Women's Breast Health Research Articles

Beyond October, Beyond Pink: A Year-Round Revelation for Women's Breast Health.

Beyond October, Beyond Pink: A Year-Round Revelation for Women's Breast Health.

Attachment to God and coping with the diagnosis and treatment of breast cancer: a longitudinal study.

Religious/spiritual factors are important for some individuals in the context of life stress. To the authors' knowledge, the present study is the first to explore the role of women's attachment to God (anxious vs secure) in their adjustment to breast cancer. To explore the (1) pattern of change in women's attachment to God across time and (2) relationship between attachment to God and coping behaviors and depression. All English-speaking women who were scheduled to receive a core breast biopsy at a women's breast health center were eligible to participate in the study. Women were assessed on attachment to God, positive and negative coping, and depression at pre-diagnosis and 3, 6, and 12 months post-diagnosis. Women who received a benign diagnosis and those with a diagnosis of breast cancer participated in the study. Attachment to God remained stable across time for both diagnostic groups (cancer, benign). Women from both groups who had a more anxious attachment to God utilized more avoidance coping and reported more depression at different points across time. Breast cancer patients with a more anxious attachment to God reported engaging in less acceptance coping post-diagnosis. Finally, the association between attachment to God and depression was partially mediated by avoidance coping at pre-diagnosis. Findings indicate that a more anxious attachment to God may contribute to negative patterns of adjustment while a secure attachment may help women remain more directly engaged in their coping with the threat of breast cancer and related diagnostic procedures. It is suggested that clinicians remain sensitive to and assess the role of spiritual beliefs in women's adjustment to the threat of breast cancer from pre-diagnosis up to 1 year post-diagnosis. In particular, women's belief in and experience of a secure or an anxious attachment with God or higher power may function as a potential resource or as an exacerbating factor, respectively, in their adjustment to breast cancer.

Related factors affecting women early breast cancer screening behavior and effect of nursing intervention

Objective To explore women's influence factors early breast cancer screening behavior and the effect of nursing intervention. Methods A total of 100 women were selected as the research object, the intervention group was given a one-year for breast cancer knowledge and health belief model nursing intervention measures, while control group was given 1 normal mammary gland disease health education knowledge. Results Intervention group was improved health beliefs, perceived susceptibility and benefits early screening than those of control group. At the same time, self examination, clinical examination and X- ray radiography inspection participation were also significantly higher than those in control group. Conclusions Understand related factors affecting women early breast cancer screening behavior and health belief to guide nursing intervention measures, could obviously enhance women's breast health care consciousness, promote breast check behavior and improve medical participation rate. Key words: Breast cancer in women; Early screening; Behavior factors; The health belief model; Nursing intervention

Abstract P1-10-10: Organizational Use of Evidence-Based Strategies To Promote Timely Mammography among Medically Underserved Clients Recruited through the Avon Breast Health Outreach Program

Abstract Background: Income-related disparities in breast cancer screening rates are due to barriers to mammography that are more prevalent among lower-income groups. To address barriers to completion of screening mammography, the US Preventive Services Task Force recommends client-oriented interventions to increase demand and improve access. While evidence-based strategies have shown increased use of mammography for lower-income populations, little is known about the use of these strategies in real-world settings. Since 2001 the Avon Foundation for Women Breast Health Outreach Program (Avon BHOP) has granted over $53 million to more than 200 organizations to promote screening for breast cancer. Data collection and reporting requirements examine the reach of the program and utilization of evidenced-based interventions in diverse settings to promote repeat use of mammography among low-income women. Methods: This cross-sectional study describes the use of evidence-based strategies among Avon BHOP grantees to promote rescreening among returning clients, age 40-64, with no history of breast cancer; and examines associations between the strategies and use of mammography within the previous two years. Data were collected from two sources: 1) online survey administered to 149 organizations in 2009 to ascertain program strategies and 2) client intake form completed by clients or staff at Avon-funded agencies when women returned for annual mammograms. Organizational-level analysis included agencies that responded to the online survey and were funded by Avon from 2006-2009. Results: Characteristics of the 86 organizations in the sample included: US geographic location (17% Mid-West, 27% Northeast, 30% South, and 26% West); 45% clinical sites; and delivery of the program to underserved populations including a high percentage of clients that: belonged to racial or ethnic minority group (62%), reported annual income of $25k or less (72%), and/or were uninsured (62%). Use of evidence-based strategies was common across organizations, including use of client reminders to schedule appointments (83% printed reminders, 74% telephone calls) and provision of patient navigation (51%). Use of strategies did not differ between clinical sites and community groups, and the rate of recent mammogram use was similar for both (clinical sites 84%, community groups 88%) and exceeded the target rate for Healthy People 2010 (70%). Figure 1. The Proportion of Returning Clients Age 40-64 Yeats Who Had a Mammogram Within the Past 2 Years, by Type of Organization, Avon BHOP. 2007-2009. Discussion: Avon BHOP programs are effective in recruiting underserved women for mammography screening. Both clinical and non-clinical organizations reported high rates of use of evidence-based strategies and high rates of recent mammogram for returning clients. These results suggest that strategies used to promote use of mammography among underserved populations previously enrolled in programs may be equally effective if implemented in clinical or non-clinical settings. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-10-10.

Preventive Health Behaviors in Unaffected High-Risk Women: The Impact of Perceived vs Actual Risk and Preferred Involvement in Decision-Making.

Abstract Background: While major advances have been made in the diagnosis and treatment of breast cancer, more limited progress has been made in the prevention of the disease. Although several clinical trials have demonstrated the advantages of lifestyle alteration, weight loss and use of anti-estrogens, uptake of such strategies is generally sporadic in women at high risk. It has been particularly challenging to engage even women at very high risk in clinical trials aimed at primary prevention. These decisions may be influenced by several factors, among which perceived risk, actual risk and preferences for participation in preventive decision making may be particularly important. In this project, we seek to describe how perceived risk, actual risk and the preferred level of involvement in the decision jointly impact the risk management intentions and subsequent decisions.Methods: As a regular component of risk assessment process at the High Risk Breast Assessment Clinic (HRBAC) of the Ottawa Regional Women's Breast Health Centre, a detailed questionnaire is administered to women referred to the clinic before their first risk assessment consultation. The questionnaire includes several items required for calculating actual risk (using Gail score) as well as questions concerning health practices (breast screening, clinical breast examination, breast self-examination) and lifestyle practices (weight, height, smoking, alcohol and physical activity). Women's perceived risk is assessed by the following question: “What do you think the likelihood is of you developing breast cancer in your lifetime?”, and women are required to provide a percentage to express their risk. Women are also asked to indicate their intentions about breast cancer prevention and to identify which prevention strategy is the most important to them. Preferred role involvement in decision making is also assessed by the following question: “What role would you like to take in making your decision?”and women are classified as active or passive. Patient's charts are used to obtain information about the prevention decisions that women made 1 year after receiving risk counselling.We hypothesize that risk reduction counselling will weaken the association between perceived risk and prevention decisions and conversely will strengthen the correlation between actual risk and risk reduction option considered by women.Results: Correlational and chi-square analyses of the demographic data, actual(calculated0 and perceived risk, as well as prevention behaviour uptake obtained from 300 patients will be presented. A low correlation between perceived and actual risks is expected before patients receive risk counselling at the clinic. Statistically reliable association between perceived risk and precounselling prevention intentions and a low level association between actual risk and precounselling prevention intentions are also expected. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1040.

Putting Breast Health First: Establishing No-Cost Comprehensive Breast Care for the Indigent and Underinsured Requires a Well-Orchestrated Community Collaboration

Mary Bird Perkins Cancer Center's unique CARE Network in Baton Rouge, Louisiana, is used as a best-practice model to illustrate what can be achieved when breast cancer care facilities set aside politics and collaborate to put women's breast health needs first. How the CARE Network, working in partnership with other health care agencies, was established to meet a regional need and how it has maximized various funding sources to provide free mobile mammography and comprehensive breast cancer services to an uninsured and underinsured population is described. The essential services required to reach and treat this population to help lower the rate of breast cancer deaths in a state which has one of the highest cancer mortality rates in the country are delineated.

Knowledge of breast cancer and screening practices

Objective To assess young women's breast health knowledge and explore its relation to the use of screening mammography. Methods A convenience sample of 180 women aged 25-45 residing in Toronto, Canada, with no history of breast cancer and mammography received an information brochure and four questionnaires which assessed their knowledge of breast health, sociodemographic/clinical character istics, and intended decision to use screening mammography. Results Women's overall baseline knowledge score ranged from 0-18 with a mean of 10 and SD of 3.9. About half of the participants had a low score (0-9), 31 per cent did not know that the risk of breast cancer increases with age, 43 per cent did not know what was the appropriate age to start breast self examination (BSE), and 48 per cent did not know how frequently BSE should be performed. The overall knowledge score was significantly higher for those women who intended to use screening than those who did not (10.8 vs. 8.4, p<0.001). The intended use of screening was associated with women's knowledge ( p<0.001), self-perceived health ( p=0.02), perceived susceptibility to breast cancer ( p=0.04) and perceived usefulness of information ( p=0.001). Conclusion The study demonstrates that breast health knowledge is limited even among highly educated young women. This finding suggests the need for providing breast health education to women at earlier stage in their life when they have ample time to go through a logical series of decision stages on their way to adopting a new behaviour.

A Review of Effective Strategies for Native Women's Breast Health Outreach and Education

This commentary provides a summary of a pilot study designed to assist the American Cancer Society in revising the Circle of Life breast health program for American Indians and Alaska Natives (AIANs). Included are analyses of a literature review focusing on breast health outreach strategies among AIANs and in-depth interviews with breast health focus group facilitators. Over 70 AIAN breast or cervix cancer screening articles were reviewed, and approximately 20 focus group facilitators were interviewed. A primary finding was that AIAN breast cancer outreach, education, and screening programs are most effective when community-driven and culturally relevant to local tribal nations and geographic regions.

Improvement of women's breast health services.

Improvement efforts for women's breast health services were initiated to provide a co-ordinated comprehensive breast health system and increase patient satisfaction for women using the service. The Breast Health Center, initially established to better meet the needs of the community with screening services provided an environment that reduced the anxiety associated with screening mammography services. However, women that required diagnostic follow-up expressed dissatisfaction and increased anxiety as they waited for test results. The diagnostic follow-up process in need of improvement required additional scheduling for services and often lead to delays, added anxiety, and decreased patient satisfaction for women maneuvering through a complex system.

Young Women's Breast Health Needs

Young Women's Breast Health Needs

Storytelling as a method to teach African American women breast health information.

The purpose of this study was to explore the use of storytelling as a method to teach breast health information to older African American women. A qualitative design utilizing the focus-group method. Six story types (categories) emerged from the focus-group data and were integrated into the breast health education class. Categories were: 1) loss, 2) pain, 3) suffering, 4) fear and worry/stress, 5) death, and 6) faith in God and prayer. Three major outcomes resulted from the storytelling format: 1) peer teaching enhanced learning, 2) incorrect information was identified and clarified, and 3) personal experiences were validated. Integration of African American women's self-identified issues and concerns with breast health messages through storytelling resulted in a meaningful teaching-learning experience.