rigorous assessment of AI systems' utility and cost-effectiveness in clinical practice. Of the 1652 initially identified articles, 104 were deemed eligible for inclusion in the review. Most studies examined the clinical effectiveness of AI-based systems (78.84%, n= 82), with one study focusing on safety in clinical settings, and 13.46% (n=14) focusing on patients' benefits. Of the studies, 31.73% (n=33) were ethically approved to be carried out in clinical practice, whereas 25% (n=26) evaluated AI systems legally approved for clinical use. Notably, none of the studies addressed the organizational implications of AI systems in clinical practice. Of the 104 studies, only two of them focused on cost-effectiveness analysis, and were analyzed separately. The average percentage scores for the first 102 AI-based studies' quality assessment based on the MI-CLAIM checklist criteria were 84.12%, 83.92%, 83.98%, 74.51%, and 14.7% for study design, data and optimization, model performance, model examination, and reproducibility, respectively. Notably, 20.59% (n=21) of these studies relied on large-scale representative real-world breast screening datasets, with only 10.78% (n =11) studies demonstrating the robustness and generalizability of the evaluated AI systems. In bridging the gap between cutting-edge developments and seamless integration of AI systems into clinical workflows, persistent challenges encompass data quality and availability, ethical and legal considerations, robustness and trustworthiness, scalability, and alignment with existing radiologists' workflow. These hurdles impede the synthesis of comprehensive, robust, and reliable evidence to substantiate these systems' clinical utility, relevance, and cost-effectiveness in real-world clinical workflows. Consequently, evaluating AI-based health technologies through established HTA methodologies becomes complicated. We also highlight potential significant influences on AI systems' effectiveness of various factors, such as operational dynamics, organizational structure, the application context of AI systems, and practices in breast screening or examination reading of AI support tools in radiology. Furthermore, we emphasize substantial reciprocal influences on decision-making processes between AI systems and radiologists. Thus, we advocate for an adapted assessment framework specifically designed to address these potential influences on AI systems' effectiveness, mainly addressing system-level transformative implications for AI systems rather than focusing solely on technical performance and task-level evaluations.

Modelling the health, financial protection and equity impacts of upscaling the ACT NOW early intervention breast cancer pilot program in the Philippines: an extended cost-effectiveness analysis

IntroductionWomen in the Philippines experience significant health and economic burdens of breast cancer. The Philippines has reformed financial protection for breast cancer but does not have a national early detection...

Exploring barriers to early breast examination and screening among Arab women in the MENA region: A KAP study

Exploring barriers to early breast examination and screening among Arab women in the MENA region: A KAP study

Assessment of antenatal care quality in Ethiopia: Facility-based study using service provision assessment data.

Antenatal care (ANC) coverage in low- and middle-income countries has increased in the past few decades. However, merely increasing care coverage may not enhance maternal and newborn health unless the recommended service components are also provided. Our aim was to assess the quality of ANC and its associated factors in Ethiopia. We used data from 2,042 pregnant women whose first ANC consultation was observed. Data were obtained from the 2021-2022 Ethiopian Service Provision Assessment survey conducted among a nationally representative sample of 1,158 healthcare facilities. Twenty-four components of ANC were assessed, and their values were summed to generate a total ANC quality score (range: 0-24). A higher score indicated a superior ANC quality. A multiple generalized Poisson regression model was fitted to identify factors influencing the quality of ANC. All statistical analyses were performed using STATA version 16. The mean ANC quality score was 11 (standard deviation [SD]: 3.8). Blood pressure measurement was the most commonly performed ANC component, at 79.5%, and breast examination for cancer screening was the most neglected component of ANC, at 3.3%. ANC quality was higher in the Amhara region (incidence rate ratio [IRR]: 1.088; 95% confidence interval [CI]: 1.0-1.171) and Southern Nations, Nationalities, and Peoples' Region (IRR: 1.081; 95% CI: 1.002-1.166), and when the care was provided by a female healthcare worker (IRR: 1.054; 95% CI: 1.021-1.088). On the other hand, ANC quality decreased in rural healthcare facilities (IRR: 0.964; 95% CI: 0.932-0.998), clinics (IRR: 0.666; 95% CI: 0.581-0.764), and health posts (IRR: 0.817; 95% CI: 0.732-0.91). Similarly, ANC quality decreased when gestational age at the first antenatal visit increased (IRR: 0.994; 95% CI: 0.992-0.996) and when care was received from a non-nearby healthcare facility (IRR: 0.956; 95% CI: 0.923-0.990). Overall, the quality of ANC in Ethiopia is suboptimal. Encouraging women to initiate ANC early and utilize nearby facilities, assisting providers in delivering standardized services through preservice training, supervision, and continuous education, and ensuring the availability and proper use of necessary resources at all facilities are important to improve ANC quality.

Acceptability and Determinants of Opportunistic Screening for Breast Cancer in Indian Women.

Screening for breast cancer has been effective in decreasing mortality. Mammography is not readily available in resource-limited countries like India. Annual clinical breast examination has been demonstrated to be as effective as biennial mammography in reducing mortality with much less cost. In absence of an organized systematic screening program opportunity of women visiting the hospital can be used to educate and screen. The current study was designed to assess the acceptability, determinants of acceptability and effectiveness of opportunistic breast cancer screening. A prospective cross-sectional study was conducted at a tertiary care center in central India. Women of age >35 years with no breast complaints were offered to undergo screening for breast cancer by clinical breast examination. Women with non-breast related complaints or accompanying some other patients were included. Abnormal findings on clinical breast examination were followed by ultrasound (<40 years of age) or mammography (>40 years of age). Standard methods of examination were used. The sample size was 382 and the duration of the study was 2 years. In the study out of 382 participants 255 (66.74%) accepted the examination and 127 denied. Only 66% of participants consented for screening and a lump was detected in seven (2.7%) women. All seven women with breast lump refused further diagnostic work-up. Acceptance of screening was not significantly affected by religion, educational status, marital status and occupation. There was low acceptability to screening, awareness about breast cancer and treatment compliance rates to further management. Acceptability of screening is not affected by socioeconomic or educational status.

Knowledge, Attitude and Practice of Breast Cancer among Female Students: A Cross-Sectional Study from Pakistan

Breast cancer is a significant global health concern, with early detection being critical for improving survival rates. Objective: To evaluate the Knowledge, Attitudes, and Practices (KAP) regarding breast cancer among female university students. Method: Data were collected through structured questionnaires administered to a representative sample of students. Results: The study showed a positive attitude among female students regarding Breast Cancer (BC): 80% believed BC could be prevented, 67% recognized family history as a risk factor, 77% felt comfortable discussing BC with doctors, and 93% emphasized public education. However, significant gaps in practices were observed: 46% never attended BC awareness sessions, 28% never adopted preventive lifestyle changes, 36% did not seek medical advice for breast changes, 73% never had a mammogram, and 30% never performed breast self-examinations. Conclusion: These findings underscore the need for improved education and practical interventions to enhance BC awareness and early detection behaviors.

The Influence of Audiovisual Educational Media on the Knowledge and Attitudes of Female Adolescents at SMUN 5 Pekanbaru regarding Breast Self-Examination (SADARI)

The incidence of breast cancer has increased and is ranked first in relation to cancer in Indonesia and is one of the leading causes of death due to cancer with the number of new cases reaching 68,858 cases. This incident can be prevented by early detection which can be done by self-breast examination. The purpose of this study was to see whether there was an influence of audio-visual educational media on the knowledge and attitudes of female adolescents at SMAN 5 Pekanbaru regarding self-breast examination (SADARI). This study was conducted using a quasi-experimental method with a sample size of81 people were taken by proportioned stratified random sampling. The analysis was conducted using the Wilcoxon test. The results obtained were that there was an influence of audiovisual educational media on the Knowledge and Attitudes of adolescent girls with a pvalue of 0.000 for knowledge and 0.000 for attitudes. It is hoped that in the future the provision of information can be done using audiovisual media.

The Prevalence of Breast Self-Examination Practice Among Women in Iran: A Systematic Review and Meta-Analysis

The Prevalence of Breast Self-Examination Practice Among Women in Iran: A Systematic Review and Meta-Analysis

AN ANTHROPOLOGICAL STUDY ON BREAST CANCER AWARENESS AMONG WOMEN (WITH REFERENCE TO THE MAHAOYA DIVISIONAL SECRETARIAT IN AMPARA DISTRICT, SRI LANKA)

Cancer can be identified as a worldwide health problem. The health sector has been given more attention to the breast cancers, as this is a rapidly growing serious condition among women. Although this condition is fatal, the condition can be controlled with early detection. However, the death rate caused by breast cancer is growing worldwide. According to the data of the World Health Organization, 685,000 people died from breast cancer in 2020. Breast cancer accounts for 12.5% of all cancers reported annually worldwide. There is also a trend of breast cancer being reported in the Sri Lankan society as the increase of 4%. It shows that there is a minimum level of awareness about the early dection of breast cancer among women. Taking this as a research problem, this study was conducted with the aim of identifying the awareness among women about breast cancer. Study area was selected at the Unuwathurabubula village in the Mahaoya divitional secretarial in Ampara district. Random sampling and judgment sampling methods were used to select the study sample. Judgment sampling method was used to select 05 women with breat cancer with the support of the midwife and random sampling method was used to select 55 women over the age of 35 living in the village to get the data after gettting their consent. Data were collected using an interview schedule, observation and through case studies. It was revealed that the highest number of respondents, 69%, do not know the need of doing a self breat examination with age. It was clear that 20% of the respondents had a family hisory for breast cancer too. Aaccording to the case studies, all the respondents were affected by breast cancer in the age of 40-50 years. All these respondents (100%) have ignored the early symptoms for a long time due to the lack of awareness. The main finding was that the majority (80%) of the women who were affected by the disease were under some kind of mental stress in recent time durations before the onset of the disease. It is timely important to educate women about the breast cancers and to stress the importance of self breast examination to detect them in early stages to get rid of complications.

Factors associated with knowledge and practice of breast self-examination among female governmental school teachers in Gondar Town, Northwest Ethiopia, 2019.

Breast cancer is the most common cancer among women globally, and early detection through breast self-examination can improve survival rates. However, this practice is limited in developing countries like Ethiopia. This study aimed to assess the factors influencing knowledge and practices related to breast self-examination among female governmental school teachers in Gondar Town, Northwest Ethiopia. A cross-sectional study was conducted from May 1 to 30, 2019, with 422 female teachers in Gondar metropolis governmental schools selected through simple random sampling. Data were collected using a self-administered questionnaire and analyzed using EPI INFO version 7 and SPSS version 20. A total of 415 female teachers participated in the study, with a response rate of 98.3%. The mean age of respondents was 38.64 years. Only 41.9% had good knowledge of breast self-examination, while 14.5% reported good practice. Factors associated with knowledge included secondary education, higher degrees, and exposure to information. Factors influencing practice included having a degree or higher education and prior experience with breast self-examination. The study revealed low levels of knowledge and practice of breast self-examination among female teachers. Educational level was significantly associated with both knowledge and practice. Recommendations include implementing health education campaigns, organizing events like breast cancer awareness days, and forming support groups in schools to promote awareness and encourage regular breast self-examination among female teachers in Ethiopia.

Clinical breast examination and its associated factors among reproductive age women in Ghana: multilevel logistic regression analysis.

Breast cancer poses a significant health burden in Ghana and globally, being the primary cause of cancer-related illness and death among women. The World Health Organization has identified clinical breast examination as the gold standard for women in low and middle-income countries. However, the uptake of clinical breast examination remains low in these settings, including Ghana, where the nationwide prevalence and associated factors of this practice have not been determined. Therefore, this study aimed to assess the prevalence and factors associated with clinical breast examination among women of reproductive age in Ghana, using data from 2022 Ghanaian Demographic and Health Survey. In this study, data from the most recent Ghanaian Demographic Health Survey conducted in 2022 were utilized. The survey used a two-stage stratified sampling technique, and a weighted sample of 15,013 participants was included in the analysis. Descriptive statistics, such as frequencies, percentages, and graphical representations, were utilized to present the study's findings. Multilevel mixed-effects logistic regression analysis was employed to identify factors associated with clinical breast examination. The study found that the prevalence of clinical breast examination was 18.39% (95% CI: 17.8-19.0%). Age group of 45 to 49 (AOR=2.84, 95% CI: 2.13, 3.78), having completed secondary education (AOR=1.70, 95% CI: 1.41, 2.06), having diploma or above education (AOR=3.63, 95% CI: 2.86, 4.61), using modern contraception (AOR=1.12, 95% CI: 1.00, 1.25), having health insurance coverage (AOR=1.53, 95% CI: 1.24, 1.89), listening to the radio at least once per week (AOR=1.35, 95% CI: 1.20, 1.53), reading a newspaper at least once per week (AOR=1.75, 95% CI: 1.39, 2.21), being tested for HIV (AOR=1.92, 95% CI: 1.68, 2.19), undergoing screening for cervical cancer (AOR=6.64, 95% CI: 5.51, 7.99), being currently employed (AOR=1.17, 95% CI: 1.02, 1.34), visiting a health facility within the past 12 months (AOR=1.36, 95% CI: 1.23, 1.51), belonging to the wealthiest wealth categories (AOR=1.70, 95% CI: 1.27, 2.28), being from the North East region (AOR=1.96, 95% CI: 1.19, 3.22) or Oti region (AOR=0.54, 95% CI: 0.34, 0.92), having a greater distance to a health facility (AOR=0.86, 95% CI: 0.75, 0.98), and being from a community with a higher proportion of educated individuals (AOR=1.31, 95% CI: 1.07, 1.61) were significant associated factors of clinical breast examination. The study revealed that the magnitude of clinical breast examination among Ghanaian women was low. Age, educational status, modern contraceptives utilization, health insurance coverage, media exposure, HIV testing, cervical cancer screening, occupation, health facility visits, wealth index, and region were significantly associated with clinical breast examination. These findings suggest that public health interventions should prioritize addressing these factors to increase clinical breast examination uptake and promote early detection of breast cancer to improve the survival of women with breast cancer.