The effect of breast self-exam practices and physician examinations on extent of disease at diagnosis

doi:10.1016/0091-7435(80)90235-2

Preventive Medicine

Volume 9, Issue 3, May 1980, Pages 409-417

https://doi.org/10.1016/0091-7435(80)90235-2 Get rights and content

Abstract

To determine the relation between breast self-exam (BSE) practices and detection of tumors, a sample of 230 breast cancer patients from a population-based cancer registry in Washington State were interviewed during 1977–1978. Patients practicing BSE were significantly more likely to find their own tumors than patients not practicing BSE (80 vs 67%, P = 0.047). Yet, in contrast to other studies, no statistically significant associations were found between method of detection and extent of disease as measured by stage, tumor size, or number of lymph nodes involved. Nor did other covariates—demographic factors, menopausal status, and histology—alter the relation between BSE and extent of disease. Methodologic comparisons between the major studies and suggestions for future research were made to clarify the inconsistent evidence of the benefits from breast self-exam on extent of disease.

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Breast cancer is the single most common cause of death in women aged 35 to 54 years. The increasing incidence of the disease and the little change there has been in survival rates over the past 50 years, despite progress with treatment options, makes breast cancer an important health problem for women (Nettles-Carlson 1989, Cancer Research Campaign 1991, American Cancer Society 1991). According to Blamey et al (1994):
Lack of knowledge of the pathogenesis of breast cancer means that primary prevention is currently a distant prospect. Screening represents an alternative approach to reduce mortality from breast cancer.
The Department of Health (1992) has targeted a reduction in breast cancer related mortality as one of its major targets. It predicts that there will be 1 250 less deaths per annum as a result of the National Breast Screening Programme in the UK. However, this programme is only offered to women aged between 50 and 64. What of those women in the younger and older age groups, who are not part of the National Screening Programme, or women who present with symptomatic disease? Blamey et al (1994) have suggested that these women may receive an inferior service to that offered via the National Screening Programme.
Dispositional optimism, self-efficacy, and health beliefs as predictors of breast self-examination
1994, American Journal of Preventive Medicine
This cross-sectional study examined relationships among predictors of breast self-examination (BSE) derived from the Health Belief Model and behavioral self-regulation theory. Subjects were 427 gynecology outpatients. Although 64% indicated that they had practiced BSE at least once during the past year, only 27% indicated they practiced BSE monthly. The majority of the subjects knew about most of the recommended BSE steps. The most frequently endorsed reasons for completing BSE were early detection, recommendation from a doctor, and peace of mind. The most frequently endorsed barrier was forgetting/being too busy. Multivariate analysis showed that several psychological variables—including reasons for doing BSE, self-efficacy, and barriers to doing BSE—were related to frequency of BSE. Overall, the variables in this model accounted for about 37% of the variance in BSE frequency.
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^☆: Supported in part by Contracts NO1-CP610V-9, I-R18CA 16404, and Cancer Epidemiology Training Grant 5T32CA 01968, from the National Cancer Institute.

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General articleThe effect of breast self-exam practices and physician examinations on extent of disease at diagnosis☆

Abstract

Epidemiologic comparison of breast cancer patients with early and late onset of malignancy and general population controls

J. Nat. Cancer Inst.

Clinical classification of extent of disease in cancer of the breast

J. Nat. Cancer Inst.

The epidemiology of breast cancer; a review and prospects

Int. J. Cancer

On the bimodal age distribution of mammary carcinoma

Brit. J. Cancer

Cancer of the breast: size of neoplasm and prognosis

Cancer

Breast self-examination practices and breast cancer stage

New Engl. J. Med.

Female breast cancer—a re-evaluation

Ann. Surg.

Estimated effect of breast self-examination and routine physician examinations on breast cancer mortality

New Engl. J. Med.

A Guide for the Tumor Registry Secretary in Recording Stage

Epidemiological characteristics of breast cancer in middle and late age

Brit. J. Cancer

General article
The effect of breast self-exam practices and physician examinations on extent of disease at diagnosis☆