Can Breast Self-examination and Clinical Breast Examination Along With Increasing Breast Awareness Facilitate Earlier Detection of Breast Cancer in Populations With Advanced Stages at Diagnosis?

Albeshan, Salman M.; Hossain, Syeda Zakia; Mackey, Martin; Brennan, Patrick C.

doi:10.1016/j.clbc.2020.02.001

Cited by 45 publications

(35 citation statements)

References 46 publications

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“…Additional education programs aiming to increase awareness and public education has been recommended [ 43 ] to improve awareness of breast cancer signs and symptoms. There is an urgent need to develop communication and education strategies regarding breast cancer symptoms and early detection for Indonesia, such as specifically motivating early detection practices and breast self-examination [ 44 ]. Various methods could be explored, including mass media, various forms of literature, and programmes.…”

Section: Discussionmentioning

confidence: 99%

Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study

et al. 2022

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Purpose To investigate factors associated with delays in presentation and diagnosis of women with confirmed breast cancer (BC). Methods A cross-sectional study nested in an ongoing prospective cohort study of breast cancer patients at Dr Sardjito Hospital, Yogyakarta, Indonesia, was employed. Participants (n = 150) from the main study were recruited, with secondary information on demographic, clinical, and tumor variables collected from the study database. A questionnaire was used to gather data on other socioeconomic variables, herbal consumption, number of healthcare visits, knowledge-attitude-practice of BC, and open-ended questions relating to initial presentation. Presentation delay (time between initial symptom and first consultation) was defined as ≥3 months. Diagnosis delay was defined as ≥1 month between presentation and diagnosis confirmation. Impact on disease stage and determinants of both delays were examined. A Kruskal-Wallis test was used to assess the length and distribution of delays by disease stage. A multivariable logistic regression analysis was conducted to explore the association between delays, cancer stage and factors. Results Sixty-five (43.3%) patients had a ≥3-month presentation delay and 97 (64.7%) had a diagnosis confirmation by ≥1 month. Both presentation and diagnosis delays increased the risk of being diagnosed with cancer stage III-IV (odds ratio/OR 2.21, 95% CI 0.97–5.01, p = 0.059 and OR 3.03, 95% CI 1.28–7.19, p = 0.012). Visit to providers ≤3 times was significantly attributed to a reduced diagnosis delay (OR 0.15, 95% CI 0.06–0.37, p <0.001), while having a family history of cancer was significantly associated with increased diagnosis delay (OR 2.28, 95% CI 1.03–5.04, p = 0.042). The most frequent reasons for delaying presentation were lack of awareness of the cause of symptoms (41.5%), low perceived severity (27.7%) and fear of surgery intervention (26.2%). Conclusions Almost half of BC patients in our setting had a delay in presentation and 64.7% experienced a delay in diagnosis. These delays increased the likelihood of presentation with a more advanced stage of disease. Future research is required in Indonesia to explore the feasibility of evidence-based approaches to reducing delays at both levels, including educational interventions to increase awareness of BC symptoms and reducing existing complex and convoluted referral pathways for patients suspected of having cancer.

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Section: Discussionmentioning

confidence: 99%

Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study

et al. 2022

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“…Breast cancer is a frequently reported malignant adenocarcinoma that develops in breast tissue and causes high morbidity and mortality among women worldwide [39]. Although treatments including surgery, chemotherapy and radiotherapy are performed to eradicate the primary tumor, breast cancer is still a fatal disease in many patients [40]. TNBC is one of the most clinically challenging breast cancer subtypes and is characterized by high risks of metastasis and recurrence and a low 5-year survival rate [41].…”

Section: Discussionmentioning

confidence: 99%

Caudatin Isolated from Cynanchum auriculatum Inhibits Breast Cancer Stem Cell Formation via a GR/YAP Signaling

et al. 2020

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In the complex tumor microenvironment, cancer stem cells (CSCs), a rare population of cells, are responsible for malignant tumor initiation, metastasis, drug resistance and recurrence. Controlling breast CSCs (BCSCs) using natural compounds is a novel potential therapeutic strategy for clinical cancer treatment. In this study, a mammosphere assay-guided isolation protocol including silica gel, a C18 column, gel filtration, and high-pressure liquid chromatography was used to isolate an inhibitory compound from Cynanchum auriculatum extracts. The isolated inhibitory compound was identified as caudatin. Caudatin inhibited breast cancer cell proliferation, mammosphere formation and tumor growth. Caudatin decreased the CD44+/CD24− and aldehyde dehydrogenase+ cell proportions and the levels of c-Myc, Oct4, Sox2, and CD44. Caudatin induced ubiquitin (Ub)-dependent glucocorticoid receptor (GR) degradation and blocked subsequent Yes-associated protein (YAP) nuclear accumulation and target gene transcription signals in BCSCs. These results show that the GR/YAP signaling pathway regulates BCSC formation and that caudatin may be a potential chemopreventive agent that targets breast cancer cells and CSCs.

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“…Screening mammography (SMG) has been shown to reduce breast-cancer-specific mortality [2]. However, evidence for clinical breast examination (CBE) in screening is not sufficient [9][10][11][12][13]. CBE is an application that provides an opportunity to educate people about the importance of early diagnosis, breast cancer risks, and breast diseases [2,9,11].…”

Section: Introductionmentioning

confidence: 99%

“…However, evidence for clinical breast examination (CBE) in screening is not sufficient [9][10][11][12][13]. CBE is an application that provides an opportunity to educate people about the importance of early diagnosis, breast cancer risks, and breast diseases [2,9,11]. Not all breast cancers can be detected with SMG, which is not recommended for women in certain age groups [11,14].…”

Section: Introductionmentioning

confidence: 99%

Practical Utility of Diagnostic Clinical Breast Examination in the Diagnosis of Breast Cancer

Turan

Sözen

Eminsoy

et al. 2021

Cureus

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We aimed to investigate the effectiveness of physician-performed diagnostic clinical breast examination (DCBE) for the diagnosis of breast cancer in clinical practice and to determine the rates of breast cancer diagnosed with DCBE compared to the results of breast ultrasonography (US), mammography (MG), and histopathology. MethodsIn the retrospective cohort study, the files of female patients diagnosed with breast cancer and admitted to the general surgery outpatient clinics of a university hospital over a 10-year period (2011-2021) were examined. Patients with complete DCBE findings in their files were identified and analyzed (n = 1,091). The examinations of the patients were performed by general surgery specialists with 5-22 years of experience and by radiologists with 4-15 years of experience. ResultsThe mean age of breast cancer diagnosis of the patients was 55.1 ± 13.5 years. While the sensitivity of DCBE was found to be 88.9%, MG sensitivity was 89.8% and breast US sensitivity was 95.1%. Cancer was detected by MG, breast US, and DCBE in 47.9% (n = 523), by breast US and DCBE in 38.9% (n = 424), by MG and breast US in 5.6% (n = 61), by DCBE alone in 3.6% (n = 39), by MG and DCBE in 2.4% (n = 26), and by breast US alone in 1.6% (n = 18). Early-stage breast cancer (p = 0.00) consisted of 73.2% (n = 383) of cancers detected with DCBE, breast US and MG, 74.6% (n = 316) of cancers detected with DCBE and breast US, 93.4% of cancers detected with breast US and MG (n = 57), 92.3% (n = 24) of cancers detected with DCBE and MG, 94.4% (n = 17) of cancers detected with breast US alone, and 69.2% of cancers detected with DCBE alone (n = 27). ConclusionsCBE still maintains its importance in societies where screening participation and awareness of breast cancer are low. A breast cancer diagnosis is often done after a complaint of a palpable mass in the breast, and only then are more advanced-stage breast cancers are seen. CBE is among the important diagnostic methods preventing breast cancer from being overlooked, especially in places where health resources are limited.

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Can Breast Self-examination and Clinical Breast Examination Along With Increasing Breast Awareness Facilitate Earlier Detection of Breast Cancer in Populations With Advanced Stages at Diagnosis?

Cited by 45 publications

References 46 publications

Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study

Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study

Caudatin Isolated from Cynanchum auriculatum Inhibits Breast Cancer Stem Cell Formation via a GR/YAP Signaling

Practical Utility of Diagnostic Clinical Breast Examination in the Diagnosis of Breast Cancer

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