Screening Mammograms: How to Teach Patients & Promote Compliance

What Is Patient Teaching about Breast Cancer Screening – Mammography?

  • Patient teaching about breast cancer screening mammography (SM)  can defined in simple terms as the process of providing helpful information to patients before, during, and after mammography. This is to increase their knowledge of the procedure and enhance their ability to cope with the procedure and related results.
    • What Patients need to know about screening mammograms:

      screening mammogramPatient teaching about Screening Mammogram involve: –

      • Teaching patients about the purpose of breast cancer screening
      • The risks involved and benefits of screening mammograms
      • How to prepare for mammography
      • What to expect during the procedure
      • Strategies for coping with the screening mammogram procedure and findings.
      • Screening mammogram is the single most effective method for early breast cancer detection because it can identify breast cancer several years before physical signs and symptoms are apparent.
      • Lack of screening mammograms and infrequent  screening mammogram are widely recognized as major factors contributing to increased breast cancer mortality
    • How to teach patients about screening mammograms:

      First time experience can be uncomfortable to many women but with correct teaching, compliance can be achieved. Teaching and motivational activities like face-to-face instruction, written materials, video presentations and pre-visit tours can be utilized to teach and support patients in learning about mammography and breast cancer screening

      • Make teaching and learning an ongoing process by using combination strategies like sending a reminder letter, providing a pamphlet about screening mammograms & discussing concerns about discomfort during mammography. This has been shown to be more beneficial than face-to-face instruction only
      • Use of informed decision-making process is important when promoting health screening such as screening mammogram. In educated population, research has shown that use of leaflets with decision aids appear to increase knowledge and participation in breast screening and have a positive impact on reducing decisional conflict.
    • Where does teaching about screening mammograms occur?

      Patient teaching about breast cancer screening mammograms typically begins in primary care, but can also be introduced at any time of clinic or hospital visit. Public education has shown to yield the best results about screening mammograms.

      • Every possible effort should be made to promote seamless delivery of patient teaching throughout the course of care and after screening mammogram.
      • Conflicting information about breast cancer screening mammograms should be avoided to reduce frustration and confusion and increase
    • Who is the best to teach about breast cancer screening mammograms:

      Patient teaching about breast cancer screening mammogram can be given by healthcare professionals like physicians and nurses and should not be delegated to assistive clinical staff or none clinical staff.

      • Research has shown that the most effective educators of women undergoing mammography are those who individualize information to specifically address their learning needs – women just like them

Breast Cancer Mission Trips to Kenya, Africa

Medical data from reputable organizations like World Health Organization (WHO), CDC, etc has shown that the highest mortality rates related to breast cancer is in third world countries, especially Africa.

However, other faster mass killers like Malaria and HIV has received unparalleled international attention in Africa, Thanks to organizations like Gates Foundation and others.Despite the high mortality of breast cancer and cervical cancer in Africa, cancer in general has not received the attention it deserves in Africa

While the cost of diagnosing and treating breast cancer is expensive, Cancer Free Women believes the man ion the mirror can make a positive impact in the lives of high risk African women

Looking up to The Gifted and Talented: Breast Cancer Mission Trips to Kenya, Africa.

Cancer Free Women will be conducting regular breast cancer related mission trips to Africa, starting with East African region. We appeal to medical practitioners from all over the world to volunteer in this region to: –

  • Create breast cancer awareness
  • Educate women about breast cancer and life saving Breast Self Exam (BSE) techniques.
  • Diagnose breast cancer cases and educate local clinicians, doctors and nurses how to be proactive about breast cancer
  • Train local surgeons on less invasive and potentially life saving surgical techniques
  • Create a breast cancer awareness culture in youths that can be easily reached in boarding high schools and colleges
  • Reinforce positive learning and foster continuity by offering free exchange programs. Teaching hospitals and universities willing to train African medical professionals are more than welcome.
  • Identifying opportunities that can be exploited to create breast cancer awareness and promote breast health culture

Change the World for Ever!

Saving women lives, especially in Africa is guaranteed way to change and impact the world. Majority of bread winners in Africa are women. The most important society building block in Africa is a woman. Kids eat, go to school, etc mostly because of the presence of a woman. A potential breast cancer related death affecting a mother, almost always, mean end of family.

Will You Take a Mission Trip to Kenya, Africa?

You may underestimate your impact in African women lives. If your presence saved just 1 (one) woman life, think about how many generations you’ll have impacted.

““We make a living by what we get. We make a life by what we give.”
― Winston Churchill

“It’s not how much we give but how much love we put into giving.”
― Mother Teresa

Make that change

Free Breast Cancer Screening in Kenya: Should you bank on it?

Tags: #Breastcancerscreening #Breastcancerinkenya #stage4breastcancer #selfbreastexam #cancerfreewomen

According to Daily Nation newspaper published on October 23, 2013, Mary Namata, a Ugandan lady stayed with breast lesion for 4 years before she could seek medical help. The wounds became too painful for her to live like that and it was until that point she went to seek medical help. By the time she went to the hospital, Mary was diagnosed with stage 4 breast cancer. To be exact, Mary had stage 4 fungating breast cancer where the cancer wounds had penetrated the skin and had opened outside the breast.

In Kenya, hundreds of thousands of women tune on the news and hit on google searching for free breast cancer screening in their areas. This is a very good sign because it implies that the number of women recognizing October as breast cancer month in Kenya is increasing. It is at “creating” awareness level that we must start to control this African women slayer overshadowed by HIV/AIDS & Malaria.

But, is it wise to risk your life waiting for free breast cancer screening, mammograms? Kenya has less than 15 mammogram machines primarily in private settings, meaning, chances of actually getting a free mammogram without a sponsor are very low. Notice that Kenya has far more mammogram machines than all other East African states combined.

Here is the good news, you can start the fight against breast cancer early by doing Breast self Exam (BSE) starting age 20. To carry an effective self breast exam, this is what you should know: –

Learn how your normal breast feel and look:

The key to early detection of breast cancer is the key to survival. Success in Self Breast Exam (BSE) is dependent on knowing more about your normal and your risk factors. That way, if you detect anything abnormal, you would be able to notice it and take the necessary action…Mammogram!

To learn your normal breast, it is recommended you check your breast at least once a month in front of a mirror. You should expect to see

  • Breasts that are in usual shape, size and color. In most women, breast that are equal in size. Should you doubt any of these, get a clinician to take a look.
  • Breast that are evenly shaped without any disfigurement or distortion. No dimpling, puckering or bulging of the skin.
  • Nipples that are even, well contoured without swelling, redness or inwardly inverted. Any unexpected discharge from the nipples must be reported immediately to a doctor for further evaluation.

Know the warning signs of breast cancer: Memorize them!

  • A lump, hard knot or thickening inside the breast or armpit(s).
  • Any wound, pimple, boil or blister occurring on your breast or underarm area
  • Swelling, warmth, redness or darkening of the breast
  • Change in the size or shape of your breast
  • Dimpling or puckering of the skin
  • Itchy, scaly sore or rash on the nipple or anywhere on the breast. Do not ignore Itchiness!!
  • Pulling in of your nipple or other parts of the breast
  • Nipple discharge of any colour (not milk for expectant or breast feeding mothers) that starts suddenly.  High alert if the discharge is from one breast, comes out without squeezing, is clear or bloody.
  • New pain in one spot that doesn’t go away, or pain that cannot be related to any traumatic event.

Know your risk factors:

  • Family history of breast cancer: If anyone in your family (father or mother’s side) has breast cancer or died of breast cancer, consider yourself a high risk. This is because family lineage in Africa is poorly defined
  • Overweight or obese. Being overweight in Africa is seen as a sign of wellbeing but in actual sense, this increases breast cancer risk
  • Being female: Meaning, every woman should consider themselves as breast cancer risk factor.
  • Increase in age. The more you age, the higher the risk
  • Beginning of menstrual cycles too early, before age 12
  • Giving birth to a first child after age 35. This increases your breast cancer risk factor
  • Having never been pregnant: Women that have never been pregnant have a much higher risk of breast cancer
  • Drinking alcohol: Women that drink alcohol are at higher risk of breast cancer than those who doesn’t

Do not wait until you can get a free breast cancer screening in Africa. It may never happen and waiting could put your life and your family in danger. Remember without women in Africa, our societies would collapse. A woman is the single most important figure in our society. You are important and worth everything in the world. Be safe!

Breast Cancer Screening in Kenya: Why Wait For October?

 

October is now known worldwide as the breast cancer month. The world has taken this month seriously to campaign and create awareness about breast cancer. Billions of dollars are put towards breast cancer in those 30 days in October, something that has helped tame breast cancer.

However, it is heartbreaking to notice that most of us in Africa wait for October to get “free breast cancer screening” and “Free mammograms”. Looking at google keyword search terms that led visitors to our website can paint a clear picture of what most of us in Africa think about breast cancer month.

Don’t wait for October

breast cancer awarenessDon’t wait for October to get screened for breast cancer. You can wait but breast cancer does not wait. You may wait hoping to get free breast cancer screening or free mammogram and not get it. Will you wait for another year’s October to take a chance of getting free breast cancer screening?

The best way to chances of surviving breast cancer and any other cancer for that matter is staring treatment early. The earlier you start, the better the outcomes before cancer spread to other organs (metastasis)

While mammogram is the single most useful and accurate breast cancer screening tool available, learn about other free ways of detecting breast cancer like Breast Self Exam (BSE). Have regular clinician breast cancer exam (CBE) to minimize chances of breast cancer going unnoticed until damage to other organs has occurred

Stay ahead of breast cancer and don’t wait for October to get breast cancer screening. October is breast cancer awareness month, not free breast cancer screening month. Be proactive. The world cannot be what it is without you! Our societies would collapse without women. Our kids would not have a family without our women. Let’s join hands and fight breast cancer together, early enough to maximize survival.

Free Breast Cancer Screening in October. Should I Wait?

Susan Ngure, a breast cancer survivor hoping to inspire women to get screened today

Susan Ngure, a breast cancer survivor hoping to inspire women to get screened today

Susan Ngure, a now cancer free woman narrates her story how she felt a breast lump and waited for the lump to go away. She waited and waited only to later learn her lump was breast cancer. So are millions of other women in Kenya who are sitting on assumption that everything is okay.

Hundreds of thousands more women wait for November for free breast cancer screening. Well, while the month of November is breast cancer awareness month, and there are usually a number of donor programs conducting free breast cancer screening, getting a free breast cancer exam may be harder than just going to breast health facility and get checked. Furthermore, time determines how far breast cancer may have progressed

Lucky for Susan Ngure, she was in Australia when she first experienced a breast lump. She waited and waited for the lump to go away but it never happened. Susan recommends going for screening BEFORE you get a lump. You may never get breast cancer but given that 1:8 will be diagnosed with breast cancer in their life time, better to get screened than to be too late.

Rarely do we hear many stories of breast cancer survivors who have fought the battle in Kenya and stayed in Kenya throughout until they became cancer free. These cases are there but the cost of breast cancer treatment is large enough that those who can afford full course treatment would rather go to first world where breast cancer treatment is advanced and all modes of therapies are available.

99.9% of Kenyan women cannot afford full course breast cancer treatment and this is why everyone in Kenya needs to learn breast self exam (BSE) and clinicians needs to recommend clinical breast exam (CBE) for anyone above age 40.

CDC recommends annual mammogram for every woman over age 50 and over age 30 in high risk families. Unfortunately, in Africa, it is nearly impossible to tell who comes from high risk family since those who may have died of breast cancer died undiagnosed or without getting into national breast cancer database.

Your best bet is… Get screened today. Don’t wait for October to get breast cancer screening. Don’t assume everything will be okay while you can get the truth by getting screened. Don’t wait for free breast cancer screening because it might be too late. The earlier breast cancer is diagnosed, the better the outcomes of treatment.

Cost of Mammogram in Kenya. Does it Matter?

So, if breast cancer is such a killer in Africa, how comes women are not lining up to get mammograms in cities like Nairobi? Is it the cost of mammography in Kenya that is too high or is it that there are no equipment to service all the women at risk? Is it that women are not even aware of the risk or it is that no one really cares about breast cancer?

The truth is, all of the above factors contribute to this. In a simple random survey done in Kiambu Kenya, 71% of women of all women interviewed have never heard of the word “Mammogram”. 88% of women over 40 years old of those interviewed have never heard of mammography in Kenya. Only 11% have heard about mammography and only 7% have ever had a mammogram. None of those interviewed had a preventive screening mammogram

Cost of Mammogram in Kenya
Mammograms in Kenya have no standardized price. The cost primarily depends on where it is taken. Some hospitals like Nairobi Hospital charge around KSH8,000 or about $100. Compared to world average, this is relatively cheaper than most countries. But the cost of $100 for preventive mammogram is not affordable to over 80% of susceptible women in Kenya. Even 25% of that price is not affordable to 80% of Kenyan women. The only way to increase the number of preventive mammogram screening is through government funded project or donor funded mammography.

Mammogram Machines in Kenya
Kenya has a population of about 45 million people and about 18-20 million women are over 40 years old, requiring annual mammograms per Center of Disease and Control (CDC) recommendations. While mammogram machines are not the most expensive gadgets Kenyans can afford, it is discouraging to investors to buy equipment but consumers cannot afford to pay for tests. It’s heartbreaking to note that over 90% of all mammograms done in Kenya today are done for diagnostic reasons, not preventive reasons. Kenya has just over 10 mammogram machines and 95% of all these machines are located in Nairobi

Lack of Knowledge
While they say “Ignorance is a bliss”, the kind of ignorance we face in Kenya is not a bliss. This is the ignorance that kills because not knowing about breast cancer does not stop breast cancer from killing young moms and sisters. The level of awareness about breast cancer in Kenya and the rest of Africa is extremely low. We have to create necessary awareness starting with the closest woman we can reach.

Kenyans living abroad should really consider informing their loved ones about preventive mammograms. Sponsoring mammograms for loved ones in Kenya could help save a life of some one you really love.

Expertise
Believe it or not, there is not one single mammography trained specialist among the few radiologists in Kenya. The few radiologists in Kenya have cross-trained across many disciplines to accommodate many under-served areas of diagnostics. Mammography technicians are as well cross-trained across many disciplines and have no mammography specific training backed by continuous education and skills update as technology and evidence based practice evolve.

CONCLUSION
The cost of mammography in Kenya is not standardized but even the most expensive hospitals charge below developed countries average price. Mammography machines are expensive and sometimes not the most worthwhile investors can channel their money to. Majority of Kenyans live below poverty line and cannot afford even highly subsidized mammograms annually. Majority of women in Kenya and all over Africa have never heard of mammograms. Lack of awareness is the biggest contributor to poor breast cancer screening in Kenya.

Understanding Mammograms

A mammogram is an x-ray picture of the breast.

Mammograms are designed to check for very early signs of breast cancer in women before the symptoms can be experienced. Mammograms are better when used to check for breast cancer in women who have no signs or symptoms of the disease. This type of mammogram is called a screening or preventive mammogram. Screening mammograms usually involve two mammogram pictures, or images, of each breast. These images are carefully read by a radiologist to detect tumors that cannot be felt by Self Breast Exam. Screening mammograms can also find microcalcifications (tiny deposits of calcium) that sometimes indicate the presence of breast cancer.

MammogramDiagnostic Mammograms are used to check for breast cancer after a lump or other sign or symptom of the disease has been found. Unfortunately, at this point, the mammogram is only used to confirm the diagnosis. This is the commonest mammogram ordered by physicians in Kenya and the rest of Africa.

Besides a lump or breast disfigurement, signs of breast cancer can include breast pain, thickening of the skin of the breast, nipple discharge, or a change in breast size, shape or colour. Only a mammogram or breast ultrasound can determine if this is breast cancer or not. A diagnostic mammogram can also be used to evaluate changes found during a screening mammogram.

The difference between screening and diagnostic mammogram is that diagnostic mammography takes longer than screening mammography because more x-rays are needed to obtain views of the breast from several angles. The radiologist or radiographer may magnify a suspicious area to produce a detailed picture that can help make an accurate diagnosis.

Screening mammograms helps in early detection of breast cancer, which means that treatment can be started earlier in the course of the disease, possibly before it has spread to other parts of the body. Screening mammography can help reduce the number of deaths from breast cancer by 30-40% among women ages 40 to 70. Unless family history of breast cancer exists, breast mammograms are only recommended after age 40.

If you have any questions about your breast health condition, call us now. Let us help you clear the doubts that you may have. We have nurse educators and clinicians ready to help you with the answers you need to stay safe from breast cancer