PURPOSE: The purpose of this study was to determine the effects of an environmental enrichment program on barrier, benefit, confidence, and compliance of breast self-examination in women at 3 months after instruction. METHODS: Nonequivalent control group pretest-posttest design was conducted among 62 healthy women. Data were collected through the self-reported questionnaires from December 2008 to March 2009. Women were assigned to one of two treatment groups: (a) no-support of environmental enrichment with the instruction control group; (b) the support of environmental enrichment with the instruction experimental group. All women received the same instruction on breast self-examination once a week for two weeks. Data were analyzed with paired t-test, McNemar test and ANCOVAs of controlling for age run using SPSS/WIN 17.0. RESULTS: The experimental group was significantly lower than control group on perceived barrier (F=5.91, p=.02) and higher than control group on compliance of breast self-examination (F=4.57, p=.04) after environmental enrichment program. However the environmental enrichment program did not make significant differences on benefit (F=0.01, p=.91) and confidence (F=0.77, p=.38). CONCLUSION: Findings suggest that the environmental enrichment should be needed to support women's breast self-examination and expanded for compliance of breast self-examination to promote the secondary prevention of women breast cancer.
Breast ; Breast Neoplasms ; Breast Self-Examination ; Compliance ; Female ; Humans ; Surveys and Questionnaires ; Secondary Prevention

OBJECTIVE: To evaluate the condition of cancer-related fatigue (CRF) in breast cancer patients with chemotherapy and to explore the effect of Yoga on it. METHODS: After the completion of Yoga, 100 breast cancer patients with CRF (CFS>0) were selected and were randomly divided into the Yoga group and the control group (n=50). Patients in the control group only received routine cure and care while patients in the Yoga group received extra Yoga exercise, lasting for 4 months. Cancer fatigue scale (CFS) was evaluated in the 2nd, 4th and 6th round of chemotherapy. RESULTS: At the end, 82 cases qualified for the study, 42 cases for the control group and 40 for the Yoga group. The mean score of body fatigue was 12.67±3.46. There was no significant difference in CRF between the Yago group and the control group before the Yoga intervention (P>0.05). After the 4th round of chemotherapy, the mean scores of CFS and body fatigue in the Yoga group were significantly lower than that in the control group (P<0.05). After the 6th round of chemotherapy, the mean scores of CFS, body fatigue and cognitive fatigue in the Yoga group were lower than that in the control group (P<0.05). Repeated analysis of variance showed that the difference in the overall fatigue, body fatigue and cognitive fatigue between the Yoga group and the control group was significant (P<0.05); the time influence on the overall fatigue, body fatigue and emotional fatigue was significant difference between the 2 groups (P<0.05); there were interactions between the effect of Yago and time on the overall fatigue, body fatigue and cognitive fatigue (P<0.05). CONCLUSION The body fatigue was more serious in breast cancer patients with chemotherapy. Yoga intervention could significantly reduce body fatigue, cognitive fatigue, thus reduce the overall fatigue in breast cancer patients with chemotherapy.
Breast Neoplasms ; rehabilitation ; Emotions ; Fatigue ; prevention & control ; Female ; Humans ; Yoga

PURPOSE: This study was done to develop an integrated breast health program for prevention and early detection of breast cancer, integrating primary and secondary prevention factors using cognitive-behavioral strategies. METHODS: This methodological study conducted as follows; Selection of components for the program through a literature review, survey to identify women's knowledge and risk perception of breast cancer and diet, and building prototype for the program using discussion based on findings. Using structured questionnaires, interviews were done with 130 women aged 40-59 who lived in a rural area. RESULTS: Primary prevention (diet pattern, knowledge about breast cancer, and risk perception) and secondary prevention (early detection behaviors) factors were identified through the literature review. The survey showed that women lack knowledge and awareness about the risks of breast cancer, and have a low compliance rate for early detection behavior. Based on these results, a program was developed utilizing counseling and models to provide education and practice related to diet, breast cancer, and early detection behaviors. CONCLUSION: Use of this integrated and tailored breast health program with women at risk will contribute to better breast health, but further study is needed to verify the effects.
Aged ; Breast ; Breast Neoplasms ; Compliance ; Counseling ; Diet ; Female ; Humans ; Primary Prevention ; Program Development ; Surveys and Questionnaires ; Secondary Prevention

OBJECTIVEA randomized trial of breast self-examination (BSE) program was carried out to evaluate whether the intensive BSE can reduce the death number of women from breast cancer.

METHODSA total of 266,064 women (age of 30 to 64 years) associated with 519 textile factories in Shanghai had been randomly assigned to a BSE instruction group (132,979 women) or a control group (133,085 women) since 1989. Initial instruction in BSE group included demonstration of proper palpation techniques. It was followed by 2 reinforcement sessions during the subsequent 4 years including video shows, BSE instruction sessions and BSE practice under medical supervision. These activities were continued for 5 years. Attendance at all events was recorded. The cohort was followed through July 2000 for development of breast diseases, and the breast cancer cases were followed up through 2001 for vital status. The data analysis methods used included Kaplan-Meier plots, Log-rank test and Cox modeling.

RESULTSAmong women under instruction, 864 breast cancers were detected and 133 breast cancer deaths occurred, and 896 breast cancers were detected and 130 deaths recorded in the control group. The tumor size (P = 0.07), TNM stage (P = 0.39) and cumulative breast cancer mortality rate (P = 0.72) were not significantly different between the 2 groups. However, more and smaller fibroadenomas were detected in the instruction group than in the control group (P < 0.01).

CONCLUSIONIntensive instruction in BSE can not reduce mortality rate of breast cancer, but more and smaller benign breast lumps can be detected.

Adult ; Breast Neoplasms ; diagnosis ; epidemiology ; prevention & control ; Breast Self-Examination ; China ; epidemiology ; Female ; Humans ; Incidence ; Mass Screening ; Middle Aged

Breast cancer ranks second or third to uterine cervix cancer and stomach cancer as a cause of death in women, and as a common site of primary cancer. The large difference in its incidence between Westernized and non-Westernized countries is remarkable. There is a linear increase with age that is observed in Western countries, which are high-incidence areas, on the contrary to the inverted V shape curve seen in Asian countries. Epidemiologic studies conducted in Korea have shown that an older age, a family history of breast cancer, early menarche, late menopause, late full-term pregnancy, and never having had a breast-fed child are primary risk factors in the development of breast cancer. The estrogen-augmented-by-progesterone hypothesis explains the roles of these factors to some extent. On the other hand, recent molecular studies have revealed the existence of novel gene environmental interactions. Epidemiological features suggest that the breast cancer incidence rate in Korea will increase, but the age specific curve would not be changed in keeping with what is observed in Western countries. Strategies aimed at controlling breast cancer that include the screening guidelines and the identification of individual predispositions may give us further insights into both the etiology and the prevention of breast cancer.
Breast Neoplasms/*epidemiology/physiopathology/prevention & control ; Female ; Humans ; Korea/epidemiology ; Risk Factors

The aim of this review is to discuss the impact of breast screening on pathology. The advent of the national mammographic screening programme in Singapore has led to changes in the manner in which breast specimens are handled in the pathology laboratory, an increased detection of borderline lesions which pose diagnostic challenges, the occurrence of specific issues regarding core biopsies, and the need for awareness of histologic artefacts associated with preoperative needling procedures. There are also economic and workload implications, in addition to the essential requirement for quality assurance and educational programmes to maintain high professional standards. A multidisciplinary approach and commitment to continual professional upgrading are key to surmounting the pathologic challenges brought about by breast screening.
Biopsy ; Breast Neoplasms ; diagnosis ; prevention & control ; Female ; Humans ; Mammography ; Mass Screening ; Singapore

Breast cancer is the most common malignant tumor among women in China. In 2016, there were about 306 000 new cases of breast cancer in Chinese females. Of these, about 33% (100 400) occurred in rural areas. County-level (counties or county-level cities) hospitals are the first diagnosis units for most rural breast cancer patients and play an important role in cancer prevention, screening, maintenance treatment, rehabilitation, follow-up, and referral. Due to economic and geographical constraints, county-level hospitals are relatively deficient in medical equipment, health human resources, and drug accessibility. There is an imperative need for breast cancer prevention and management guidelines that are suitable for the actual situation in China's counties. Therefore, under the policy background of hierarchical diagnosis and treatment, the Chinese expert group formulated the "Guideline for the management path and quality control of breast cancer prevention and treatment in China's counties (2023 edition)", aiming to expand the availability of quality medical resources and ensure they are better distributed among regions, enhance the capacity for breast cancer prevention and treatment, so as to improve the prognosis and quality of life of patients in China's counties. This guideline provides path diagrams which are concise, unambiguous and easy to translate into clinical practice, as reference for clinicians in county-level hospitals.
Humans ; Female ; Breast Neoplasms/prevention & control* ; Quality of Life ; Quality Control ; Asian People ; China/epidemiology*

Objective: To analyze the data of malignant tumor mortality and change in disease burden in Hebei province from 1973 to 2013. Methods: Cancer mortality rate, age-standardized mortality rate and the years of life lost due to premature mortality (YLLs) were calculated by using the data from three rounds of all death causes survey and database of cancer registry in Hebei during 1973-2013. Results: From 1973 to 2013, a linear upward of malignant tumor mortality was observed, with a 51.57% increase. The mortality rate during 1973-1975 was 98.52/100 000 and it was 149.33/100 000 during 2011-2013. During 1973-1975, the YLLs was 17.0/1 000 in males and 12.8/1 000 in females. While during 2011-2013, the YLLs was 23.2/1 000 in males and 15.9/1 000 in females. During 1973-1975, esophagus cancer, stomach cancer and liver cancer were top three leading causes of deaths. During 2011-2013, lung cancer, stomach cancer and liver cancer were main leading causes of deaths. During the past 40 years, the deaths of esophagus cancer and cervix cancer decreased dramatically, but the deaths of lung cancer and breast cancer increased sharply. Conclusions: The disease burden caused by malignant tumor is becoming more serious in Hebei. It is necessary to strengthen the primary prevention and screening of malignant tumor.
Breast Neoplasms ; Esophageal Neoplasms ; Female ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Male ; Mortality/trends* ; Mortality, Premature ; Neoplasms/mortality* ; Primary Prevention ; Reference Standards ; Registries ; Stomach Neoplasms ; Uterine Cervical Neoplasms

Germline mutations in BRCA1 and BRCA2 confer high risks of breast and ovarian cancer. Among BRCA1- and BRCA2- mutation carriers, the average cumulative risks for ovarian cancer by age 70 years were 39% and 11%, respectively. There are other hereditary cancer syndromes such as Hereditary nonpolyposis colorectal cancer also confer a higher risk for developing ovarian cancer, but over 90% of all hereditary ovarian cancers are thought to be associated with BRCA1 or BRCA2 mutations. This report concerns a Korean woman diagnosed with ovarian cancer present with a family history of ovarian and various other cancers, in whom a germline BRCA1 mutation was identified and the same mutation was found in one of two daughters of her's. Since there could be more hereditary ovarian cancer patients in Korean than clinicians thought, both primary and secondary prevention of ovarian cancer based on family history and genetic information is important to reduce cancer incidence and mortality.
Breast ; Colorectal Neoplasms, Hereditary Nonpolyposis ; Female ; Germ-Line Mutation ; Humans ; Incidence ; Neoplastic Syndromes, Hereditary ; Nuclear Family ; Ovarian Neoplasms ; Secondary Prevention

OBJECTIVETo introduce the concept, methods for calculation and application of "number needed to be screened" (NNBS) in epidemiologic studies.

METHODSThe concept of "number needed to treat" (NNT) was extended for disease screening strategies. For the purpose of illustration, the values of number needed to invite for screening (NNI) and number needed to be screened (NNBS) were calculated on the basis of the results from two randomized controlled screening trials--Nottingham randomized controlled trial of faecal-occult-blood screening for colorectal cancer and Swedish mammographic screening trial for breast cancer in two counties.

RESULTSIn order to prevent one death from the colorectal cancer among local people aged from 45 to 74 during the 14 years of follow-up, the NNI and NNBS for faecal-occult-blood screening program were 1220 and 665, respectively. In addition, in order to prevent one death from breast cancer among local women aged 40-74 during 8 years of follow-up, the NNI and NNBS for mammographic screening program were 1961 and 1494, respectively.

CONCLUSIONCompared with the traditional indices, NNBS can evaluate the overall effectiveness of a screening program in an intuitively understandable manner so as to facilitate the communication among medical researchers, health workers, health policy makers and the public.

Breast Neoplasms ; diagnosis ; epidemiology ; prevention & control ; Colorectal Neoplasms ; diagnosis ; epidemiology ; prevention & control ; Epidemiologic Studies ; Humans ; Mass Screening ; statistics & numerical data ; Sample Size