The ability of trained nurses to detect lumps in a test set of silicone breast models

BACKGROUND. Screening for breast carcinoma is a Healthy People 2000 objecti ve and physical examination is an important component of the screening proc ess. However, many women do not have access to a high quality breast examin ation. To help address this problem for Native American women, the authors developed the Nurses Providing Annual Cancer Screening (NPACS) training pro gram, a week-long training session conducted at the nurses' clinical site. The goal of the current study was to demonstrate that, after receiving trai ning, the nurses can detect masses in breast models at acceptably high rate s. METHODS, Thirty-four nurses who had completed the NPACS training program pe rformed examinations of a test set of six silicone breast models. True-posi tive and false-positive rates of lump detection were calculated. RESULTS. The nurses were able to detect more lumps in the simulated breasts than both untrained and trained physicians tested in previous trials using the same methodology. On the average, nurses found 76% of the 18 lumps in the 6 breast models. However, their rate of false-positive detections also was somewhat higher. Although the modal number of false-positive detections for both physicians and nurses was 0, the median number of false-positive detections was 0 for the physicians and 1.0 for the nurses. CONCLUSIONS. In the current study, trained nurses were able to detect masse s in breast models at high rates. This observation suggests that widespread training of nurses to perform screening breast examinations might be consi dered as a response to the breast carcinoma screening needs of adult women. (C) 1999 American Cancer Society.