Evaluation of effect of self-examination and physical examination on breast cancer

- A community based project for the evaluation of screening breast examinations and the teaching of breast self-examination has been conducted in Yazd City, Iran.
- Randomization to an intervention and a control group was successful, as evidenced by an almost identical distribution of breast cancer risk factors in the two groups.
- A high response to invitations to attend a primary health centre for breast examination in the intervention group was achieved and telephone calls in the control.
- Women who developed advanced cancer in the control group may have failed to report their breast abnormality (or receive treatment for breast cancer).
- Follow-up is planned to a total of 10 years; attempts will be made to identify women in the control group who have hidden their cancer.

BackgroundBreast cancer is the number one cancer of women in the world. More than 90% of breast cancers can be cured with early diagnosis followed by effective multimodality treatment. The efficacy of screening by breast self-examination (BSE) and breast physical examination (BPx) is best evaluated using randomized screening trials.MethodA total of 12,660 women aged 35-64 years, 6330 in the intervention group and 6330 in the control group, were randomly selected from four areas of Yazd city, I.R. of Iran. The number of detected cancers along with kind of cancer, staging of cancer, the route of detected cancer and the number of deaths during the first 5 years of the study were collected and analyzed.ResultsNo significance difference between the two groups was seen in respect to socio-demographic and socio-economic variables (P > 0.05). Subjects in the intervention group had a response rate of 83.5% for attending the health center and 80.2% for visiting the assigned surgeon. A total of 31 and 13 new cases of breast cancer were identified in the intervention and control groups, respectively, of which 48.5% of cases in the intervention group were <50 yr of age. A significant difference between the cumulative incidence of breast cancer in the two groups with a ratio of 2.4 was observed.ConclusionBSE & BPx have a significant effect in detecting breast cancers at early stages (<3) suggesting they are effective screening tests with high availability and low costs that can be applied at the community level.