{"id":11722,"date":"2024-04-01T01:45:39","date_gmt":"2024-04-01T01:45:39","guid":{"rendered":"https:\/\/nurs.essaybishops.com\/barriers-to-breast-cancer-screening-and-mammograms\/"},"modified":"2024-04-01T01:45:39","modified_gmt":"2024-04-01T01:45:39","slug":"barriers-to-breast-cancer-screening-and-mammograms","status":"publish","type":"post","link":"https:\/\/homeworkacetutors.com\/nursing\/barriers-to-breast-cancer-screening-and-mammograms\/","title":{"rendered":"Barriers to Breast Cancer Screening and Mammograms"},"content":{"rendered":"
\n

Abstract<\/h3>\n

The mammography screening recommendations have been ambiguous and disagree with suggesting institute to institute.\u00a0 Thus, it is up to women to make choices about mammogram inspection based on their personal health beliefs<\/a>.\u00a0 This paper explores 6 published articles that report results from various research conducted on women with an average risk of breast cancer<\/a>. These studies examined the connection between observed benefits and alleged barriers to mammography and compliance with mammography screening in women age 40 and older and among minorities.\u00a0 It also discusses the latest findings and guidelines according to the American Cancer Society.\u00a0 Other articles discuss their reviews to support mammogram screening for women under 50, a systemic review of the benefits and harms of breast cancer screening and factors that influence breast cancer screening in Asian countries.<\/p>\n

Introduction<\/h2>\n

Currently, breast cancer is one of
\nthe most common cancers in women and one of the chief causes of death
\nworldwide. (Oeffinger,Fontham, Etzioni, et al.)\u00a0
\nAccording to the American Cancer Society 2015, it is the leading
\ncontributor to cancer mortality in women aged 40 to 55.\u00a0 Several risk factors increase the likelihood
\nof the disease occurring.\u00a0 These factors
\ninclude: (1) aging, (2) personal history of breast cancer, (3) family history
\nof breast cancer, (4) history of benign breast disease, (5) menarche younger
\nthan 12 years, (6) nulliparous, or a first child after age 30, (7) higher
\neducation or socioeconomic level, (8) obesity and\/or high fats diets, (9)
\nmenopause after age 50, (10) lengthy exposure to cyclic estrogen and (11)
\nenvironment exposure (American Cancer Society, 2015).\u00a0 The cause of breast cancer is still unspecified,
\nyet these risk factors are known to play a part in the risk of developing this
\ndisease.\u00a0 Essentially all women can be
\nconsidered at risk.\u00a0 No successful cure
\nor preventative methods exist, and early recognition offers the best
\nopportunity for decreasing morbidity and mortality.<\/p>\n

Literature Review<\/h2>\n

The first article that I reviewed is
\ntitled \u201cBenefits and Harms of Breast Cancer Screening, A Systemic Review\u201d.\u00a0 According to Myers, et al., mortality from
\nbreast cancer has declined substantially since the 1970\u2019s, a drop attributable
\nto both the accessibility of screening methods, particularly mammography, and better-quality
\ntreatment of more advanced cancer.\u00a0 This
\nliterature pointed out that, although there has been stable evidence that
\nscreening with mammography reduces breast cancer mortality, there are a number
\nof possible harms, including false-positive results, which result in both needless
\nbiopsies and added distress and anxiety associated to the potential diagnosis of
\ncancer.\u00a0 In addition, screening may lead
\nto over diagnosis of cancers that may not have become life-threatening.\u00a0 With their investigation in the meta-analyses
\nof RTCs (randomized clinical trials) that stratified by age, screening women
\nyounger than 50 years was constantly associated with a statistically
\nsignificant reduction in breast cancer mortality of approximately 15% while
\nscreening women 50 years or older was linked with slightly greater mortality
\nreduction (14-23%).\u00a0 In general, based on
\ntheir research, they have concluded that \u201cregular screening with mammography in
\nwomen 40 years or older at average risk of breast cancer reduces breast cancer
\nmortality over at least 13 years of follow-up, but there is uncertainty about
\nthe magnitude of this association, particularly in the context of current
\npractice in the United States.\u201d<\/p>\n

In summary, this review concluded
\nthat among women of all ages at average risk of breast cancer, screening was related
\nwith a reduction in breast cancer mortality of approximately 20%, although
\nthere was ambiguity about quantitative estimates of the association of
\ndifferent breast cancer screening strategies in the United States.\u00a0 These findings and the related uncertainty
\nshould be considered when making suggestions based on judgments about the
\nbalance of benefits and harms of breast cancer screening. (Myers et al. 2015).<\/p>\n

Mammography can pinpoint tumors too
\nsmall to be detected by palpitation of the breast by the woman or her health
\ncare provider.\u00a0 Early detection of breast
\ncancer in women improves the possibility of successful treatment and thus cuts
\nmorbidity and mortality from the disease (American Cancer Society, 2015).\u00a0 Yet, there still exists an observable lack of
\ncompliance with the recommended screening guidelines.\u00a0 According to an article in the Journal of the
\nAmerican College of Radiology by Monticciolo, et al. (2015), they pointed out
\nthat previous to the presentation of widespread mammographic screening in the
\nmid-1980s, the mortality rate from breast cancer in the US had stayed unaffected
\nfor more than 4 decades.\u00a0 From 1990, the fatality
\nrate has fallen by at least 38%.\u00a0 Considerably,
\nthis change is recognized to prompt detection with mammography.\u00a0 <\/p>\n

In this next article, Miranda-Diaz,
\net al. (2016) studied the Hispanics Puerto Rican subjects, inner-city women and
\ndeterminants of breast cancer screening and suggested that women with low
\nincomes and education were less likely to partake in mammography.\u00a0 Lack of submission of breast cancer screening
\ntests is more prevalent among minorities.\u00a0
\nThey added that Hispanic women are less likely to receive a Physician\u2019s
\nrecommendation for breast cancer screening, therefore, it was the primary
\nreason for not doing a mammogram.\u00a0 Other
\nbarriers for lack of compliance among Hispanic women and Latinas living in California
\nare lack of health insurance, age, usual source of care, having a busy
\nschedule, fear, cost and feeling uncomfortable during the procedure. <\/p>\n

In conclusion, the authors of this
\narticle did a study that was limited by the small sample size and may not be
\ngeneralizable to the entire population of the island. In order to improve
\ncompliance as well as educating health care providers about the importance of
\nreferral, a tailored health education interventions directed to describe the
\nnature and benefit of cancer screening test needed to be put in place. <\/p>\n

Similarly, another article stated
\nthat early detection of breast cancer, while the tumor is still small and
\nlocalized, provides the opportunity for the most effective treatment.
\n(Mandelblatt, Armetta, Yabroff, et al.) According to the American Cancer
\nSociety 2015, detection guidelines recommended that women with an average risk
\nof breast cancer should undergo regular screening mammography starting at age
\n45 years. \u00a0Women aged 45- 54 years should
\nbe inspected annually and women 55 years and older should changeover to
\nbiennial screening or have the opportunity to begin annual screening between
\nthe ages of 40 and 44 years.\u00a0 The suggested
\noutcome of the guideline would result in earlier detection because breast
\ncancers found by mammography in women in their forties are smaller and more
\ntreatable than those found by self-breast exam or clinical breast exam.\u00a0 Consequently, earlier detection by
\nmammography could save lives.<\/p>\n

According to an article by Kathy
\nBoltz, Ph.D. (2013), amid the 609 definite breast cancer deaths, 29% were including
\nwomen who had been screened with mammography, while 71% were among unscreened
\nwomen.\u00a0 In tally, her investigation found
\nthat of all breast cancer deaths, only 13% happened in women aged 70 years or
\nolder, but 50% occurred in women under 50 years old. Her studies were done to
\nsupport mammogram screening for women under age 50.\u00a0 In the meantime, Dr. Cady, MD, Professor of
\nSurgery of Harvard Medical School in Boston, Massachusetts, and his teammates
\nset out to deliver complete information on the value of mammography screening
\nthrough a technique called \u201cfailure analysis\u201d.\u00a0
\nSuch evaluations look backward from the time of death to determine the
\nconnections at diagnosis, rather than looking forward from the start of a
\nstudy.\u00a0 Only one other failure analysis
\nrelated to cancer has been published to date.\u00a0
\nIn this evaluation, invasive breast cancers analyzed at Partners
\nHealthCare hospitals in Boston between 1990 and 1999 were followed through
\n2007.\u00a0 Facts for the study comprised
\ndemographics, mammography use, surgical and pathology reports, and recurrence
\nand death dates.\u00a0 The article also stated
\nthat the study showed a dramatic shift in survival from breast cancer
\nassociated with the introduction of screening.\u00a0
\nIn 1969, half of the women diagnosed with breast cancer had died by 12.5
\nyears after diagnosis.\u00a0 Between the women
\nwith aggressive breast cancer in this review who were spotted between 1990 and
\n1999, only 9.3% had expired.\u00a0 \u201cThis is a
\nremarkable achievement, and the fact that 71% of the women who died were women
\nwho were not participating in screening clearly supports the importance of
\nearly detection,\u201d said co-author Daniel Kopans, MD, also of Harvard Medical
\nSchool.<\/p>\n

The study of the \u201cperception of
\nbreast cancer risk and screening effectiveness\u201d was studied by Black, Nease,
\n& Tosteson (1995).\u00a0 The purpose of
\nthe study was to determine how women 40-50 years of age perceive their risk of
\nbreast cancer and the effectiveness of screening and how these perceptions
\ncompare with estimates derived from epidemiologic studies of breast cancer
\nincidence and randomized clinical trials of screening. A random sample of 200
\nwomen, age 40-50 years old who had no history of breast cancer was chosen
\nthrough the computerized medical records of Dartmouth-Hitchcock Medical Center.\u00a0 Thirty-nine percent had an annual family
\nincome of $50,000 to $100,000, and 62% had at least a college education.\u00a0 The subjects received the questionnaire in
\nthe mail which asked questions pertaining to breast cancer risk and screening
\neffectiveness.\u00a0 Seventy-three percent
\nresponded with a complete questionnaire.\u00a0
\nThe results showed that the women overestimated their probability of
\ndying of breast cancer within ten years by more than twenty times.\u00a0 When asked about their relative risk
\nreduction from breast cancer screening, they overestimated by six times.\u00a0 These results are based on assuming a 10%
\nrelative risk reduction from cancer screening.\u00a0
\nEighty-eight percent of the subjects agreed that the benefits to
\nscreening mammography outweighed the barriers.\u00a0
\nThe generalizability of this study is very limited because of this
\npopulation is better educated and of higher income than the general U.S.
\npopulation of women of the same age range.\u00a0
\nAlso, the subjects\u2019 breast cancer risk was not precisely known, and the
\neffectiveness of modern screening mammography is unknown.\u00a0 The limitations also include the
\nquestionnaire which has not been previously tested. \u00a0<\/p>\n

The last article is a literature
\nreview of \u201cfactors influencing breast cancer screening in Asian countries.\u201d\u00a0 Studies done by Ahmadian and Samah (2012),
\nfound that breast cancer arises in the younger age group of Asian women, 40 to
\n49 years old compared to the other Western counterparts, where the peak
\nprevalence is realized between 50 to 59 years.\u00a0
\nAccording to multiple sources and authors, in Singapore, Malaysia, Iran,
\nThailand, Pakistan, and Arab women in Palestine, more than half of new cases of
\nbreast cancer were diagnosed in women below the age of 50 years and in advanced
\nstages III or IV.\u00a0 \u00a0Schwartz et al. (2008), discovered that breast
\ncancer screening activities among Asian women living in their native country
\nare low and mammography screening in Middle Eastern countries are also low.\u00a0 Analyses of the information have shown that
\nonly 23% of Turkish people testified having at least one mammogram.\u00a0 Fewer women about 10.3% in the United Arab
\nEmirates had mammography, which was attributed to poor knowledge of breast cancer
\nscreening and infrequent offering of screening by healthcare workers (Schwartz
\net al., 2008)\u00a0 In conclusion of this
\narticle, the authors stated that in order to improve women\u2019s participation in
\nbreast cancer prevention programs\/ screenings, especially among the at-risk
\nsubgroup, the intervention strategies should be tailored to their knowledge and
\nsocio-demographic factor.\u00a0 The approaches
\naccepted should also take into account the women\u2019s emotional and ethnic matters
\nin order to support lifelong mammography screening practice for Asian people
\nwhich is based on hypothetical interventions. In addition, healthcare
\nprofessionals working with Asian women should cautiously tackle the misapprehensions
\nsuch as worry about mammogram devices and fatalism. (Ahmadian & Samah, 2012)<\/p>\n

Conclusion<\/h2>\n

In summary, after reading and reviewing
\nthe 6 related articles pertaining to breast cancer and mammogram screening for
\nwomen under 50, I have concluded that there are both pros and cons, benefits
\nand harms, perceived benefits and alleged barriers, and compliance factors that
\naffect women worldwide.<\/p>\n

Breast cancer has claimed millions
\nof lives throughout the world and women should be encouraged to be mindful of
\nand to consider their family history and medical history with a physician to determine
\nif early detection is a warrant.\u00a0 If the
\nwoman has an average risk of developing breast cancer, the American Cancer
\nSociety supports a discussion of screening around the age of 40 years.\u00a0 According to the guideline, ACS recommends
\nthat women be provided with information about risk factors, risk reduction, and
\nthe benefits, limitations, and harms associated with mammography screening.\u00a0 While it is recognized that there is a
\nbalance of risks and benefits to the mammogram, women should be provided with
\nguidance so that they can make the best choice about when to start and stop
\nscreening and how frequently to be screened for breast cancer.\u00a0 So, if you or your loved ones have an average
\nrisk of breast cancer and over 40 years old, would you prefer to have a checkup
\nonce a year or once every two years?\u00a0
\nThis is rather a personal choice but with early detection, the benefit
\nof mammogram will prove to outweigh the risk and could possibly save your life.<\/p>\n

References<\/h2>\n

Ahmadian, M and Samah, A.(2012) A Literature Review of Factors Influencing Breast Cancer Screening in Asian Countries.Life Sci J 2012;9(2):585-594.\u00a0 (ISSN: 1097-8135).\u00a0 http:\/\/www.lifesciencesite.com<\/a>.\u00a0 Accessed January 16, 2018<\/p>\n

Breast Cancer Screening and Diagnosis (version 1.2015).\u00a0 National Comprehensive Cancer Network. http:\/\/www.nccn.org\/professionals\/physician_gls\/PDF\/breast-screening.pdf<\/a>Accessed January 16, 2018.<\/p>\n

Mandelblatt, JS, Cronin, KA, Bailey, S, et al. (2009) Breast Cancer Working Group of Cancer \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Intervention and Surveillance Modeling Network.\u00a0 Effects of mammography screening under different screening schedules: model estimates of potential benefits and harms. Ann Intern. Med. 2009;15(10):738-747.<\/p>\n

Mandeltblatt, JS, Armatta, C, Yabroff, R, Liang, W, Lawrence, W. (2004) Descriptive Review of the Literature on Breast Cancer Outcomes: 1990 Through 2000. JNCI Monographs, Volume 2004, Issue 33, 1 October 2004, Pages 8-44.<\/p>\n

https:\/\/academic.oup.com\/jncimono\/article\/2004\/33\/8\/933605<\/a>Accessed January 17, 2018.<\/p>\n

Oeffinger, KC, Fontham, ETH, Etzioni, R, et al. (2015). Breast Cancer Screening for Women at average risk: 2015 Guideline Update from the American Cancer Society. Jama.2015. doi:10.1001\/jama.2015.12783.<\/p>\n

https:\/\/provimaging.com\/wp-content\/uploads\/2015\/11\/JAMA-Network-_-JAMA-_-Breast-Cancer-Screening-for-Women-at-Average-Risk_-20.pdf<\/a>Accessed January 17, 2018.<\/p>\n

Schwartz, LM, Woloshin, S, Sox, HC, Fischloff, B, Welch, HG.(2000) US Women\u2019s Attitudes to False Positive Mammography Results and Detection of Ductal Carcinoma in Situ: \u00a0Cross Sectional Survey. BMJ. 2000;320 (7250):
\n1635-1640.<\/p>\n

http:\/\/www.bmj.com\/content\/320\/7250\/1635.<\/a>Accessed
\nJanuary 20, 2018<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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