To determine the relation between different methods of breast self-examination (BSE) and actual existence of breast lumps, the authors studied 108 patients in the Rome University “Tor Vergata” from 1 October 2006 to 31 August 2007. The panel is composed by women suspecting and/or actually having detected breast lumps. These 108 women were split into two equal groups: Group 1 was issued the Donna Glove, a grade one medical device designed to enhance sensitivity of palpation. The objective was to determine if an improved lump detection rate could be achieved. Group 2 continued to make breast self examinations (BSE) with the bare hand. At a medium follow-up time of 6 months 84% of all patients had a re-occurrence of lumps confirmed by mammography. These were equally present in both groups, 45 patients in each group had a recurrence of lumps. Group 1 had a 100% detection rate, all 45 positives were detected. Group 2 had a below 50% detection rate, only 22 positives were detected while 23 failed to detect any existing lumps. Since lumps can grow within a week, is highly recommended that women in such high risk groups have BSE at least weekly. The significant difference persisted after adjusting for any combination of the age, method of detection, family history of breast cancer. The subsequent mammography confirmed these percentages. The authors conclude that, in this population of potential breast cancer patients, breast self-examination with glove is related to a greater earlier detection and thus, in case of cancer lumps, improves survival chances than the one made with bare hands.

MATERIAL AND METHOD

Across-sectional study of 108 women presenting for screening mammography was conducted with a self-administered questionnaire. Data were collected regarding sociodemographic information, health care provider information, breast self-examination practices.

Breast Self-Examination: Early Cancer Detection Is Key

The best reason for performing monthly breast self-examinations is the fact that 90 percent of all lumps and just under half of all breast cancers are actually discovered by women or by their partners. As with all tumors, early detection leading to early treatment is the single most important factor in successful tumor removal and preservation of the breast.One in every nine Italian women will develop breast cancer. It is the most common cancer among Italian women. As in all types of cancer, early detection and treatment saves lives. We adopted an easy-to-follow modern breast self-examination education and training, using a 3 layers plastic glove, brand name DONNAGlove, manufactured and supplied by the Italian company POGGIO FIORITO srl ABSE should be performed on each breast in a routine fashion to be sure no area is missed. To perform a breast self-examination, a woman should lie down and place her right arm behind her head to begin examining her right breast. It is not recommended to perform a BSE standing up because the position does not allow the breast tissue to spread evenly over the chest wall.

By lying down, the tissue is spread thinner and thus makes it easier to detect any possible changes. After the breast has been examined, it is important for a woman to also examine each underarm for any lumps or signs of enlarged lymph nodes. This part of the exam can be done while sitting or standing. Each arm should be raised only slightly so that the tissue is not tightened. For women who choose to perform monthly breast self-examinations, it is important to do the exam regularly and become familiar with their breasts. Awoman (or man) who detects a change or lump in the breast should first check the other breast. It is normal to find some lumpiness, especially if both breasts feel the same. However, a patient should contact their physician if any of the following signs or symptoms develop: - Development of a lump in the breast or underarm area - Irregular thickening of breast tissue - Swelling - Skin irritation - Dimpling or puckering - Nipple pain - Nipple retraction (turning inward) - Redness or scaliness of the nipple or breast - Discharge from the nipple (other than breast milk) recommend breast self-exams, as important part of the three-step process to screen for breast cancer. The three steps include: - Breast self-examination (BSE) - Clinical breast examination (CBE) - Mammography In the end, the most important goal is to report any changes in her breasts to a physician.

For some women, has been helpful to be trained in the skill of breast self-examination by a health care professional, but for the majority of women, the teaching aids produced by a self-explaining brochure proved to be sufficient. They found the glove easy to be used and stated that the fact of having it has greatly increased their awareness of the breast cancer prevention importance. More frequent breast self-examination is associated with a greater likelihood of the patient's detecting her own cancer, less delay from first symptom to histologic diagnosis, earlier clinical stage, smaller pathologic tumor size, and fewer axillary node metastases. Authors: 1. Prof Oreste BUONOMO - Breast Unit - TorVergata University - ROME 2. Prof Stefano VERARDI - Plastic Reconstructive Surgery Unit - TorVergata University - ROME

REFERENCES

American Cancer Society. (2006). Breast cancer facts & figures 2005-2006. Atlanta: American Cancer Society. Retrieved January 8, 2007, from http://www.cancer.org/downloads/STT/CAFF2005BrF.pdf

Clarke, V. (1999). The effectiveness of breast self-examination: Aliterature review. Woolloomooloo, N.S.W., Australia: NHMRC National Breast Cancer Centre.

Fentiman, I. S., & Hamed, H. (1997). Atlas of breast examination. London: BMG Pub. Group.

Milan, A. R. (1980). Breast self-examination: a pictorial manual. New York: Workman Publishing Company.

National Cancer Institute. (1983). Coordinators guide for the BSE-in-hospitals program: Nurses teaching patients breast self examination. NIH Publication No. 83-2404. Washington, DC: US Department of Health and Human Services, Public Health Service.