The Susan G. Komen Race for the Cure is a national event held on different dates throughout the year in cities across the United States and in three other countries as well.1 The success of this event surpasses all other efforts to raise funds for breast cancer awareness, education, treatment, and research. The year 2008 will mark the 25th anniversary of the race. Part of its success may be the fact that the race empowers individuals and communities to make a difference in the fight against breast cancer through fundraising and individual and collective advocacy.
Nurse practitioners (NPs) are advocates for their patients and partner with them to foster behaviors that promote breast health, such as breast self-exams (BSE), clinical breast exams (CBE), and utilizing age-appropriate or situation-indicated imaging studies. Breast health should be a priority for all women; but we know that is not the case for myriad reasons.
Fear of Finding Out
For many years, I was a breast cancer speaker and BSE trainer for the American Cancer Society. I had the opportunity to speak to many lay women of all ages in group settings, mostly ethnic minority populations (at that time). What I present here is anecdotal and not based on any scientific process.
The most commonly expressed reason for not performing BSE or even having a CBE among the women I encountered was fear of finding something wrong. Many women could not even utter the word 'cancer.' If they had cancer, they did not want to know. A fatalistic world view guided some-what was to be would be. Others admitted they knew very little about breast cancer and did not realize they might be at risk.
A major barrier to practicing BSE was a feeling of discomfort in touching their own breasts, stating they had been raised to think that only bad girls did that. Our society's obsession with breasts as sexual objects also fueled this idea.
Another misconception was that cancer was always accompanied by pain and suffering. Many shared stories of watching or caring for mothers, sisters, aunts, and friends who had died from breast cancer. More than likely those women had been diagnosed during late stages of the disease. Women said they had never received any information about breast health nor had they been informed about services available in their communities for the uninsured or underinsured.
Patients Need Education
All my reflections, of course, are anecdotal. It is discouraging to admit that access to health services is not available for all.
October is National Breast Cancer Awareness Month, but we NPs do not need a reminder because we observe breast cancer awareness every day with all our patients, including the men. (Men seem surprised and smile when I remind them they too have breast tissue.)
I invite you to find the time to read the excellent article in this month's issue written by Michaela A. Barron, CNRP, MSN and Rhonda S. Fishel, MD, FACS. You can even earn CE credits. Patients have many questions when a lump is found. There are many tests and reports to decipher. The availability of genetic testing for breast cancer has also raised awareness about risk for certain populations. There is still much that is not known about breast cancer. No woman is without risk, so NPs, do as the authors say, "Talk to Your Patients about Breast Disease".
Jamesetta Newland, APRN, BC FNP, FAANP, FNAP, PhD
Editor-in-Chief
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