Breast Cancer Symptoms Research Articles

Evaluation of Knowledge, Perception, and Risk Awareness About Breast Cancer and Its Treatment Outcome Among University of Gondar Students, Northwest Ethiopia.

Background: Breast cancer is among the most common life-threatening public health problems of global concern including Ethiopia. Knowledge and awareness about the disease will help to reduce the number of cases who present at late stages of the disease. The objective of this survey was to assess the knowledge, perception and risk awareness about breast cancer among female medical and health science students of University of Gondar, Ethiopia.Methods: A cross sectional survey was conducted from May 03 to June 01, 2017 at University of Gondar, Ethiopia. Three hundred students were proportionally selected from nine departments using simple random sampling method. Using a structured questionnaire data on risk factors, symptoms and perception about breast cancer and its management approach was collected. Data were entered to and analyzed using SPSS version 21.Results: A total of 300 students had fully completed the survey making the response rate 95.24. The participants' mean age was 21.4 years with the standard deviation (SD) of 2.13 years. The overall level of knowledge on breast cancer was low. Majority of the participants were unaware for complex risk factors such as first child after the age of 30 years (51%), early onset of menses (55.3%), and menopause after the age of 55 years (47.7%) are liked with breast cancer even though they acknowledged old age, family history, and smoking as possible risk factors for breast cancer. Pain in the breast region, change in the shape of the breast, and nipple discharge were the most frequently correctly identified symptoms of breast cancer. Majority of the study participants had also correct beliefs about breast cancer management and its outcomes. however, they had negative perception of breast cancer treatment by considering it to be a long-term and painful process. In binary logistic regression analysis department (p = 0.000) and year of study (p = 0.008) were found to be an independent predicting factors for knowledge among the study participants.Conclusions: The overall level of knowledge on breast cancer and clinical breast examination guidelines was found to be low even though majority had positive perception toward the treatment and its outcomes. Hence, intensive breast health awareness campaign, which should also stress on the importance of early detection and reporting, is necessary to improve the knowledge about breast cancer.

Breast Cancer Awareness and Barriers to Early Presentation in the Gaza-Strip: A Cross-Sectional Study.

PurposeTimely detection of breast cancer (BC) is important to reduce its related deaths. Hence, high awareness of its symptoms and risk factors is required. This study aimed to assess the awareness level of BC among females in Gaza. Materials and MethodsA cross-sectional study was performed during September and October 2017 in Gaza, Palestine. Stratified sampling was used to recruit patients from four hospitals and seven high schools. The validated Breast Cancer Awareness Measure (BCAM) was used to assess confidence and behavior in relation to breast changes, awareness of BC symptoms and risk factors, barriers to seek medical help, and knowledge of BC screening. Women (age ≥ 18 years) visiting or admitted to any of the four hospitals, and female adolescents (age 15 to 17 years) in any of the seven schools, were recruited for face-to-face interviews to complete the BCAM. ResultsOf 3,055 women approached, 2,774 participants completed the BCAM questionnaire (response rate, 90.8%); 1,588 (57.2%) were adults, and 1,186 (42.8%) were adolescents. Of these, 1,781 (64.2%) rarely (or never) checked their breasts, and 909 (32.8%) were not confident to notice changes. In total, 1,675 (60.4%) were aware of the availability of BC screening programs. The overall mean ± standard deviation score for awareness of BC symptoms was 5.9 ± 2.9 of 11, and that of risk factors 7.5 ± 3.1 of 16. Feeling scared was the most reported barrier to seeking advice reported among women (n = 802; 50.2%), whereas feeling embarrassed was the most reported in adolescents (n = 745; 62.8%). ConclusionAwareness of BC symptoms, risk factors, and screening programs is suboptimal in Gaza. Educational interventions are necessary to increase public awareness of BC and to train local female breast surgeons to address barriers to early detection.

Promoting Early Diagnosis of Breast Cancer in Nigeria Using Materials Designed to Cross Communication Barriers of Fear, Taboo and Literacy Between Health Care Teams and the Community at Risk From Breast Cancer

Background: Nigeria, annually, has the highest numbers of death from breast cancer (BC) in Africa, estimated at 10,000. While BC incidence is declining in many parts of the world, it is increasing in Nigeria. Delay in BC diagnosis in Nigeria is due to: i) health care professionals (HCPs) and patients having poor knowledge of BC causation and symptoms; ii) incorrect diagnosis of symptoms; iii) delay in treatment seeking; iv) use of ineffective/harmful treatment methods.1 Low literacy rates, fear of cancer and the cultural taboos associated with BC create communication hurdles difficult to overcome.2 Aim: Increased HCP and patient of knowledge of BC causes, symptoms and detection, and improved communication between HCP and patients, resulting in increased and improved diagnostic protocol adherence, more patients self-reporting symptoms, and ultimately down-staging of patients. Methods: i) Aggregation of historical data of participating clinics of patients BC stage at diagnosis; ii) survey of HCP knowledge of BC symptoms and diagnostic protocols before and after seeing Worldwide Breast Cancer´s (WBC) Know Your Lemons (KYL) education materials; iii) frequency of display of KYL posters in clinics; iv) HCP survey of frequency of BC health discussions during a clinic visit; v) pre- and postsurvey of patient knowledge, interest and willingness to report symptoms at community education sessions, vi) count of number of patients reporting symptoms while making/attending clinic appointments. Results: Increase in HCP knowledge of symptoms and diagnostic protocols before and after seeing the KYL education materials; more visible use of patient friendly BC education materials displayed in the clinic; increase in frequency of breast health discussions initiated by HCPs with their patients; improved patient interest and knowledge of symptoms and diagnostic protocols; increase in patient confidence in being able to recognize a BC symptom; increase in patients making clinic appointments and self-referring symptoms to HCPs. Conclusion: As proven in other parts of the world with the KYL education materials, the researchers aim to prove, in undertaking this study in Lagos, Nigeria, that training HCPs (e.g., patient navigators, community workers, primary care physicians, mammography technicians) and patients in the signs/symptoms and risk factors for breast cancer using WBC´s bright, appealing and eye catching KYL materials can improve how HCPs and patients communicate about BC symptoms and detection option, which leads to earlier stage of diagnosis. 1. Agba et al, 2012; American Cancer Society, 2011; Cancer Today, 2012; Ogundipe, 2011; Osain, 2011; Prevalence of Breast Cancer, 2015. 2. Okpara and Kabongo, 2011; Total Facts Nigeria, 2017; World Atlas, 2017.

Improving Breast Health Literacy Through an Innovative Breast Cancer Awareness Campaign Using the Know Your Lemons (KYL) Materials in Malaysia

Background: Breast cancer (BC) is the most common cancer in Malaysia but has the worst survival in the Asia Pacific region. Main drivers identified in previous research include late-stage disease at presentation, poor adherence to treatment and sociocultural barriers. Factors affecting late presentations include lack of awareness on basic symptoms of BC and poor access to early detection. Although BC awareness campaigns have been done, Hadi et al., showed low BC awareness among university students in Malaysia. This is an evaluation of the “Show You Care, Be Aware” campaign that was done in University of Malaya, Kuala Lumpur in October 2017. The campaign was carried out using KYL materials through use of posters, awareness booths and public forums. The materials contain information on the normal breast, 12 symptoms of BC, information on breast self examination (BSE), screening and diagnostic (detection) pathways in Malay and English language. Aim: To evaluate the campaign effect on breast health literacy. Methods: A quasi-experimental research was conducted. The KYL materials were forward and backward translated by 2 native bilingual individuals. The context and content of the translation was ensured to be accurate and fitted into the KYL design. A total of 679 participants participated in the study. A self-designed questionnaire was used to assess effectiveness of the materials. Educational intervention sessions were provided in the form of KYL materials (leaflets, posters and banners) displayed in awareness booths in the campus. Discussion on leaflets and questions and answers, and practical demonstrations of BSE dummy were done. The questionnaire was administered through face to face interview. The data were analyzed via SPSS 20; descriptive and Wilcoxon matched paired signed rank test was performed. Results: 72% (n=492) of our participants were Malay, 19% (n=119) Chinese and 10% (n=68) Indians and others. Majority of our participants were female (94.2%), age 30 or below (61%), single (62.9%), had college or university education (85.7%). Most of our participants, 96.2% stated that the language used in the KYL materials were clear and understandable; 95.3% thought materials were attractive and 89.2% found them acceptable in Malaysian culture. 52.7% preferred Malay materials, 40.4% English and 6.5% in both Malay and English. The materials improved perceived knowledge on the process of detecting BC (96.5%). 92.8% agreed or strongly agreed that they felt more confident in recognizing the symptoms of BC themselves. There was an increase in self reported knowledge of BC; mean scores before and after exposure to KYL materials were 2.83 versus 4.30 respectively ( P < 0.001). Conclusion: Health education using KYL materials promoted breast cancer awareness, confidence in detecting symptoms and knowing processes of diagnosis among urban and educated Malaysians. Future research in lower educated and rural communities in Malaysia is warranted.

Overdiagnosis in breast cancer screening

The purpose of breast cancer screening is to reduce breast cancer mortality. In order to achieve this purpose, an X-ray search—a mammography examination—is made of the breast tissue of healthy women to detect potential cancers that have not given rise to symptoms. With early detection, a woman with breast cancer can be offered a more efficient treatment than it would otherwise had been possible. If screening works, women with screen-detected breast cancer will have a better prognosis than women diagnosed with symptoms of breast cancer.

A Community-Based Clinical Breast Examination Program: Is it Feasible?

Purpose Breast cancer presents in advanced stages in low- and middle-income countries where screening mammography is not available. In Malaysia, almost 60% of women, particularly in those the low socioeconomic group, present with stage III and IV breast cancer. We evaluated the feasibility of a community-based early detection program using clinical breast examination (CBE) carried out by the Breast Cancer Welfare Association, a nongovernmental organization. Methods Using a mobile clinic that was equipped to carry out CBE, a team of six health professionals trained in CBE techniques reached out to urban poor communities on the outskirts of the city and the rural population at the invitation of community leaders. At these events, breast self-awareness was taught to the community, with particular regard to the signs and symptoms of breast cancer and to breast self-examination. CBE was carried out in those women who agreed to be examined. Women who were found to have breast lumps were referred to the nearest public hospital and were observed for compliance. Women with anxiety were counseled. Results In 2016 to 2017, CBE was performed for 7,503 women, and 295 (3.9%) were found to have a palpable breast lump. These women were referred to the nearest hospital for additional assessment. Of these women, 156 (52.9%) consulted the doctor and sought additional examination. A total of 153 patients had no malignant findings, whereas three were found to have breast cancer. The mean age for women found to have a palpable breast lump was younger than 40 years—35 years in 2016 and 33 years in 2017—whereas the median age among the 295 women was 33 years in 2016 and 31 years in 2017 (range, 17 to 67 years). Conclusion A community outreach program using CBE as a method of early detection is feasible in Malaysia. Additional study is required to determine why 47% of those who were found to have a breast lump did not seek additional assessment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

“Alerta Rosa” Breast Cancer Navigation Program in Mexico: Initial Results and Plan of Action

Background and context: In Mexico, median time between breast cancer (BC) symptom detection and treatment initiation has been reported to be 7 months. We designed the “Alerta Rosa” navigation program with the intent to break down medical care barriers and reduce delays, as well as improve quality of care, by identifying and prioritizing patients with breast symptoms or abnormal breast imaging studies in Nuevo Leon, Mexico. In the first year, we achieved a median time from alert activation to treatment initiation of 33 days, thus shortening health system intervals and supporting the replication/adaptation for other limited resource settings. This project is supported by Susan G. Komen Foundation. Aim: We seek to increase efficiency and outreach of our navigation process in our region, as well as scale up and replicate the program in other parts of Mexico. Strategy/Tactics: Based on the results obtained and limitations observed during the initial year, we have designed changes that will improve our navigation model and patient outcomes. Patients with a palpable breast mass, bloody nipple discharge, nipple/skin retraction or BI-RADS 4 or 5 results will now be given maximum priority. Additionally, we will develop/adapt a computer software that will help refine logistics and care coordination activities, which will lead to increased operational efficiency and reduced costs. Finally, additional breast referral facilities will be incorporated to the current navigation program. These rearrangements will be implemented and evaluated in 2018. Program/Policy process: The following year, we will expand “Alerta Rosa” to a second city, evaluate sustainability and scalability, and make modifications to the program navigation and logistics as needed. After proving success, we intent to further increase the program reach to other regions across Mexico, to ultimately achieve an efficient referral system that will ease earlier BC care. Outcomes: We aim to keep our current standard of healthcare interval duration, while reaching a larger number of women and eventually expanding the project to other regions of the country. The indicators to measure success include time intervals from alert activation to diagnosis, referral, and treatment initiation. Other variables that are being collected are number of activated alerts, medical assessments, follow-ups, biopsies, and BC diagnoses. What was learned: In low-middle income countries, where BC screening programs do not effectively reach the target population, it is crucial to focus efforts in identifying and prioritizing symptomatic patients or those with abnormal imaging studies, to ultimately downstage BC. “Alerta Rosa” proved to be successful in reducing health system intervals and should be replicated and adapted for other limited resource settings. Therefore, we will work toward promoting the integration of this program to improve the current standard of BC healthcare in Mexico.

Cancer Awareness Among Community Pharmacists: A Systematic Review

Background: The WHO recognizes that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms. Aim: The aim of this review was to critically appraise evidence gathered from studies that; (1) explore or assess knowledge of community pharmacist on signs and symptoms of cancer, (2) explore or assess knowledge of community pharmacist on cancer screening. Methods: Embase (Ovid), CINAHL (EBSCOhost) and MEDLINE (EBSCOhost) were systematically searched for studies conducted between 2005 to July 2017. Studies that focused on knowledge of community pharmacist in cancer screening, signs and symptoms were included. Results: A total of 1538 articles were identified from the search, of which 4 out of the 28 potentially relevant abstracts were included in the review. Findings of the selected studies revealed lack of sufficient knowledge on breast cancer screening, signs and symptoms. Both studies attributed knowledge limitation as the cause of reason for the key findings of their studies. Conclusion: The selected studies focused largely on breast cancer, which hinder the generalizability and transferability of the findings. Hence there is a need for more studies to be conducted in this area to draw a better conclusion.

1571P - Breast cancer treatment waiting time, patient and provider contributions: An Egyptian breast cancer centre experience

Background: Breast cancer is the most common type of female cancer in Egypt and world wide. Most of the cases present as locally advanced or metastatic rather than early stages in Egypt. There is no data to assess waiting times in the Egyptian breast cancer patient journey from developing first symptom until initiating treatment. Methods: This is a descriptive study in which the electronic records and paper notes of 200 patients presenting from April until September 2016 to a public non governmental breast cancer centre in Cairo were reviewed for different waiting times. The wait time from developing the first symptom until commencing treatment was divided into stages; Symptom to call (booking an appointment), call to review , review to diagnosis, diagnosis to multidisciplinary team meeting (MDT) and MDT to first therapy. Results: The average time from developing symptom to booking an appointment (patient factor) was 131 days /4.4 months. The time lag from booking until medical review was 47 days /1.5 months. This is because of the booking system waiting list. The mean time taken from review until getting a final diagnosis was 11 days. All cases were discussed in the MDT and therapy ensued the MDT by 17 days in average. The mean in hospital waiting time (time from review until commencing treatment whether surgery, systemic therapy or radiotherapy) was 37 days while the mean time for the whole journey (symptom to treatment) was 214 days /7.1 months. Patients contributed to 61% of the wait time (131 days / 4.4 months) whereas the provider contributed by 39 % with average of less than 3 months. Conclusions: Patients contributed to the biggest part of the delay. The second factor was the booking system waiting list. Once reviewed by the medical team the process was accelerated. This indicates a need to improve public awareness of breast cancer symptoms and facilitate patient access to services. Legal entity responsible for the study: Baheya Research Centre (BRC). Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Evaluation of Breast Cancer (BC) Awareness among Female University Students in Zarqa University, Jordan.

The purposes of this study were to assess the level of Breast Cancer (BC) awareness of Jordanian female university students, measure their attitudes toward BC treatment, and compare the level of awareness and attitudes of students in the science and humanities faculties. The current study was cross-sectional and conducted among female students in Zarqa University in Jordan. Stratified random sampling and simple random sampling were employed to select the colleges and the students, respectively. The sample size was 326 students. Data was collected and analyzed by self-administered questionnaire and SPSS version 23.0, respectively. The number (proportion) of university students who had poor levels of awareness of BC, general knowledge about BC scale, knowledge about BC symptoms scale, and knowledge about risk factors of BC scale were was 270 (83%), 166 (51%), 182 (56%) and 292 (90%), respectively. Also, 92 (28%) students and 234 (72%) students had high and medium attitudes toward BC treatment, respectively. There were significant differences between the humanities and science faculties students' awareness about BC and their attitudes toward BC treatment (p<0.05). Also, the results revealed that the students' main information source about BC was mainly health-care professionals, followed by internet and television. The current status of awareness of BC among Jordanian female students and their attitudes toward BC treatment are insufficient. Therefore, university compulsory courses need to be modified to include BC topics and promote awareness about BC.

Poziom wiedzy z zakresu czynników ryzyka i profilaktyki raka piersi wśród studentek wrocławskich uczelni

ABSTRAKT Wstęp: Dotychczasowe badania wskazują, że mimo wielu kampanii informacyjnych na temat raka piersi wiedza kobiet w tym zakresie jest niewystarczająca lub niewykorzystywana w praktyce. Celem pracy była ocena wiedzy młodych kobiet (studentek) z zakresu czynników ryzyka i profilaktyki raka piersi. Materiały i metody: W badaniach uczestniczyło 320 studentek, respondentek z Akademii Wychowania Fizycznego we Wrocławiu (AWF), Politechniki Wrocławskiej, Uniwersytetu Wrocławskiego oraz Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu (UM). Narzędziem badawczym był kwestionariusz ankiety. Analiza uwzględniała miejsce zamieszkania oraz rodzaj uczelni. Wyniki: Miejsce zamieszkania nie wpływało na poziom wiedzy studentek w zakresie czynników ryzyka i profilaktyki raka piersi. Studentki w większości znały czynniki ryzyka raka piersi oraz jego objawy. Większą wiedzą w tym zakresie wykazały się studentki UM oraz AWF. Studentki z reguły nie miały wykonywanego badania piersi u lekarza, w większości nie dokonywały także samobadania piersi bądź robiły je nieregularnie. Najczęściej młode kobiety czerpały wiedzę na temat czynników ryzyka i profilaktyki raka piersi z mediów i prasy. Wnioski: Poziom wiedzy z zakresu czynników ryzyka i profilaktyki raka piersi wśród studentek wrocławskich uczelni można uznać za zadowalający, uzależniony był on jednak od wybranego kierunku studiów. Wiedza teoretyczna nie była wykorzystywana w praktyce. Niezależnie od profilu uczelni respondentki zgłosiły potrzebę prowadzenia kampanii na rzecz walki z rakiem w Polsce.

The \u2018Be Cancer Alert Campaign\u2019: protocol to evaluate a mass media campaign to raise awareness about breast and colorectal cancer in Malaysia

BackgroundBreast and colorectal cancer are the two most common cancers in Malaysia. Low awareness coupled with stigma and erroneous beliefs delay help-seeking behaviours, lead to late presentation and contribute to poor detection rates. Promoting cancer awareness through mass media may be effective in improving cancer-related knowledge and uptake in screening tests. However, research is sparse regarding the cultural translation and implementation of mass media campaigns in Malaysia (and Asia) in terms of raising awareness about colorectal and breast cancer.MethodsA collaborative partnership comprising researchers from Malaysia and the UK as well as policy makers, public health experts and non-government organisations from Malaysia was formed to design, deliver and evaluate the Be Cancer Alert Campaign. Each awareness-raising campaign will run for five weeks (Colorectal Cancer in April 2018, followed by Breast Cancer in October 2018). Evaluation of the campaigns will take place in Gombak district (Colorectal Cancer) and Petaling district (Breast Cancer) respectively, in the form of a pre-post randomly selected household survey and collection of service utilisation data. Occupants who are aged 40-years and above and are able to answer questions independently will be selected from each household. A sample of 730 with 80% power will detect a change of 6.09% in knowledge that unexplained lump or swelling is a symptom of breast cancer or changes in bowel habits is a symptom of colorectal cancer.DiscussionMalaysia and most South-East Asian countries have a low middle-income economy, with limited resources for cancer control. Late-staged cancers impose a significant economic burden on patients, households, communities, employers, health systems and governments. Our proposed strategy for the implementation of the culturally sensitive mass media cancer awareness-raising campaign will serve as a blueprint for cancer prevention and control policy in South-East Asian countries where the burden of cancer is increasing and there are high cancer death rates.

Alerta Rosa: Novel Alert and Navigation Breast Cancer Program in Nuevo Leon, Mexico, for Reducing Health System Interval Delays

In Mexico, the median time between breast cancer (BC) symptom detection and treatment initiation is approximately 7 months. Alerta Rosa is a program that was developed with the intent of breaking down medical care barriers and reduce delays. Through several media campaigns, we reached out to patients with breast symptoms or abnormal imaging studies. Patients contacted our call center or Facebook page. A navigator recorded their main complaint and scheduled a medical consultation with a specialist. We prioritized patients according to clinical risk. Those diagnosed with BC were referred to their health affiliation unit for care. To date, 656 patients have contacted our program. Median age was 44 years (range, 7-82). Patients reported becoming aware of Alerta Rosa mainly by word of mouth and TV. A total of 446 medical consultations were scheduled, and 309 patients attended their appointments. A biopsy procedure was solicited for 39 patients, and 22 were diagnosed with BC. Most patients had stage II (45%) or stage III (32%) disease. The median time from alert activation to treatment initiation was 33 days (range, 19-56) and from first medical evaluation to treatment initiation was 28 days (range, 16-48). In low- or middle-income countries, where BC screening programs do not effectively reach the target population, it is crucial to focus efforts in identifying and prioritizing symptomatic patients or those with abnormal imaging studies to ultimately downstage BC. Alerta Rosa proved to be successful in reducing health system intervals and could be replicated and adapted for other limited resource settings. In countries such as Mexico, infrastructure and financial drawbacks limit the implementation of effective screening mammography programs. This article presents a novel and effective alternative to optimize resources and reduce health system intervals, so that patients in limited-resource settings can have access to prompt quality care. This strategy for early breast cancer detection focused efforts in prioritizing symptomatic women and those with abnormal breast imaging studies. This article presents novel information that will be useful for the development of effective early breast cancer detection with a focus on opportunistic rather than population-screening mammography in low-resource settings.

Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria.

Objectives The aim of this study is to describe the characteristics and predictors of discontinuation during follow-up care among breast cancer patients at the Radiation Oncology Department, University College Hospital (UCH), Ibadan, Nigeria. Methodology This is a retrospective cross-sectional study of 504 patients with histological diagnosis of breast cancer referred for radiotherapy to the breast or chest wall. Data extraction form was used to obtain information on sociodemographic and disease related variables and time to discontinuation of care. Discontinuation rates and its predictors were estimated using Kaplan-Meier, Log rank test, and Cox's regression method of analyses. Results Five hundred and four breast cancer patients were studied. The mean age was 47.7years, 58.2% presented late with advanced stage disease, and 40% and 39% had metastasis and anaemia, respectively. Seventy-seven percent of patients discontinued follow-up care before completion of ten-year period. The 5-year and 10-year discontinuation rates were 69.8% and 92.6%, respectively. The median discontinuation time was 44 months. Discontinuers were more likely to be older than the age of 45years {HR=1.415; 95% CI= 1.044 - 1.917}, have metastasis {HR=1.793; 95% CI=1.396 - 2.302}, be anaemic {HR=1.404; 95% CI = 1.120 - 1.760)}, and have late-stage disease {HR=1.310; 95% CI = 1.407-1.639)}. Conclusion Breast cancer care discontinuation is associated with late presentation and advanced stage of disease. Therefore a system of community follow-up care and public awareness about breast cancer symptoms is recommended to reduce late presentation and discontinuity of care.

Breast Cancer Trend, Incidence, and Mortality in Kerman, Iran: A 14-Year Follow-up

Background: The present study aimed to investigate breast cancer trend, incidence, and mortality among Iranian women and was one of the first provincial and population-based studies to investigate breast cancer changes during 14 years in the largest province of Iran, Kerman. Methods: This was a population-based longitudinal study. Information about women diagnosed with breast cancer from 2001 to 2014 was obtained from the Cancer Registry of Kerman University of Medical Sciences. Independent-samples t test, one-way analysis of variance, linear regression, time series graphs, and fitted line plots were performed using SPSS 22 and Minitab 17.Results: A total of 2771 women were diagnosed with breast cancer in Kerman province from 2001 to 2014. The mean age of female patients was 49.52±12.88 years. The total incidence rate was 13.5 per 100,000 women and there was an increasing trend for incidence and age at diagnosis. Also, 254 women died from breast cancer during these 14 years and the mean mortality age was 54.16±14.33 years. There was also an increasing trend for mortality and age of death.Conclusion: There is an increasing trend for incidence and mortality from breast cancer in Kerman province and this requires interventions such as appropriate screening programs. Also, enabling physicians and increasing patient awareness to identify breast cancer symptoms is necessary.

Knowledge, attitude, and practice of breast Cancer among nurses in hospitals in Asmara, Eritrea

BackgroundBreast cancer accounted for 1.03% of all deaths in 2014 in Eritrea. Yet the knowledge, attitude, and practice (KAP) of the population in general or the health personnel in the country in relation to the disease, remains unknown. Hence, this study was designed to assess the KAP regarding breast cancer among female nurses working in ten hospital wards in Asmara, Eritrea.MethodsThis was a cross-sectional study conducted among 414 nurses. Descriptive statistics, t-test, and ANOVA were used to evaluate the KAP of the nurses.ResultsNurses’ knowledge about the possible risk factors of breast cancer was low but the nurses knew the signs and symptoms of breast cancer since each sign or symptom was mentioned by > 50% of them. The practice of breast cancer screening, however, was low (only 30 and 11.3% practiced clinical breast examination and mammography respectively). Respondents’ family history of breast cancer, having breast problems, their professional level and unit where they worked were associated with the KAP of nurses about breast cancer.ConclusionTraining programs could help to increase the nurses’ knowledge about the risk factors of breast cancer and practice of breast cancer screening. This could also help to increase the knowledge of the public about breast cancer.

Introduction to Breast Carcinogenesis – Symptoms, Risks factors, Treatment and Management

This paper aims to review current research and advancement in prevention and management of breast cancer. Occurrence of breast cancer has increased globally in the last decade. It been recorded that 15% of cancer-specific breast cancer. It is a comprehensive literature review on Breast cancer and its dependent variables created a theoretical foundation of the paper. Using the review-centric theory, a model was developed and presented to encapsulate the knowledge of the benefits associated with exercise on breast cancer outcomes through adiposity and immunological mechanisms. The model highlights breast cancer and its relationship with immunological biomarkers, obesity-related biomarkers, exercise or physical activity, biomarkers for adiposity. However more research is needed to understand the use of low doses of radiation inadequate screening, sometimes a screening test may not be able to show with certainty that there is no cancer, or occasionally may miss breast cancer. Overtreatment, some breast cancers that are found by mammography would never become a health problem in the woman’s lifetime. False negatives, other test results miss breast cancer. This shows how signs and symptoms of breast cancer, causes ad risks factors associated with breast cancer, treatment of breast cancer and the management of breast cancer malignancy can help in the decreased of mortality rate in woman and men who has and are likely to test malignancy to breast cancer disease.

Introduction to Breast Carcinogenesis – Symptoms, Risks factors, Treatment and Management

This paper aims to review current research and advancement in prevention and management of breast cancer. Occurrence of breast cancer has increased globally in the last decade. It been recorded that 15% of cancer-specific breast cancer. It is a comprehensive literature review on Breast cancer and its dependent variables created a theoretical foundation of the paper. Using the review-centric theory, a model was developed and presented to encapsulate the knowledge of the benefits associated with exercise on breast cancer outcomes through adiposity and immunological mechanisms. The model highlights breast cancer and its relationship with immunological biomarkers, obesity-related biomarkers, exercise or physical activity, biomarkers for adiposity. However more research is needed to understand the use of low doses of radiation inadequate screening, sometimes a screening test may not be able to show with certainty that there is no cancer, or occasionally may miss breast cancer. Overtreatment, some breast cancers that are found by mammography would never become a health problem in the woman’s lifetime. False negatives, other test results miss breast cancer. This shows how signs and symptoms of breast cancer, causes ad risks factors associated with breast cancer, treatment of breast cancer and the management of breast cancer malignancy can help in the decreased of mortality rate in woman and men who has and are likely to test malignancy to breast cancer disease.

Proportion of Specific Factors Risk of Breast Cancer on Women Age 25-65 Years

&lt;p&gt;Women who do early detection of breast cancer can be said to be still a little. Though the importance of breast examination since early is to know a woman's breasts under normal circumstances or not. This study aims to determine the proportion of several specific factors that cause the risk of breast cancer incidence in women aged 25-65 years with an observational analytic method with case control design. Sampling is done by using probability sampling with simple random sampling technique approach. The sample size was 23 women in the case group and 46 women in the control group in the working area of Gandus and Dempo, South Sumatera – Palembang sub-districts from May to September 2017. Screening data were collected using a questionnaire and analyzed by bivariate analysis using chi square and fisher's exact statistical tests, continued with multivariate analysis using multiple logistic regression statistic test. Based on the results of bivariate analysis found that there are 7 specific risk factors from the overall 15 related factors (p value &amp;lt;0.05) with risk factors for breast cancer incidence. The seven specific risk factors were age (OR: 0.6, 95% CI: 0.53-0.79), first menstrual period (OR: 24; 95% CI: 2.76-207.98), history of tumor (OR: 3.2, 95% CI: 2.28-4.75), long breastfeeding (OR : 95% CI: 2.23-4.54), consumption of fatty foods (OR: 0.2; 95% CI: 0.07-1.00), types of hormonal contraceptives (p value &amp;lt;0 , 05). The result of multivariate analysis with multiple logistic regression was found that menstrual age was the specific factor of a person detected at risk of breast cancer (p value 0.05-0.55) is very important because most women are not aware of breast cancer symptoms and risk factors that are difficult to handle.&lt;/p&gt;

Illness perceptions of Chinese women with breast cancer and relationships with socio-demographic and clinical characteristics.

The aim of the study is to explore the illness perceptions of Chinese women with breast cancer and relationships with their socio-demographic and clinical characteristics. A descriptive, correlational, and exploratory design was used. The Chinese version of the Revised Illness Perception Questionnaire was modified and used to collect data. Of the 16 common symptoms of breast cancer, the participants recognized only 2.81 symptoms, on average. Of the 6 causal factors, "uncontrollable factors" had the highest mean score, while "behavioural factors" received the lowest score. Most of the participants knew little about the disease, perceived that this illness is cyclic in nature and would not last for a long time, believed that the illness could have serious consequences but could be controlled, and reported having negative emotional responses to this illness. Most of the dimensions of illness perception were significantly correlated with one another. Furthermore, some socio-demographic and clinical characteristics were confirmed to be predictors of illness perceptions. These findings suggest that illness perceptions should be regarded as a whole to guide the coping process of Chinese women with breast cancer and provide new clinical information to support care for this group.