Impact of regular Breast Self‐Examination on breast cancer size, stage, and mortality in Thailand

Abstract

The incidence of breast cancer in Thailand has increased during the past decade. Besides, most of the patient present with the locally advanced stage. 1 Mammography has not reached all women in Thailand. Breast self-examination (BSE) is simple and feasible for breast cancer screening among developing countries comparing to mammography and clinical breast examination (CBE). 2 We evaluate a cohort study of 1 906 697 women without a history of breast cancer aged 30-70 years who participated in a breast cancer awareness program in Thailand. We excluded women with known breast cancer or in process of investigation. BSE program in this study was shown in Figure 1. The village health volunteers (VHV) helped reminding the cohorts to perform BSE regularly through the use of BSE record booklet. The innovative BSE record booklet contained the instruction to help cohort to perform BSE precisely and record monthly in the booklet which was verified by the VHV and confirmed by health personnel. The participants had been followed up from October 2012 to September 2017. The participants who reached the regularity (at least once in every 2 months) of BSE within 12 months before diagnosis were defined as regular BSE. When abnormalities presented, the participants were referred for screening by CBE then confirmed by imaging and pathology. The data of BSE and Breast Cancer Individual (BCI) Record Form were collected and analyzed. There were 2,956 women diagnosed with breast cancer in this study (Figure 2). Breast cancer size and stage were diagnosed according to the AJCC 7th staging system. We categorized tumor size into small (≤2 cm) and large (>2 cm) and stage into early (0-II) and late (III-IV). Death due to breast cancer was also recorded.Of 1 906 697 women who participated in this study, 61%were aged < 50 years. 72% of participants performed BSE regularly. During 5 years of follow-up, 2956 participants were diagnosed with breast cancer. The average incidence rate per year was 31 (range 27.5-33.5) per 100 000 women aged between 30 and70 years old (Table 1). 97.9% of them found a breast lump themselves and were sent for confirmation by imaging and histopathology. The other presenting symptoms were breast pain (12.8%) and unequal breast size (7.9%). Some of participants (1.2%) did not have any signs or symptoms. Data on breast cancer size were available for 2,031 patients (68.7% of all patients with breast cancer). The risk of a large tumor size in nonregular BSE patients was 1.348-fold higher than regular BSE patients. Data on breast cancer stage were available for 2659 patients (90.0% of all patients with breast cancer). Most of the patients were diagnosed with stage II, (47.9%) and 31.5% were diagnosed with stage III-IV.The risk of late-stage breast cancer in nonregular BSE patients was 1.319-fold higher than in regular BSE. Of 2956 patients, 176 (5.9%) died during 5 years of follow-up. The survival rate of regular BSE patients was significantly higher than nonregular BSE This is an open access article under the terms of the Cre...

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Knowledge and awareness of breast cancer and breast self-examination among college-going female students in Delhi-NCR: a cross sectional study

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“…However, for younger women aged below 35 years, who are at a higher than average risk of BC, and also in situations more relevant to a developing country like India, where several sociocultural barriers and resource constraints exists, and mammography and/or CBE screening is not always an accessible option, being self-breast aware or BSE if taught and implemented competently could definitely have wider implications in detecting anomalous changes in a woman's breasts early. Studies on the effect of regular BSE on BC diagnosis and prognosis have shown increased frequency and odds of detection of breast mass at an early stage and increased odds of survival in BC patients (Kamproh and Fungpong, 2008;Thaineua et al, 2020). And although mammography has a greater potential to down-stage women who are asymptomatic, the procedure is complicated and expensive, and require additional logistics with the need for behavioral adjustments to seek screening and healthcare or referral at a tertiary care center, and this disbars its use in low-resource settings (Black and Richmond, 2019).…”

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