Significance of early screening in disease/illness prevention – This book covers the entire syllabus of “Community Health Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate latest information and topics.
This book is examination friendly setup according to the teachers’ lectures and examination’s questions. At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourished. The unique way of presentation may make your reading of the book a pleasurable experience.
Significance of early screening in disease/illness prevention
Breast screening
Breast screening leads to early diagnosis of breast cancer. Breast cancer is the most common cancer among women and the incidence is rising. Early detection and treatment have resulted in incident survival rates. Screening for breast cancer has a favorable effect on mortality from breast cancer.
The basic techniques for early detection of breast cancer are
1. Self-examination of Breast (BSF)
2. Palpation by physician;
3. Thermography and
4. Mammography.
All women should be encouraged to perform breast self- examination. Although the effectiveness of BSF has not been adequately quantified. It is a useful technique to early ca.se detection. In many countries BSF will probably be the only feasible approach to wide population coverage for a long time to come. Through regular monthly self-examination of breast (BSF) & woman learn to recognize her normal findings, which helps her detect changes, if they occur. Every woman who has begun to menstruate should know the correct way to perform breast self- examination.
Risk factors for breast cancer
Risk factors:
- Gender (100 times more common in women)
- Age (risk increases with increasing age)
- Genetics,
- Family history of breast cancer
- Personal history of breast cancer.
- Early menarche and late menopause.
- No natural children.
- First child born to mother older than age 30.
- Oral children use (slight risk).
- Regular alcohol intake, especial with two to five drinks daily.
- Higher education and socioeconomic status.
- Previous breast irradiation Hormone replacement therapy with progesterone.
- Wet earwax
Possible Risk Factors for Breast Cancer
- Taller height
- High waist-to-hip ratio
- Height-fat-diet.
- Low number of births.
- No breast-feeding.
- Low level of physical activity, possible
Risk Factors for Mortality
- No (or poor) breast self- examination
- Poor screening (physical examination or mammography)
Precaution for risk of breast cancer
- Not delaying pregnancy until after 30 years of age.
- Breast-feeding.
- Performing monthly breast self-examination (BSF).
- Following the American Cancer Society Guidelines for clinical evaluation and mammography
- Strenuous exercise, especially in youth but also in adulthood
- Non-steroidal anti- inflammatory drug (NASID) therapy (may have protective effectives)
Techniques of Breast self-examination
The breast self- examination should be done at the same me each month at the end of the menstrual period for menstruating female or on the same date each month for women who have ceased menstruating.
The best time to reform a BSE is 2 or 3 days after period ends, when breast are least likely to be tender or swollen, he nurse’s responsibilities include teaching the importance of breast self-examination, demonstrating the examination and evaluating the patient’s ability to perform a return demonstration. There are six steps following for breast self-examination.
Step-1
- Stand before a mirror;
- Check both breasts for anything unusual.
- Look for discharge from the nipple, puckering, dimpling, or scaling of the skin.
The next two-step are done to check for any changes in the contour of your breast. As you do them, you should be able to feel your muscles tighten.
Step-2
Watch closely in the mirror as you clasp your hands behind your head and press your hands forward. Note any change in the contour of your breast.
Step-3
1. Next, press your hands firmly on your hips and elbow slightly toward the mirror as youpull your shoulders and elbows forward.
Some women do the next part of the examination in the shower. Your fingers will glide easily over soapy skin, so you can concentrate on feeling for changes inside the breast.
Step-4.
1. Raise your left aim
2. Use three or four fingers of your right hand to feel your left breast firmly, carefully, and thoroughly.
3. Beginning at the outer edge, press the left part of your fingers in small circles, moving the circles slowly around the breasts.
4. Gradually work toward the nipple.
5. Be sure to exam the whole breast.
6. Pay special attention to the area between the breast and the under arm, including the underarm itself
7. Feel for any unusual lamps or masses under the skin.
Step-5
1. Gently squeeze the nipple and look for a discharge.
2. If you have any discharge during the month whether or not it is during BSF-sce your doctor Repeat the examination on your right breast.
Step-6
1. Step 4 and 5 should be repeated lying down.
2. Lie flat on your with your back with your left are over your head and a pillow or folded towel under your left shoulder. (This position flattens your breast and makes it easier to check).
3. Use the same circular motion described above.
4. Repeat on your right breast.
Note: After maturation of the breasts, girls can be taught how to examine themselves for early signs of cancer, regular examination, of the breasts should follow each I menstrual period. BSE can be taught during the physical assessment, but films and group discussions are helpful in reinforcing the importance and acceptability of this self- care responsibility. The nurse reminds girls to make an immediate appointment with their health care providers for a breast examination if they feel a breast mass.
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