Mammography, ultrasounds, genetic testing… Lifestyles of the rich and the famous? Well, at least that is how many people living in South Africa feel.
Some people do not even know what a mammogram is. But is this important? Should every woman be going for screening? Why is it that in a country where imaging and treatment is available do women still present with late stage cancer?
The answer is that basic breast self-examinations (carried out by oneself) and clinical breast examinations (performed by a trained health care professional) are not actually being carried out. Yes, mammograms are relevant in certain cases, as are ultrasounds, genetic testing and various other tests and screening – but in our country it is not the answer for the millions of women that have no easy access or funding to go for these tests. Breast self-examination and clinical breast examinations are the number one “tests” that need to be carried out.
It is vitally important that if a woman finds a new lump in her breast, that she goes for a clinical breast examination. Many women in South Africa do not have access to health care facilities like hospitals as the hospitals are often very far from where the people live (and therefore expensive to travel to) and are also often back-logged with patients. The first point of care for the majority of women in South Africa would be a clinic where a primary health care nurse would assess them.
The Breast Course for Nurses – one of the partner organisations that make up the Advocates for Breast Cancer – aims to equip primary health care nurses with the knowledge to perform clinical breast examinations and to know the differences between the normal changes to the breast and changes that need to be referred. The Breast Course for Nurses was started by Dr Jenny Edge, a general surgeon from Cape Town with a special interest in breast conditions. Dr Jenny Edge and Professor David Woods, a retired neonatologist (of the PEP foundation), wrote the Breast Care book which the course is based on. (Click here to equip yourself with a copy!)
To date, courses have been completed in Cape Town, Johannesburg and Durban with courses currently running in Cape Town and Port Elizabeth. We are so excited to see what an impact this course is making! Look at the photos taken at the courses across the country here.
The Breast Course for Nurses focuses on the following topics:
- the normal breast
- clinical assessment of the breast
- special investigations of the breast
- benign changes of the breast
- cancer of the breast
- treatment of breast cancer
- side effects of breast cancer treatment
- palliative care
- community outreach programmes
The course starts with a one day session where the first two modules of the book are discussed. It then consists of six months of distance learning with multiple choice questions (MCQ’s) for each module that need to be completed. The course then ends with a two day residential course where the remaining modules are discussed, wound care and palliative care are addressed and networking takes place. Practical sessions about biopsy techniques and lymphoedema therapy are carried out.
Although the core content of the course remains the same, both the input and practical sessions differ regionally depending on the needs of the nurses. The emphasis of the course is on learning rather than teaching and is primarily aimed at equipping nurses with the skills and knowledge to manage women with breast problems.
The World Health Organisation predicts that the mortality due to non-communicable diseases in the developing world will increase by 17% in the next 10 years. This will have a major impact on an already overburdened system.
Primary health care nurses will remain the first point of contact for many women as time goes on. The Breast Course for Nurses aims to educate these primary health care nurses so the correct clinical examinations can be carried out and an efficient referral system can be implemented.