Breast self-examination education for BRCA mutation carriers by clinical nurse specialists
Annemiek Visser1, Wilmy C A M Bos, Judith B Prins
1Author Affiliations: PhD Student (Ms Visser), and Professor in Psychosocial Oncology, Clinical Psychologist, and Head of Department (Dr Prins), Department of Medical Psychology; Clinical Nurse Specialist (Ms Bos) and Medical Oncologist (Dr Laarhoven), Department of Medical Oncology; Professor in Hereditary Cancer, Medical Specialist for Internal Medicine, and Head of Outpatient Clinic for Hereditary Cancer (Dr Hoogerbrugge), Department of Genetics, Radboud university medical center Nijmegen; Professor in Translational Oncology and Medical Oncologist (Dr Laarhoven), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Purpose:
Breast self-examination (BSE) may be beneficial for women with a BRCA1 or BRCA2 mutation. Therefore, these women are often advised to perform BSE. However, only 20% to 35% is performing BSE monthly, and proficiency levels are low. Recently diagnosed carriers are educated by a specially trained clinical nurse specialist (CNS) on how to perform BSE, as part of the yearly surveillance. Clinical nurse specialists are already commonly involved in breast cancer care. However, CNSs are not yet involved in the counseling of BRCA mutation carriers. The aim of this RCT was 2-fold: (1) to evaluate the feasibility of CNS-led BSE education (based on the Health Belief Model) as part of BRCA surveillance and (2) to evaluate the effects and feasibility of additional written information leaflets concerning BSE.
Methods:
Thirty-seven female BRCA1 or BRCA2 mutation carriers were randomized into the intervention or control group. Women in both groups were educated about BSE by a specially trained CNS during the yearly visit to the outpatient clinic. The intervention group received additional written BSE instructions. After 3 months, 29 patients filled out a questionnaire, covering demographic characteristics, BSE behavior, and patient satisfaction.
Results:
The BSE frequencies did not significantly differ between both groups. A significant increase in the self-reported frequency of BSE after CNS-led education (P < .001) was shown. Before the education, the main reason for not performing BSE was that women had felt unable to perform BSE (42.9%). Patient satisfaction with the CNS-led education was high.
Conclusion:
CNS-led BSE education is feasible for the yearly breast surveillance of BRCA mutation carriers. In addition, a leaflet was shown to be useful as an additional source of information for patients.
Implications:
These results indicate that it is feasible to involve a CNS in the yearly surveillance of BRCA mutation carriers, which could be a solution for the continuous increased demand for care, while providing continuing high-quality care.
More Related Videos
13:04In Vivo and Ex Vivo Approaches to Study Ovarian Cancer Metastatic Colonization of Milky Spot Structures in Peritoneal Adipose
Published on: October 14, 2015
08:53Identifying the Effects of BRCA1 Mutations on Homologous Recombination using Cells that Express Endogenous Wild-type BRCA1
Published on: February 17, 2011
Related Concept Videos
02:59Cancer Prevention
01:19Mitral Valve Prolapse III: Nursing Management