 |
 Breast Cancer Pink Ribbon 3 sizes Rhinestone Iron On Transfer Bling $5.99 Time Remaining: 27d 13h 52m Buy It Now for only: $5.99 |
 100 NO MELT Flat Head Pins Breast Cancer Pink Quilting Sewing $0.99 (1 Bid) Time Remaining: 3d 15h 32m |
 2 yards Pink BREAST CANCER Awareness Ribbon elastic HEADBAND Hair Ties FOE 5 8 $2.80 Time Remaining: 13d 4h 41m Buy It Now for only: $2.80 |
 PINK LETTER WITH BREAST CANCER RIBBON RHINESTONE IRON ON TRANSFER HOT FIX BLING $5.99 Time Remaining: 7d 23h 37m Buy It Now for only: $5.99 |
 HOPE Pink breast cancer ribbon rhinestone hot fix iron on transfer 85 by 8 $3.99 Time Remaining: 11d 16h 33m Buy It Now for only: $3.99 |
 Breast Cancer Awareness Iron ons $2.99 Time Remaining: 10d 18h 19m Buy It Now for only: $2.99 |
 Pink breast cancer ribbon rhinestone hot fix iron on transfer 85 by 8 $4.99 Time Remaining: 12d 2m Buy It Now for only: $4.99 |
 BREAST CANCER RIBBON Set of 2 1 EMBROIDERED IRON ON APPLIQUE PATCH $1.34 Time Remaining: 26d 19h 21m Buy It Now for only: $1.34 |
 PINK BREAST CANCER RIBBON RHINESTONE TRANSFER IRON ON $6.99 Time Remaining: 15d 19h 51m Buy It Now for only: $6.99 |
 RHINESTONE BREAST CANCER AWARENESS HOPE CURE RIBBON SURVIVOR IRON ON TRANSFER $4.00 Time Remaining: 4h 33m Buy It Now for only: $4.00 |
 6pc Breast Cancer Iron On Patches FAITH ENDURANCE STRENGTH HOPE Pink Ribbons NIP $5.95 Time Remaining: 4d 19h 21m Buy It Now for only: $5.95 |
 2 breast cancer PINK RIBBON rhinestone IRON ON TRANSFERS 25x6 $5.00 Time Remaining: 21d 17h 36m Buy It Now for only: $5.00 |
 1 Breast Cancer Awarness Pink Ribbon Iron On Applique $2.00 Time Remaining: 12d 21h 28m Buy It Now for only: $2.00 |
 Breast Cancer Losing not an Option Iron on Transfer 42 $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 Hope Large Pink Breast Cancer Ribbon Rhinestone Iron on Transfer Hot Fix Bling $5.99 Time Remaining: 14d 1h 32m Buy It Now for only: $5.99 |
 Tamsco 35 Stainless Steel Embroidery Scissors Pink w Breast Cancer Logo NEW $7.99 Time Remaining: 11d 21h 4m Buy It Now for only: $7.99 |
 Pink Breast Cancer Ribbon iron on embroidered patch with black background $4.99 Time Remaining: 4d 17h 54m Buy It Now for only: $4.99 |
 3 pc pink ribbon iron on transfer breast cancer awareness relay for life cute $0.99 Time Remaining: 1d 10h 48m Buy It Now for only: $2.99 |
 Wild about a cure Pink Breast Cancer Ribbon Iron on Rhinestone Transfer Bling $8.99 Time Remaining: 18d 21h 5m Buy It Now for only: $8.99 |
 Breast Cancer Awareness Peace Cure Iron on Transfer $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 Fight Like a Girl Breast Cancer Iron on Transfer $3.00 Time Remaining: 15d 10h 6m Buy It Now for only: $3.00 |
 HOPEPink breast cancer ribbon rhinestone hot fix iron on transfer 85 by 8 $3.99 Time Remaining: 26d 17h 46m Buy It Now for only: $3.99 |
 BREAST CANCER RIBBON 2 IRON ON APPLIQUES $1.25 Time Remaining: 9d 18h 48m Buy It Now for only: $1.25 |
 Fight like a girl breast cancer rhinestone hot fix iron on transfer $5.79 Time Remaining: 24d 22h 41m Buy It Now for only: $5.79 |
 Rhinestone Transfer Pink Breast Cancer Ribbon 2 Sizes $5.99 Time Remaining: 25d 22h 9m Buy It Now for only: $5.99 |
 8 Pcs Rhinestone Iron On Hot Fix Pink Red Breast Cancer Ribbon IR013D $7.99 Time Remaining: 21d 17h 26m Buy It Now for only: $7.99 |
 PINK RIBBON BREAST CANCER AWARENESS ITEM SOFT TAPE MEASURE SEWING EMBROIDERY $6.25 Time Remaining: 2d 16h 13m Buy It Now for only: $6.25 |
 Breast Cancer Awareness Iron On Transfer $2.50 Time Remaining: 15d 2h 3m Buy It Now for only: $2.50 |
 6 PINK BREAST CANCER RIBBON RHINESTONE IRON ON TRANSFER $19.99 Time Remaining: 20d 1h 33m Buy It Now for only: $19.99 |
 PINK BREAST CANCER RIBBON IRON ON TRANSFERGREAT ON TANKTOPSSWEATS SHIRTS $4.49 Time Remaining: 25d 20h 11m Buy It Now for only: $4.49 |
 Breast Cancer Awareness There Fake Iron on Transfer $2.50 Time Remaining: 15d 2h 3m Buy It Now for only: $2.50 |
 Breast Cancer Awareness Custom Iron on Transfer 34 $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 Save the Boobies Breast Cancer Heat Transfer T Shirt Sweatshirt Iron On 735b $2.75 Time Remaining: 11d 22h 17m Buy It Now for only: $2.75 |
 Breast Cancer Awareness Iron on Transfer $2.50 Time Remaining: 15d 10h 6m Buy It Now for only: $2.50 |
 6 pc pink ribbon iron on transfer breast cancer awareness relay for life cute $2.99 Time Remaining: 2d 30m Buy It Now for only: $5.49 |
 WILD A CURE RHINESTONE IRON ON TRANSFER BREAST CANCER $8.99 Time Remaining: 28d 17h 30m Buy It Now for only: $8.99 |
 100 NO MELT Flat Head Pins Breast Cancer Pink Quilting Sewing $10.99 Time Remaining: 6d 13h 48m Buy It Now for only: $10.99 |
 Set of 6 Breast Cancer Awareness Iron on Transfers $3.50 Time Remaining: 1d 11h 31m Buy It Now for only: $3.50 |
 Breast Cancer Awareness Iron on Asstd Styles $5.99 Time Remaining: 10d 22h 31m Buy It Now for only: $5.99 |
 Rhinestone PINK RIBBON Breast Cancer Awareness Iron On $3.10 Time Remaining: 19d 12h 49m Buy It Now for only: $3.10 |
 Breast Cancer Awareness In Memory of Iron on Transfer $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 5 Cancer Awareness HOT PINK Ribbon Stick On Patch Breast Cancer $9.99 Time Remaining: 18d 22h 23m Buy It Now for only: $9.99 |
 Breast Cancer Awareness Iron on Transfer $3.00 Time Remaining: 15d 2h 2m Buy It Now for only: $3.00 |
 For The Cause Pink Ribbon Breast Cancer Rhinestuds Iron On Transfer 25 x 35 $5.95 Time Remaining: 22d 1h 52m Buy It Now for only: $5.95 |
 Pink Breast Cancer Ribbon Iron On Patch 2 In $1.59 Time Remaining: 29d 15h 10m Buy It Now for only: $1.59 |
 Breast Cancer Awareness Support Iron on Transfer $3.00 Time Remaining: 15d 2h 2m Buy It Now for only: $3.00 |
 Breast Cancer Awareness Survivor Iron on Transfer 2 $3.00 Time Remaining: 15d 10h 6m Buy It Now for only: $3.00 |
 1 Breast Cancer Awarness Pink Ribbon Iron On Applique $2.00 Time Remaining: 23d 21h 36m Buy It Now for only: $2.00 |
 Breast Cancer Awareness Personal Person Iron on Transfer $3.00 Time Remaining: 21d 22h 32m Buy It Now for only: $3.00 |
 10 1 2 yds quilt binding pink with white daisies for Breast Cancer quilts $12.99 Time Remaining: 25d 10h 52m Buy It Now for only: $12.99 |
 Bling Breast Cancer Awareness Necklace Hot Fix Rhinestone Iron On Transfer 1153 $10.99 Time Remaining: 2d 17h 31m Buy It Now for only: $10.99 |
 white Breast Cancer bear Pink ribbon embroidered patch support $3.00 (2 Bids) Time Remaining: 19h 8m |
 Breast Cancer Awareness Survivor Iron on Transfer 44 $3.00 Time Remaining: 15d 10h 6m Buy It Now for only: $3.00 |
 55 Perfect Breast Cancer Awareness Pink Ribbon Bow Tie it to a Tree or gift $3.99 Time Remaining: 25d 11h 26m Buy It Now for only: $3.99 |
 Breast Cancer Awareness Believe Iron on Transfer $3.00 Time Remaining: 15d 2h 2m Buy It Now for only: $3.00 |
 Rhinestone Iron On Transfer Breast Cancer Survivor Ribbon Design $7.99 Time Remaining: 15d 3h 56m Buy It Now for only: $7.99 |
 8 Special Edition Breast Cancer Awareness Scissors $7.29 Time Remaining: 18h 11m Buy It Now for only: $7.29 |
 RHINESTONE Iron On Transfer Breast Cancer Pink ribbon heart Crystal 4 x 5 $7.00 Time Remaining: 9d 18h 56m Buy It Now for only: $7.00 |
 Breast Cancer Awareness PINK Ribbon FABRIC Applique $6.99 Time Remaining: 4d 13h 46m Buy It Now for only: $6.99 |
 SINGER 338 SEWING MACHINE ASSORTED PARTS SUPPORT BREAST CANCER CARE RESEARCH $13.05 Time Remaining: 26d 15h 13m Buy It Now for only: $13.05 |
 20 Pink Ribbon Bow Butterfly Breast Cancer Awareness D5 $6.99 Time Remaining: 27d 19h 29m Buy It Now for only: $6.99 |
 Breast Cancer Awareness Appliques Patches Various $2.99 Time Remaining: 1h 46m Buy It Now for only: $2.99 |
 ABSOLUTELY BEAUTIFUL ART DECO SEWING MACHINE WOOD TABLE HELP FIGHT BREAST CANCER $220.00 Time Remaining: 25d 12h 28m Buy It Now for only: $220.00 |
 SAVE 2ND BASE PATCH PINK RIBBON BREAST CANCER P597 $3.99 Time Remaining: 23d 12h 44m Buy It Now for only: $3.99 |
 RHINESTONE Iron On Transfer Breast Cancer Pink ribbon Crystal 4 x 2 WALK $6.00 Time Remaining: 9d 18h 58m Buy It Now for only: $6.00 |
 Embroidered Pink Ribbon peelies Breast Cancer Awareness $1.75 Time Remaining: 7d 16h 46m Buy It Now for only: $1.75 |
 BREAST CANCER AWARENESS RIBBON 595 x 331 RHINESTONE IRON ON HOTFIX TRANSFER $9.99 Time Remaining: 14d 16h 48m Buy It Now for only: $9.99 |
 white Breast Cancer bear Pink ribbon support embroidered patch $2.00 (1 Bid) Time Remaining: 1d 12h 4m |
 Beautiful Walk for the Cure and Breast Cancer Ribbon Embroidered patch $4.99 Time Remaining: 23d 21h 42m Buy It Now for only: $4.99 |
 RHINESTONE Iron On Transfer Breast Cancer Pink ribbon Crystal 5 x 3 RUN $6.00 Time Remaining: 7d 13h 46m Buy It Now for only: $6.00 |
 BREAST CANCER ANGEL WINGS RHINESTONE IRON ON TRANSFER $13.99 Time Remaining: 22d 19h 49m Buy It Now for only: $13.99 |
 Breast Cancer Awareness Custom Iron on Transfer 33 $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 Breast Cancer Awareness Pink Ribbon Cotton Fabric FQ $2.15 Time Remaining: 17d 11h 1m Buy It Now for only: $2.15 |
 SEARS KENMORE 14812210 SEWING MACHINE FOOT 2 TYPES SUPPORT BREAST CANCER CARE $15.00 Time Remaining: 26d 15h 18m Buy It Now for only: $15.00 |
 Breast Cancer Awareness Second Base Iron on Transfer $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 Pretty Pink Survivor Ribbon Breast Cancer Rhinestud Iron On Transfer $12.98 Time Remaining: 22d 1h 51m Buy It Now for only: $12.98 |
 Breast Cancer Awareness 2nd Base Iron on Transfer $3.00 Time Remaining: 15d 2h 3m Buy It Now for only: $3.00 |
 Breast Cancer Awareness Iron ons by Wrights $2.99 Time Remaining: 10d 18h 20m Buy It Now for only: $2.99 |
 BREAST CANCER RIBBON 1 7 8 IRON ON APPLIQUES $1.25 Time Remaining: 13d 20h 46m Buy It Now for only: $1.25 |
 RETRO VINTAGE SEARS WOOD SEWING MACHINE TABLE 20 GOES TO BREAST CANCER CARE $82.65 Time Remaining: 2d 12h 6m Buy It Now for only: $82.65 |
 Rhinestone Iron On Transfer One pc Breast Cancer Peace Cure Love Design $10.99 Time Remaining: 7d 2h 52m Buy It Now for only: $10.99 |
 BREAST CANCER RIBBON IRON ON PATCH 25 inches tall $5.00 Time Remaining: 9d 18h 29m Buy It Now for only: $5.00 |
 Rhinestone Iron On Transfer One pc Breast Cancer Hope Ribbon Design $7.99 Time Remaining: 7d 2h 49m Buy It Now for only: $7.99 |
 4 LOT PINK RIBBON BREAST CANCER AWARENESS ITEM CLOTH TAPE MEASURES SALE $17.00 Time Remaining: 19d 23h 58m Buy It Now for only: $17.00 |
 Brown Breast Cancer bear Pink ribbon embroidered patch Support $2.50 (1 Bid) Time Remaining: 1d 16h 58m |
 Valentine Heart Breast Cancer Bling Balloons Iron On Hot Fix Rhinestone Transfer $11.99 Time Remaining: 28d 14h 16m Buy It Now for only: $11.99 |
 1969 ANTIQUE SEARS WOOD SEWING MACHINE TABLE 20 BREAST CANCER CARE RESEARCH $108.75 Time Remaining: 25d 9h 45m Buy It Now for only: $108.75 |
 WHITE 1546646 SEWING MACHINE ASSORTED PARTS SCREWS SUPPORT BREAST CANCER CARE $10.44 Time Remaining: 3d 20h 59m Buy It Now for only: $10.44 |
 TWO PINK RIBBON HOTFIX IRON ON TRANSFER BREAST CANCER $10.95 Time Remaining: 2d 39m Buy It Now for only: $10.95 |
 4 PINK BREAST CANCER RIBBON RHINESTONE IRON ON TRANSFER HOT FIX BLING AWARENESS $9.99 Time Remaining: 20d 14h 30m Buy It Now for only: $9.99 |
 Breast Cancer Awareness Save Melons Iron on Transfer $3.00 Time Remaining: 15d 2h 2m Buy It Now for only: $3.00 |
 ANTIQUE WOOD SEWING MACHINE TABLE 20 HELPS SUPPORT BREAST CANCER CARE RESEARCH $99.95 Time Remaining: 25d 12h 4m Buy It Now for only: $99.95 |
 Iron On Applique Beaded Sequins Sewing Pink Ribbon Bow Breast Cancer Awareness $1.05 Time Remaining: 8d 18h 38m Buy It Now for only: $1.05 |
 ORIGINAL SINGER TOUCH SEW 600 E TENSION ASSEMBLY HELP FIGHT BREAST CANCER $11.27 Time Remaining: 23d 12h 18m Buy It Now for only: $11.27 |
 BROTHER CHAMPION U 237177 SEWING MACHINE STRONG MOTOR SUPPORT BREAST CANCER $30.45 Time Remaining: 15d 17h 22m Buy It Now for only: $30.45 |
 1968 SEARS ROEBUCK SEWING MACHINE WOOD TABLE DRAWER HELP FIGHT BREAST CANCER $145.00 Time Remaining: 25d 13h 44m Buy It Now for only: $145.00 |
 WHITE ZIGZAG LOWER SEWING MACHINE BELT SUPPORT BREAST CANCER RESEARCH CARE $12.14 Time Remaining: 11d 13h 47m Buy It Now for only: $12.14 |
 Breast Cancer Awareness Pink Ribbon Rhinestone Iron On $9.99 Time Remaining: 29d 11h 28m Buy It Now for only: $9.99 |
 BLING CAUSE RIBBONS HUGE ALL COLORS TRANSFERS IRON ON $2.99 Time Remaining: 24d 12h 13m Buy It Now for only: $2.99 |
 Iron On Transfer Pink Breast Cancer Survivor Rhinestone $10.00 Time Remaining: 24d 13h 56m Buy It Now for only: $10.00 |
Breast Cancer
Early Breast cancer detection at mass level; what can be done in developing countries?
Breast cancer is the most common cancer and second leading cause of cancer death in women around the world[1]. In Indian women, breast cancer is the second most common cancer, next only to carcinoma cervix. But in many urban areas in India, the breast cancer has recently emerged as the leading cancer in women [2].Breast cancer constitutes about 19-34% of all cancer cases among women in India [3,4,5]. Age adjusted incidence of breast cancer in India varies from 16 to 25 per lac population and approximately 80,000 new cases of breast cancer are diagnosed every year.[6]. With the rapid urbanization and changing lifestyle, the numbers are likely to increase further.
Early diagnosis and prompt treatment are paramount to improving the outcome of breast cancer. In India, early breast cancer constitutes about 30% [7] and locally advanced breast cancer constitutes about 50-70% of the breast cancer load. [8]. Accordingly, the proportional mortality rates in our country are much higher compared to North America where majority of cases present in early stages. The incidence to mortality ratio in North America is 0.25 compared to 0.48 in India [9]. Similarly, 5-year survival of over 70% in North America and western Europe is much higher than less than 48 % in India [10,11] and less than 10% in other developing countries [12].
There are many barriers to early diagnosis and treatment in India and other developing countries. First, women are not able to detect a lump in their breast early. Second, even after discovering a painless lump, they fail to understand its cancerous nature or prevalent notion of incurable nature of cancer prevents them from reporting to a healthcare facility early. This fact is supported by various studies in India and other developing countries which show that 79-98% of the women surveyed don't know that a painless lump in a breast can be cancer [14,15]and more than 75% of women link painful lumps and pain in the breast to cancer.[13]. Third, access to healthcare facility is limited in rural areas where majority of population lives. Last, conservative socio-cultural milieu prevents a woman from approaching male health care personnel for early check-up. The relative contribution of each of these factors is a matter of speculation.
To facilitate early identification of a lump in the breast, there are 3 available modalities; BSE(breast self examination), CBE (clinical breast Examination) and mammography. Both Mammography and CBE are effective in decreasing mortality due to breast cancer[16-21] Recommending mammography as a regular screening test on mass scale in India is impractical because of the astronomical costs involved in developing the requisite infrastructure and manpower. Moreover, the burden of breast cancer in developing countries is more in younger age group[3] in which the efficacy of mammography to detect breast cancer is questionable[22]. Similarly regular CBE on mass scale is logistically difficult due to scarcity of trained health personnel and socio-religious taboos regarding clinical breast examination [23,24].
BSE is a simple and inexpensive tool and can be performed by women themselves. Some studies have shown that practicing BSE helps to detect breast cancer lumps of smaller sizes [25-29] and leads to early diagnosis of breast cancer [25-34]but this does not translate in to reduction in mortality from breast cancer[35-37]. Presently, there is insufficient evidence to recommend for or against the teaching of BSE [38]. Conversely, BSE increases the number of physician visits for the evaluation of benign breast lesions and leads to higher rates of benign breast biopsies[35-37]. Also, proper technique of BSE is expensive to teach and difficult to perform[39-43]. Hence, the status of BSE as a screening modality on mass scale is debatable [35,44,45]. Furthermore, even in women performing BSE regularly, many early detected tumors are found incidentally and not during self examination[46-49]. Thus conventional screening tools are impracticable in developing countries highlighting the need for novel approaches.
Prevalent misconceptions of pain associated with any cancerous breast lump and incurability of cancer are unaddressed issues in developing countries. Creating awareness on mass scale about these facts that any lump in the breast even a painless one can be cancer as well as curability of early diagnosed breast cancer is the need of the hour. This strategy is relatively easy, inexpensive and practicable in resource restricted countries till standard screening tools are universally available, affordable and accessible to masses.
References
- Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics,202. CA Cancer J Clin 2005,55(2): 74-108
- Indian Council of Medical Research. National Cancer Registry Programme of India - an Overview. NCRP: Bangalore; 2002
- National Cancer Registry Programme. Consolidated report of the population based cancer registries1990-1996. New Delhi: Indian Council of Medical Research; 2001
- National Cancer Registry Programme. Ten year consolidated report of the hospital based cancer registries 1984-1993. An assessment of the burden and care of cancer patients. New Delhi: Indian Council of Medical Research; 2001
- National Cancer Registry Programme. Consolidated report of the population based cancer registries1990-1996. Supplement: Year-wise tabulation of incident cancers and rates by site and gender. New Delhi: Indian Council of Medical Research; 2001
- Nair MK, Sankaranarayanan R, Nair KS, Amma NS, Varghese C, Padmakumari G, et al. Overall survival from breast cancer in Kerala, India, in relation to Menstrual, Reproductive, and Clinical factors. Cancer 1993;71:1791-6
- Nandakumar A, Anantha N, Venugopal TC, Sankaranarayanan R, Thimmasetty K, Dhar M. Survival in breast cancer: A population-based study in Bangalore, India. Int J Cancer 1995;60:593-6.
- Chopra R. The Indian scene. J Clin Oncol 2001;19:106S-11S
- Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999;49:33-64
- Goel AK, Seenu V, Shukla NK, Raina V. Breast cancer presentation at a regional cancer center. Natl Med J India 1995;8:6-9
- Gajalakshmi CK, Shanta V, Swaminathan R, Sankaranarayanan R, Black RJ. A population-based survival study on female breast cancer in Madras, India. Br J Cancer 1997;75:771-5
- Okobia MN, Osime U.Clinicopathological study of carcinoma of breast in Benin city. Afr J Reprod Health 2001;5(2)56-62
- Odusanya OO, Tayo OO. Breast cancer knowledge, attitudes and practice among nurses in Lagos, Nigeria. Acta Oncol 2001;40(7):844-848
- Okabia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: A cross sectional study. Wor J Surg Onco 2006;4:11-20
- Oluwatosin OA, Oladepo O.Knowledge of breast cancer and its early detection measures among rural women in Akinyele local government area, Ibadan, Nigeria. BMC Cancer 2006; 6: 271
- Kerlikowske K, Grady D, Rubin SM, Sandrock C, Ernster VL. Efficacy of screening mammography. A meta-analysis. JAMA 1995;273:149–54
- Wells MJ. Mammography and the politics of randomized controlled trials. Br Med J 1998;317:1224-1230
- Smart CR, Hendrick RE, Rutledge JH 3d, Smith RA. Benefit of mammography screening in women ages 40 to 49 years. Current evidence from randomized controlled trials. Cancer 1995;75:1619-26 (published erratum appears in Cancer 1995;75).
- Tabar L, Fagerberg G, Chen HH, Duffy SW, Smart CR, Gad A, et al. Efficacy of breast cancer screening by age. New results from the Swedish Two-county Trial. Cancer 1995;75:2507-17
- Miller AB, To T, Baines CJ, Wall C. Canadian National Breast Screening Study-2: 13-year results of a randomized trial in women aged 50–59 years. J Natl Cancer Inst 2000;92:1490–9
- Maxwell AE, Bastani R, Warda US. Demographic predictors of cancer screening among Filipino and Korean immigrants in the United States. Amer J Prev Med 2000;18:62–68.
- Maxwell AE, Bastani R, Warda US. Misconceptions and mammography use among Filipino-and Korean-American women. Ethnc and Dis. 1998;8:377–384
- Owen WL, Hoge AG, Asal NR, Anderson PL Jr, Cucchiara AJ. Self-examination of the breast: use and effectiveness. South Med J 1985;78:1170–3.
- Smith EM, Francis AM, Polissar L. The effect of breast self-exam practices and physician examinations on extent of disease at diagnosis. Prev Med 1980;9:409–17
- McPherson CP, Swenson KK, Jolitz G, Murray CL Survival of women ages 40–49 years with breast carcinoma according to method of detection. Cancer 1997;79:1923–32
- Smith EM, Burns TL. The effects of breast self-examination in a population-based cancer registry. Cancer 1985;55:432–7
- Koibuchi Y, Iino Y, Takei H, Maemura M, Horiguchi J, Yokoe T, et al. The effect of mass screening by physical examination combined with regular breast self-examination on clinical stage and course of Japanese women with breast cancer. Oncol Rep 1998;5:151–5
- Gould-Martin K, Paganini-Hill A, Casagrande C, Mack T, Ross RK. Behavioral and biological determinants of surgical stage of breast cancer. Prev Med 1982;11:429–40
- Greenwald P, Nasca PC, Lawrence CE, Horton J, McGarrah RP, Gabriele T, et al. Estimated effect of breast self-examination and routine physician examinations on breast-cancer mortality. N Engl J Med 1978;299:271–3.
- Kuroishi T, Tominaga S, Ota J, Horino T, Taguchi T, Ishida T, et al. The effect of breast self-examination on early detection and survival. Jpn J Cancer Res 1992;83:344–50
- Philip J, Harris WG, Flaherty C, Joslin CA, Rustage JH, Wijesinghe DP. Breast self-examination: clinical results from a population-based prospective study. Br J Cancer 1984;50:7–12
- Auvinen A, Elovainio L, Hakama M. Breast self-examination and survival from breast cancer: a prospective follow-up study. Breast Cancer Res Treat 1996;38:161–8.
- Thomas DB, Gao DL, Ray RM, Wang WW, Allison CJ, Chen FL, et al. Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst 2002;94:1445–57
- Semiglazov VF, Moiseyenko VM, Manikhas AG, Protsenko SA, Kharikova RS, Ivanov VG, et al. Role of breast self-examination in early detection of breast cancer: Russia/WHO prospective randomized trial in St. Petersburg. Cancer Strategy 1999;1:145–51
- Semiglazov VF, Moiseyenko VM, Bavli JL, Migmanova NS, Seleznyov NK, Popova RT, et al. The role of breast self-examination in early breast cancer detection (results of the 5-years USSR/WHO randomized study in Leningrad). Eur J Epidemiol 1992;8:498–502
- U.S. Preventive Services Task Force. Screening for breast cancer: recommendations and rationale. Ann Intern Med 2002;137:344–6
- O'Malley MS. Cost-effectiveness of two nurse-led programs to teach breast self-examination. Am J Prev Med 1993;9:139–45
- Campbell HS, McBean M, Mandin H, Bryant H. Teaching medical students how to perform a clinical breast examination. Acad Med 1994;69:993–5
- Fletcher SW, O'Malley MS, Earp JL, Morgan TM, Lin S, Degnan D. How best to teach women breast self-examination. A randomized controlled trial. Ann Intern Med 1990;112:772–9
- Campbell HS, Fletcher SW, Pilgrim CA, Morgan TM, Lin S. Improving physicians' and nurses' clinical breast examination: a randomized controlled trial. Am J Prev Med 1991;7:1–8
- Pilgrim C, Lannon C, Harris RP, Cogburn W, Fletcher SW. Improving clinical breast examination training in a medical school: a randomized controlled trial. J Gen Intern Med 1993;8:685–8
- Harris R, Kinsinger LS. Routinely Teaching Breast Self-Examination is Dead. What Does This Mean? J Nat Can Inst 2002; 94(19): 1420-1421
- World Health Organisation- Guidelines 2007. Screening for Breast Cancer
- Auvinen A, Elovainio L, Hakama M. Breast self-examination and survival from breast cancer: a prospective follow up study. Breast Cancer Res Treat 1996;38(2):161-8
- Miller AB, Baines CJ, To T, Wall C. Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50–59 years. CMAJ 1992;147:1477-88
- McPherson CP, Swenson KK, Jolitz G, Murray CL. Survival of women ages 40–49 years with breast carcinoma according to method of detection. Cancer 1997;79:1923-32
- Huguley CM, Brown RL, Greenberg RS, Clark WS. Breast self-examination and survival from breast cancer. Cancer 1988;62:1389-96
About the Author
Senior Surgeon & Internationally renowned Doctor
Department of Surgery, Fortis Super-specialty Hospital
Mohali (Chandigarh), Punjab
India
What does it mean when breast cancer (level 1 tumor) has already gone into the bones?
I have a dear family member who went to the doctor because of a fall - turned out she fractured her pelvis - but in the course of investigating it, the doctor discovered lesions in the bones pretty much all over her body. Turns out she has a level 1 tumor in her breast and that the lesions in her bones are also breast cancer. For some reason, the doctors are NOT giving her a death sentence, but I have always heard that when a cancer spreads to the bones or another organ, then there is pretty much no hope. So, is there actually hope now?
The "level 1 tumor" makes no sense. If there is breast cancer metastatic to bones, it is a stage IV breast cancer. We do not have a cure for this, but sometimes this disease can be controlled for many months or even a few years with hormonal therapy, chemotherapy, and palliative radiation therapy.
We do not cure diabetes or high blood pressure, but we can control these diseases for a time with medical treatments.
There is no reason for her doctors to "give her a death sentence" -especially since we don't know whether she will respond to simple oral hormonal agents. Is this an estrogen receptor positive or negative breast cancer? We don't have this information, but her doctors do.
I always say this - we doctors do not "give " people amounts of time to live. It is not for us to decide that. We can only quote statistics based on the experiences of other people in similar situation - none of which will be exactly like the person concerned. Each person is special and different, and doctors cannot predict the future of anyone perfectly. I preferred not to make these guesses, but people usually push for some kind of guess.
Interesting question - If you had an envelope containing the information about when exactly you were going to die, would you open it - - knowing you could do nothing to change it? I would tear it up and throw it away. Most of us don't want to give up all hope. There is hope for a good response in this situation and some good quality time.
Breast Cancer Progression and Staging