STUDY OF THE ROLE OF BREAST SELF-EXAMINATION IN THE REDUCTION OF MORTALITY FROM BREAST-CANCER

The protocol of a study, sponsored by the World Health Organization, o f the role of breast self-examination (BSE) in reduction of mortality from breast cancer is presented. The major objective of the study is t o determine pre the effect of a BSE programme on mortality from breast cancer. A population of over 193 000 women aged 40 to 64 has been def ined in Moscow and St Petersburg and randomised to study and control g roups. In Moscow the education programme is based on a two-way communi cation principle allowing efficient person-to-person education in grou ps of up to 20 individuals and feedback information through specially designed personal calendars. In St Petersburg, class and individual in struction is carried out. After a l-year. feasibility study the projec t is planned to last for 15 years. It consists of ad aggressive educat ion programme, during and following which, all newly diagnosed breast cancers will be registered and treated, and followed up for 3 to 15 ye ars. A key issue of the study is compliance of the population with BSE . The frequency and competence of BSE practice has been defined in sub samples of 400 randomly selected women by means of surveys at 6 months , 1, 2 and 3 years after the start of the project. The study is expect ed to result in the accrual of more than 1470 new breast cancer cases and 778 deaths from breast cancer. The power of the study is expected to permit detection of a 30% reduction in cumulative breast cancer mor tality, assuming that 50-70% of the women in the study group practise BSE.