Brief counseling boosts breast self-exam rates

Women who take part in a quick counseling session on breast self-examination (BSE), reinforced with a couple of follow-up calls, are more likely to perform the exams regularly, new research in the journal Health Promotion shows.

"Even brief intervention programs can be effective at encouraging self-screening for cancer," Dr. Nangel M. Lingberg of the Kaiser Permanente Center for Health Research in Portland, Oregon and colleagues write. "This intervention could easily be modified to target other screening practices (e.g., skin or testicular cancer screening) that are associated with reduced cancer morbidity and mortality."

The researchers randomly assigned 616 women 40 to 70 years old, all of whom had negative mammograms in the previous two months, to the BSE instruction program or to a "control" group given nutrition advice on preventing cancer.

The counseling session, which lasted 30 to 45 minutes, included instruction on how to do a BSE, practice using silicone models and discussion about barriers women had to doing BSE and how to address these barriers.

For example, many women said they didn't know what to do if they found a lump in their breast; they got information on how to reach their HMO's breast health clinic. Women in both groups also got follow-up calls to check on their progress one and two months after the intervention.

One year later, 59 percent of the women in the BSE group reported examining their breasts for at least five minutes every month (considered adequate BSE performance) compared to 12 percent of women in the control group.

Women who felt that they were at "great risk" of developing breast cancer were actually less likely than those who didn't believe they were at high risk to examine their breasts regularly, the researchers note, although this finding wasn't statistically significant.

This finding, they say, "underscores the complexity of the relation between self-care behaviors and perceived vulnerability to developing breast cancer."

SOURCE: Health Promotion, May/June 2009.