Improved detection of human breast lesions following experimental training

Hall, Deborah C.; Adams, Calvin K.; Stein, Gerald H.; Stephenson, Hester S.; Goldstein, Martin; Pennypacker, H. S.

doi:10.1002/1097-0142(19800715)46:2<408::aid-cncr2820460233>3.0.co;2-p

Cited by 105 publications

(42 citation statements)

References 10 publications

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“…Nurses and midwives were recruited and trained in the technique of CBE using the MAMMACARE TM10 programme tested previously in the Philippines, that uses silicone models of the breast for training purposes 11 and has been shown to enhance performance of examiners in previous studies. [12][13][14] Training was repeated for selected groups of examiners who missed or over-reported by 20% the lumps in the silicone models.…”

Section: Interventionmentioning

confidence: 99%

Outcome of screening by clinical examination of the breast in a trial in the Philippines

Pisani

Ngelangel

et al. 2005

Intl Journal of Cancer

160

120

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The value of screening by Clinical Examination of the Breast (CBE) as a means of reducing mortality from breast cancer (BC) is not established. The issue is relevant, as CBE may be a suitable option for countries in economic transition, where incidence rates are on the increase but limited resources do not permit screening by mammography. Our aims were to assess whether mass screening by CBE carried out by trained para-medical personnel is feasible in an urban population of a low-income country, and its efficacy in reducing BC mortality. Our study was designed as a randomised controlled trial of the effect on BC mortality of 5 annual CBE carried out by trained nurses. The target population was women aged 35-64 years, resident in 12 municipalities of the National Capital Region of Manila, Philippines. The units of randomization were the 202 health centres (HC) within the selected municipalities. During 1995 nurses and midwives were recruited and trained in performing CBE. The first round of screening took place in 1996-1997. The intervention however showed a refractory attitude of the population with respect to clinical follow-up and was discontinued after the completion of the first screening round. Cases of breast cancer occurring in the study population during 1996-1999 were identified by the 2 local population-based registries. In the single screening round 151,168 women were interviewed and offered CBE, 92% accepted (138,392), 3,479 were detected positive for a lump and referred for diagnosis. Of these only 1220 women (35%) completed diagnostic follow-up, whereas 42.4% actively refused further investigation even with home visits, and 22.5% were not traced. Of 53 cases that occurred among screen-positive women in the 2 years after CBE only 34 were diagnosed through the intervention. Eighty cases occurred among screen-negative women. The test sensitivity for CBE repeated annually was 53.2%. The actual sensitivity of the programme was 25.6% and positive predictive value 1%. Screen-detected cases were non-significantly less advanced than the others. Previous studies have shown that most breast cancer cases in the Philippines present at advanced stages and have an unfavourable outcome. Although CBE undertaken by health workers seems to offer a cost-effective approach to reducing mortality, the sensitivity of the screening programme in the real context was low. Moreover, in this relatively well-educated population, cultural and logistic barriers to seeking diagnosis and treatment persist and need to be addressed before any screening programme is introduced. ' 2005 Wiley-Liss, Inc.Key words: mass screening; breast clinical examination; female breast cancer; PhilippinesIn the year 2000 breast cancer accounted for over 1 million new cases per year worldwide; it is the most common cancer in women, and incidence rates are rising in low-risk countries.

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Section: Interventionmentioning

confidence: 99%

Outcome of screening by clinical examination of the breast in a trial in the Philippines

Pisani

Ngelangel

et al. 2005

Intl Journal of Cancer

160

120

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“…Hall et al (1980) also compared the teaching for detection of tumours in silicone models and human breasts. Findings indicated that detection of breast lesions increased significantly in both formats.…”

Section: Breast Modelsmentioning

confidence: 99%

An evaluation of comparative strategies for teaching breast self‐examination

Agars¹,

McMurray

1993

Journal of Advanced Nursing

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This study compared the effects of three alternative methods of breast self‐examination (BSE) instruction (booklet, film and group discussion, individual teaching) on nurses’ personal BSE practice A pre‐test and follow‐up questionnaire were administered to a convenience sample of 166 nurses from Western Australian hospitals The results demonstrated that each method of BSE instruction produced a significant improvement in the technique of BSE (P < 0 0001) However, the nurses involved in the film and discussion had the greatest improvement in BSE proficiency Findings were analysed in terms of the Health Belief Model The variables ‘barriers to action’ and ‘perceived susceptibility’(in this case, to breast cancer) were found to be predictive of BSE practice,‘perceived barriers’ at pre‐test and ‘perceived susceptibility’ at follow‐up The incidence of BSE was significantly higher in the older nurses A reminder to practice BSE was significantly associated with an effective BSE technique Implications for nursing practice are discussed

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“…In the second report, the simple breast model was also used in a validation-field study (Hall, Stephenson, Adams, Goldstein, Pennypacker, & Stein, 1980). Before and after a brief experimental training session on the model with simulated lumps, 20 trainees examined six women with a total of 13 known benign breast lesions.…”

mentioning

confidence: 99%

Major stimulus dimensions determining detection of simulated breast lesions

Bloom

Criswell

Pennypacker

et al. 1982

Perception & Psychophysics

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Five adult humans palpated silicone breast models in a lump-detection task. The effects on detection of several lump and model characteristics were studied in three phases, using both discrete trial (restricted search procedure) and "free response" (free search procedure) psychophysical methods. Size and depth of fixed steel lumps were varied in Phase 1. Depth and hardness of uniformly sized, fixed lumps were varied in Phase 2. The presence and depth of simulated breast nodularity were also studied in Phases 1 and 2. In Phase 3, all breast models were uniformly nodular and lumps varied along dimensions of size, depth, hardness, and fixation. In Phase I, lump detection was greatest with maximum lump size and minimum depth within the model. Neither lump hardness nor depth differentially influenced detection of the fixed lumps in Phase 2. When breast lumps were mobile, in Phase 3, size and hardness were major stimulus dimensions determining detection. These results suggest physical parameters for realistic breast models and lumps to be used in training effective breast self-examination and breast lump detection. 251Breast cancer is the leading cause of cancer death in women. In 1980, approximately 36,000 women were expected to die of breast cancer

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Improved detection of human breast lesions following experimental training

Cited by 105 publications

References 10 publications

Outcome of screening by clinical examination of the breast in a trial in the Philippines

Outcome of screening by clinical examination of the breast in a trial in the Philippines

An evaluation of comparative strategies for teaching breast self‐examination

Major stimulus dimensions determining detection of simulated breast lesions

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