Strategies for breast self-examination training to women of reproductive age.

Objective. To develop an effective strategy to inform Mexican women between 12 and 47 years of age about breast cancer (BC) and train them to perform breast self-examination (BSE). Material and methods. Between April, 1996 an d July, 1998, two different strategies to teach BSE were designed and evalu ated in Cuernavaca, State of Morelos, Mexico. These strategies included tea ching materials and were based on opinions of women participating in the fi rst stage of this study. Both strategies consisted of the presentation of a leaflet and a video. The first strategy was delivered by a public health n urse in charge of leading the session. The second one was presented by a BC survivor. This second strategy included slides and silicon breast models. These two strategies were then compared to a third one, consisting of a pri mary care nurse handing out a leaflet and showing a video, based on Health Secretariat's guidelines. In total, 149 women were trained. They were rando mly assigned to any one of these three strategies. The effectiveness of the teaching strategies was determined by assessing the changes in the women's knowledge of BC and BSE, as well as in their ability to identify the large st number of lumps on a natural size silicon breast, before and after train ing. Statistical analysis included Student's t rest, variance analysis, McN emar's chi(2), Pearson's chi(2) and multiple linear regression. Results. Wi th all three strategies, there was an increase of approximately 30% in wome n's knowledge of BC and BSE as well as in their ability to detect lumps. Al though at the beginning of the training only one out of every 20 women were able to identify more than three lumps in the silicon model, by the end be tween 3 and 4 of every 10 women were able to do this, with values of p<0.05 . Some factors determine women's learning of both BSE and information about BC as well as their ability to identify lumps. Conclusions. Teaching BSE w ith any of the strategies evaluated could be included in an integral progra m to educate Mexican women on breast cancer prevention and early detection. The appropriate and monthly practice of BSE is linked both to a decrease i n the amount of time elapsing between the identification of suspect signs a nd the demand for medical care. such as requesting a clinical breast examin ation, which entails identifying small tumors when BC is present.