Enhancing Breast Cancer Screening

The following is a review written by a nurse, Valerie R. Vestal, MSN, FNP, RN, at our institution on a study related to breast cancer screening.

Breast Cancer is the most wide spread cancer affecting women and the second leading cause of cancer deaths in the United States. Survival rates are highly dependent on early detection. Research has shown that breast cancer screening methods such as mammography, physical exam, and breast self exam (BSE) may increase the likelihood of early detection and survival rates.

A primary concern of breast cancer research today is to understand what motivates women to comply with breast cancer screening recommendations. Traditionally healthcare providers have thought that health teaching increases compliance; however, recent studies indicate that health teaching alone does not increase compliance with breast cancer screening.

Sixty-two university female employees consented to participate in a quasi-experimental research study to explore the value of utilizing supportive coaches as an intervention to increase breast cancer screening compliance. Secondary aims of the study were to identify the attitudes and beliefs of women toward breast cancer screening and barriers to compliance with the American Cancer Society Guidelines (ACS). A random sample of 200 university female employees were solicited from the university database to participate in the study; sixty-two agreed to consent and final demographic criteria was completed on sixty (n=60) females. Two participants could not participate in the study due to severe health reasons. Participants were predominantly college educated (82%) married middle class Caucasian females (91%) with an age range of 30-60.

All participants were required to complete a prestudy questionnaire, attend a breast cancer screening presentation, and complete a poststudy questionnaire. Questionnaires were developed based on Champion and Dodd’s and colleagues Health Belief Model (HBM) to capture demographic, personal and family health history, breast cancer screening behaviors, and beliefs and attitudes about breast cancer screening using a five point scale.

Study participants were randomly assigned to a control group and an experimental group. The experimental group was provided coaching and supportive interventions through monthly phone calls, mailings, email, posters, stickers, and comic strips. The control group did not receive any intervention. All participants completed the post study questionnaire to evaluate breast cancer screening behaviors.

Descriptive statistics were used to analyze pretest questionnaire. The findings indicate that 34% of participants have a family history of cancer and a fibrocystic breast disease. 12% had reported having had a biopsy, 1% denied a personal history gynecological cancer; however they reported a family history of 29% of breast cancer, 14% for uterine/cervical cancer, and 36% for all other cancers.

70% of the participants reported a clinical breast exam and 70% reported a mammogram in the last year. Only 18% reported performing routine BSE. The significant difference in clinical breast exam and mammography compared to BSE may be because they are included in the universities wellness package. 51% of participants were inspired by the media, 73% from health care workers, 49% from family, and 50% from various other reminders to perform BSE.

In conclusion compliance with BSE was impacted by coaching and supportive sessions. Monthly reminders were useful in assisting participants to remember to perform BSE.

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