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The Nottingham breast self-examination project.

R W Blamey1, A P Locker, A K Mitchell

  • 1Department of Surgery, City Hospital, Nottingham, England.

Acta Oncologica (Stockholm, Sweden)
|January 1, 1989
PubMed
Summary
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Breast self-examination (BSE) education for women aged 50-65 shows a reduced risk of death from breast cancer. BSE programs are cost-effective and may improve survival when added to mammography screening.

Area of Science:

  • Oncology
  • Public Health
  • Preventive Medicine

Background:

  • The Nottingham breast self-examination (BSE) project is part of a larger trial comparing early breast cancer detection methods.
  • The study analyzes data from women aged 40-64 invited for BSE education.
  • Attendance rates for BSE education were approximately 55% after accounting for register inaccuracies.

Purpose of the Study:

  • To analyze the impact of breast self-examination (BSE) education on breast cancer detection and survival.
  • To compare prognostic factors and survival rates between women educated in BSE and a control group.
  • To evaluate the cost-effectiveness and potential survival advantage of BSE programs.

Main Methods:

  • A cohort study comparing 751 cancers diagnosed in women invited for BSE education (study group) since 1979 with a control group.

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  • Prognostic factors (tumor size, lymph node involvement, grade) were assessed.
  • A case-control study evaluated the relative risk of death from breast cancer based on BSE education attendance.
  • Main Results:

    • Prognostic factors were improved in the study group, but survival curves had not yet separated.
    • Women aged 50-65 who attended BSE education had a significantly reduced relative risk of death from breast cancer (0.66, p = 0.025).
    • For women aged 40-49, the relative risk of death was 0.85, which was not statistically significant.

    Conclusions:

    • Breast self-examination (BSE) programs are inexpensive to implement.
    • BSE education may offer a survival advantage for women, particularly those aged 50-65.
    • BSE should be considered as an adjunct to mammographic screening, especially for intervals longer than 18 months.