Sexual health among patients with cancer was recognized as important, but was discussed infrequently. Additional training may improve the ability of oncology nurses to provide sexual health counseling to patients.
Br east cancer is the most frequently diagnosed cancer among women in the United States, where 1 in 8 women will face breast cancer in their lifetime.1 In 2010, this translates to approximately 207,090 women who will be diagnosed with this disease, and about 54,010 who will die of breast cancer. 1While Caucasian women have the highest incidence of breast cancer in comparison to any other cultural group, Asian American and Pacific Islander (AAPI) women, in aggregate, are more likely to die from breast cancer than any other ethnic group.2,3 Furthermore, Asian American females are the first American population to experience cancer as the leading cause of death in the United States.3,4 Death rates have increased in AAPI women by 200% since 1990. 5 In addition, AAPI women collectively have the lowest screening rates of all ethnic populations, with roughly 45% reporting that they have ever had a mammogram. 4 Hmong women, an ethnic group within the AAPI population, are among those at the highest risk for health problems due to high rates of poverty, language isolation, and cultural barriers. 3A national health initiative, Healthy People 2020, 6 was created to increase health promotion and disease prevention that address issues such as these. A primary objective identifies cancer as one of the ten leading health indicators. The goal is to reduce the number of new cases, as well as the illness, disability, and death caused by cancer. The ability to decrease cancer death rates depends on the existence and application of various types of resources, and providing culturally and linguistically appropriate information on prevention, early detection, and treatment to the public is essential in order to meet this goal. 6A new and more specific goal presented by Healthy People 2020 is to decrease the incidence of late stage breast cancer. This is of particular importance in Asianborn Asian American women with breast cancer, in which approximately 79% have a greater proportion of tumors larger than 1 cm at diagnosis.7 It has been shown that many tumors greater than 1 cm have lymph node involvement and are considered later stage disease.Another goal established from Healthy People 2020 is to increase the proportion of women aged 40 or older who have received a breast cancer screening based on the most recent guidelines. It is essential that a high percentage of females over age 40 comply with these mammographic screening recommendations in order to reduce breast cancer burden and death rates.
We describe the development and establishment of a breast care program (BCP) with service for rural breast cancer patients. Our program is a comprehensive program serving rural communities in Wisconsin. Our BCP is committed to breast health throughout the continuum from breast cancer risk assessment and prevention, advanced diagnostics, and screening tools to genetic testing and state-ofthe-art surgical techniques. To provide the highest level of care, we coordinate a breast care team involving collaboration of multidisciplinary healthcare professionals. Experts from various departments, including radiologists, pathologists, breast surgeons, medical and radiation oncologists, genetic counselors, clinical trial specialists, and our breast care navigator, all work together to provide cutting edge cancer treatment and management. Our distinctive BCP allows patients to see multiple providers without having to make multiple appointments and promotes discussion of treatment recommendations and creation of a personalized treatment plan for each patient by a team of specialists.
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