Regular readers of this blog will know that the Cancer Alliance is a collective initiative by South Africa’s main breast cancer organisations. We will be introducing each of our partners over the next few months. Today, meet Breast Course for Nurses. This blog was written by Dr Jenny Edge, Founder and director of Breast Course for Nurses.
It is an indisputable fact that women who are diagnosed with breast cancer at an earlier stage have a much better outcome than those diagnosed at a later stage. Breast cancer screening programmes are well established in high income countries.
The modality of screening used is generally mammographic screening.
There has been a lot of debate about why women are diagnosed late in low income settings. Do they present late because they are scared or cannot afford to access the health facility? Do they present with symptoms that are not recognized as cancer by the health care worker (generally a nurse in a primary clinic)? Do they get lost in the journey of diagnostic tests?
We don’t have the answer to these questions. The Breast Course for Nurses aims to educate nurses working in primary clinics and equip them with the skills to recognise normal changes to the breast and differentiate them from changes associated with breast cancer. We teach clinical breast examination with an aim to identifying breast cancers at an earlier stage.
Does clinical breast examination work as a means of breast screening?
Clinical breast examination, as a screening modality, has been studied with mixed results. A recent study carried out in Sudan showed that clinical examination does pick up breast cancer at an earlier stage than in the control population.1 In Canada, where clinical breast examination was compared to mammographic examination, the mortality from breast cancer, 20 years later, was similar in both groups although more cancers were diagnosed in the mammographically screened population2.
The Breast Course for Nurses is a combination of a self-learning program (PEP educations series) and a residential program that contextualizes the theory in the book, encourages networking amongst the participants and stimulates debate as to how to improve access to care. The courses are taught by local faculty and no course is the same.
Does our method of transferring understanding work? We will be doing various projects to look at the impact of running our course.
In the next blog, we will give details of the courses we have run over the last 12 months.
- Abuidris DO1, Elsheikh A, Ali M, Musa H, Elgaili E, Ahmed AO, Sulieman I, Mohammed SI. Breast-cancer screening with trained volunteers in a rural area of Sudan: a pilot study. Lancet Oncol. 2013 Apr;14(4):363-70. doi: 10.1016/S1470-2045(12)70583-1. Epub 2013 Jan 31.
- Anthony B Miller, Claus Wall, Cornelia J Baines, Ping Sun, Teresa To, Steven A Narod.. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast. Screening Study: randomised screening trial. BMJ: g366 doi:10.1136/bmj g 366