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CLINICAL: WOMEN’S HEALTH


Nicola West RGN BN PGFETC (CERT ED) MA


Consultant Nurse, Cardiff and Vale University Health Board


Encouraging breast


awareness in primary care By empowering women to understand their breasts, nurses can help detect breast diseases early and improve recovery rates


B


reast cancer is the most common cancer diagnosed in industrialised countries. Breast awareness screening and education as well as improvements in treatment and specialised breast units with a dedicated multidisciplinary team, have all contributed to better outcomes for patients.


This article discusses the importance of breast awareness


with regard to both malignant and benign conditions of the breast. It discusses how to be breast aware and the role of the primary care team in the education, promotion and support of breast awareness. The primary care team are the first point of contact for women


with a breast problem and play a crucial role in the management of their care. It is important that knowledge is up-to-date and that primary care nurses feel confident to encourage patients to be


BOX 1. BENIGN CONDITIONS


Fibroadenomas (fibrous lumps). Cysts (fluid-filled lumps). Breast pain (unilateral or bilateral). Gynaecomastia (enlarged breast tissue in men). Phylloides (fibro-epithelial tumours - usually fast-growing and large - can also be malignant). Mondors syndrome (inflammation of the vein running under the skin of the breast). Lipomas (fatty lumps). Hamartomas (neoplasm in the tissue). Accessory breast tissue. Sebaceous cysts. Costo-chondritis (inflammation of the chest wall muscles - often mistaken for breast pain).


breast aware, advise them appropriately and know when to refer on appropriately to a dedicated breast unit. The NHS cancer plan1


encourages prevention, education and good communica-


tion from all healthcare professionals involved in cancer care, as does the Royal College of Nursing (RCN).2


THE FACTS Breast cancer is the most common cancer amongst women in the UK with approximately 48,000 cases diagnosed every year. It is estimated that 1 in 8 women will contract the disease sometime in their lives3


cancer every month.3


and there are around a 1,000 deaths from breast Although it is predominantly a disease of


older women, there are approximately 8,000 women under the age of 50 diagnosed per year. It is the second most common cancer in women under the age of 35, and there are 1,300 deaths per year in women age 35-39. Men are also affected by breast cancer and account for approximately 400 cases per year.3 Mortality rates are decreasing as a result of better treatment, screening and earlier detection6


and therefore much of the media


attention now is on early detection and treatment. The five-year survival rate for localised breast cancer is 84 %.4


This is very


encouraging when compared to other tumour sites. A discrete breast lump is not the only sign that a woman may


have a breast cancer, which is why breast self-examination is not recommended as a stand alone screening modality. Diagnosis of a breast problem is made by a clinical examination, mammogra- phy if over the age of 35 and a biopsy of a discrete lesion. The treatment of a breast cancer can involve surgery, radiotherapy, chemotherapy, hormones, herceptin (a monoclonal antibody) or a combination of these. It is well documented that early presentation of breast cancer,


as well as better treatments and screening, lead to better outcomes1,5


and that most breast cancers are found by women


themselves. Therefore women In the UK are encouraged to be ‘breast aware’ from the age of 18. That said, some women still


60 Nursing in Practice March/April 2012


www.nursinginpractice.com


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