Breast Cancer Prevalence in the UK

Chapter 1: Introduction:

Background of research topic:

Breast cancer is the malignant tumour or lump that occurs due to the abnormal growth of some breast cells. Generally, Breast cells grow in a systematic manner, which forms the normal growth of the breast tissue, in order to for the normal structure of breast (Finnet al.2016). In case of breast cancer, some of the cells in the breast are mutated into malignant cells, which then grow in faster rates as compared to the growth of normal breast cells, leading to the development of breast cancer. According to a recent report of World Health Organisation (WHO), breast cancer can be developed in both male and females; however, women are more prevalent towards this health condition due to the size, functions and development process of the breast (WHO, 2019). National Breast Cancer Foundation has developed proper self-examination technique for women to detect the early stage of breast cancer (Abolfotouhet al. 2015). A recent report from the National Health Service (NHS), the UK is reported to have the sheer number of women suffering from breast cancer [NHS, 2019]. From the recent report on Breast cancer by World Health Organisation [WHO] in the UK, there are more than, 54,900 new cases of breast cancers in every year in the UK (www.cancerresearchuk.org, 2018). Breast cancer is one of common cancer cases in the UK, which account for nearly 20 % of different types of cancer in this country. Women in the UK are more prevalent to breast cancer, as compared to men. In cases of women the new breast cancer cases are around 54,300, whereas, in the case of a male, the number is only 370 (www.breastcancercare.org.uk, 2019). Based on the survey conducted by National Breast Cancer Foundation on NHS hospital in the UK, the huge disparity in new cases of breast cancer in men and women in the UK is due to the poor healthcare facilities, family support and health condition in the female. More than 59% of the women belonging to the ethnic community in the UK prevent breast cancer (www.cancerresearchuk.org, 2018). In England, recency 491,320 women are diagnosed with breast cancer [WHO, 2019]. In this aspect, the UK Government has taken initiative in order to reduce the increasing rates of breast cancer in case of women, through empowering them with providing health education (Amoran and Toyobo, 2015). National Health Service in England, Scotland and Wales are highly active in order to provide Health Care Executives (HSE) in these countries in order to develop the knowledge and understanding of women about causes and outcomes of breast cancer.

The rationale for the research:

This research proposal is going to highlight the thee issue, the ever-increasing rate of breast cancer in the world and the process of self-examination to prevent this health condition. In today’s fast-paced life, breast cancer is a common health condition that is observed in the majority of the women (DeSantis et al.2016). As compared to male, the female is more prevalent to occur aces of breast cancer. This is due to their living standard, economic condition, poor health status, and irregular food habits. Through detecting breast cancer at an early stage, women are able to prevent their sudden-death and organ failure that is the common reason behind the health condition (Gadgil et al. 2017). In this aspect, self-examination of detecting breast cancer is the effective and best way to prevent the prevalence and death of women due to breast cancer. Through implementing the process of self-detection of breast cancer at home women can be able to understand their chances of getting affected by breast cancer. Therefore, it is high time for representing the importance of self-detection technique of breast cancer in order to empower women to diagnose their health in n better way and promote their health as well as wellbeing. Ever increasing rate of breast cancer is an issue in today’s life as it affects the health condition and wellbeing of more than 50% of the women (www.cancerresearchuk.org, 2018). This issue needs to be highlighted in broad spectrum in order to draw the attention of health professionals, government and the organisational leaders, in order to get their financial and emotional support to the women (Swain et al.2015). Through appointing Health Care Executives in England and Wales, National Health Service (NHS) has provided effective health education facilities to women [NHS, 2019]. Health care Executives provide proper knowledge and information about the self-detection process of breast cancer, which assists women to understand whether they have breast cancer. Through the self-detection process, women are able to understand that the weather they have a lump of tumour in their breast (Amoran and Toyobo, 2015). Therefore, breast cancer in women in one of the major issues which need proper treatment process in order to promote health and wellbeing in women.

Through conducting this research researcher is going to highlight the importance of self-examination process in detecting breast cancer in women. Moreover, this research will assist research to highlight the importance of self-examination techniques that can be used by the women in order to detect their breast cancer at an early stage.

Chapter 2: Literature review

Introduction:

In this chapter, the researcher will discuss the process of self-detection of breast cancer in women. Moreover, this chapter will highlight the selected research papers which assist the researcher to identify the effectiveness of using the process of self-examination in detecting breast cancer in the case of women. Through using relevant evidence, the researcher will highlight the overall overview of breast cancer in the global healthcare spectrum. Moreover, it will discuss the effectiveness of the techniques that are used in self-detection of breast cancer in order to detect breast cancer at an early stage.

Concept of the self-detection process of breast cancer:

As stated by Swain et al. (2015), breast cancer is one of the critical and common health conditions that affect the overall health and wellbeing of people. in the UK both males and females are affected by breast cancer, however, the rate of prevalence to this health condition is more in females as compared to males. Across the globe, women are more likely to be exposed to the risk factors of breast cancer, which not only affect badly their physical health but also pose an adverse impact on their mental health (www.breastcancercare.org.uk, 2019). According to National Health Service (NHS), nurses and health staffs in the UK are highly actives in order to provide proper health education to the community people in order to educate women and men about detecting breast cancer at home through using self-examination process [NHS, 2019]. As stated by Lauby-Secretan et al. (2015), the process of self-examination is associated with detecting the size, shape and colour of nipple, breast and skin around the nipple. There are several processes through which women can detect whether they have breast cancer or not. Based on thy guidelines set by the World Health Organisation (WHO), women need to go through five different steps in which they can easily determine whether they have any lump or breast tumour.

In the first step, women can stand in front of the mirror and place their hands on their hip area in order to stretch the breast area (Nabi, 2016). After that, they need to observe the size, skin colour and structure of greatest and nipple. If there is any abnormal structure or size of the breast and nipple. they need to immediately call doctors.

In the second step, women need to raise their arms and observe the position and shape breast. Through this process, it is possible for the women to find out whether there are any abnormalities in breast size or nipple structure (Nde et al. 2015). Some health professionals stated that this step is not effective in case of detecting lumps or bulging on the breast. In case of detecting bulging in the proper way, women need to use their hand to move around the breast in a gentle way for detecting a lump or lumped muscle inside the breast.

In the next step, women can lie down which will stretch their breast on the chest area. After that, they need to feel the breast with their hand. In this aspect, women use the first four fingers of their hand and press the entire areas of breasts gently this is a highly effective process, in order to detect any kind of lump and bulging into the breast (Oladimeji et al. 2015). Through this process it is possible to detect any kind of tumour or lump inside the breast are of women can feel any bulging part inside the breast, they need to call the doctor immediately.

In the next step, women need to press their hand on the side of their breast and press it from side to side. Through this process, women are able to detect whether there is any abnormal growth inside their breast.

Concept of the importance of self-examination process of breast cancer in today's healthcare framework:

Through using the self-detection process, women are able to detect the abnormalities in their breast (Ramakant et al. 2018). Recent evidence shows that, in the UK majority of the women, residing in the poor community suffer from the high prevalence of breast cancer, due to their health condition, poor health facilities and the low level of health care support ( NICE, 2019). Throughout the UK, people belonging to the poor family are unable to get proper health check-ups and health facilities from costly healthcare framework of NHS hospitals. In this aspect, the self-detection process is highly important for women to detect breast abnormalities or tumours inside the breast tissue, in order to reduce the chances of their getting affected by breast cancer. On the contrary Yadegarfar et al. (2018) argued that it is true that, through the self-examination process, women are not able to detect whether that malignancy or not. Moreover, through, self-detection process, women are also unable to understand that whether they have cancer or the normal breast growth., then also the self-detection process of breast cancer, is highly effective in today's life as to assist the women to be enough sincere and highly concern about abnormal growth and size of their breast (Gupta et al. 2019). Through understanding whether the women have breast cancer, it is possible for them to contact with doctors, in the majority of the women suffers from a health issue in the locality in breast cancer, which is diagnosed at the later stage. Based on the recent report from WHO, in the majority of the NHS hospitals in the UK, women are trained to make proper self-examination of detecting breast cancer in the early stage [WHO, 2019]. As stated by Swain et al. (2015), Breast Self-Examination (BSE) is associated with some screening tests methods which assist the women to understand whether they have any tumour or lump inside the breast tissue. According to the National Institute of Care and Excellence (NICE), women need to follow some steps in order to detect breast cancer or tumours inside their breast [NICE, 2019]. During the first step, women can stand in front of the mirrors with their hands on the hips and check its size, colour and overall shape of the breast. If there is any lump, dimpling, bulging or puckering on the skin of the breast, then it is important to go for a check-up. In the next step, women need to detect any type of abnormalities in nipple shape and structure, such as any soreness or redness on the nipple. As stated by Amoranand Toyobo (2015), through self-examination, although it is possible for women to detect the lump or bulging in the breast, it is not effective in all time. Recent studies have shown that the overall process of BSE is important for women in order to monitor the current health status of their breast. In this aspect Akhtari-Zavare et al. (2015) argued that, through using several self-detection techniques, women are able to understand whether they have normal breast structure or abnormal breast growth. In order to understand the effectiveness of Breast Self Examination (BSE), it is important to understand the benefits of this process in case women. The benefits are discussed as follows:

An easy and regular check of breasts:

According to Gadgil et al. (2017), Breast Self-Examination (BSE) brings about several opportunities for women who find the mammography more painful than that of the self-examination process. recent research by National Breast Cancer Foundation shows that the main purpose of BSE is monitoring the overall health of the breast. As stated by Akhtari-Zavare et al. (2015), through using the BSE process, women would be more helpful for making the regular examination of their breast, which will provide them peace of mind. Through conducting BSE, women are able to make the precautionary measure for detecting breast cancer. Based on the database from the World Health Organisation (WHO) on global breast cancer issue, it can be stated that across the globe, one in eight women suffer from breast cancer [WHO, 2019]. According to Amoran and Toyobo (2015), relatives have breast cancer in the family, the chances of women getting affected by this health condition becomes doubled. National Health Service has published the report on Brest cancer treated in NHS hospitals, in which it shows that BSE assists women with breast cancer to detect their breast cancer at an early stage which reduces the chances of the high rate of adverse health issues and organ damages [NHS, 2019].

National Institute of Health suggests that mammography is one of the important techniques that are used by a health professional in order to detect breast cancer (Gadgil et al. 2017). However, in the UK, the majority of the cases of breast cancer in women are detected after the danger period, which enhances the risk of death. As stated by Finn et al. (2016), self-examination of breast cancer is important for women to understand whether they have breast cancer. The UK government has taken initiatives in order to detect breast cancer, which is associated with providing free detect service of breast cancer to poor women in the village and suburban areas of the UK. Moreover, the initiatives also provide proper health education to the women in order to empower them about how to detect the breast cancer early stage at their home (Amoran and Toyobo, 2015). National Health Service and the UK government have merged their initiatives in order to provide the effective care and support process to the pregnant mothers and women, in order to reduce their risk of breast cancer in them.

On the contrary Gadgil et al. ( 2017) argued that, although BSE is highly proffered and useful technique for all the staffs, sometimes women are unable to use BSE in a proper manner which makes delay in detecting the breast cancer at early stage, The database from World Health Organisation shows that, in some cases of breast cancer, women are at high risk of mortality and morbidity because if improper use of BSE which make them unable to detect breast cancer at early stage of this health condition (WHO, 2019). In this aspect () mentioned in their articles, BSE, although is sometimes unable to detect the early stage of breast cancer due to improper methods of its use, is highly effective and the preferred way in collecting the proper information regarding size, shape and the overall texture of the breast. Moreover, NHS suggests that BSE is highly effective for women more than 40 years ago as they find the screening process and mammography highly painful [NHS, 2019].

Availability of information about the breast:

Although American Cancer Society focuses mainly on the screening test and mammogram for detecting breast cancer in women at an early stage rather than conducting the BSE, in most of the cases women residing in below poverty level are unable to afford these tests and clinical methods due to their poor economic condition and lack of family support (Ramakant et al. 2018). National Breast Cancer Foundation has stated that women below the age group 30-40 years, do not need to do painful mammogram or screening test, rather they can use self-examination process at their home in regular wise for detecting any changes or abnormalities in their breast. In this aspect Yadegarfar et al. (2018) mentioned that recent studies suggest, women having a history of breast cancer in their family, need to understand the overall concept of breast activities, size, shape and possible changes that occur during the breast cancer. Brest Self Examination is proved to be a highly effective, painless and cost-saving process, which not only assists women to detect any abnormalities in their breast but also provide extensive knowledge to women about the normal growth, structure, functions and any abnormal condition of their breast. On the contrary Oladimeji et al. (2015) argued that sometimes BSE is not effective in providing proper information regarding the abnormalities, malignancy and tumour formation inside the breast. In this aspect, women may need to consult with their doctors about understanding the abnormal condition of their breast. Moreover, National Institute of Care and Excellence [NICE] stated that, in most of the cases of breast cancer treated in NHS hospitals, women who did BSE are ignorant about different types of breast cancer, their outputs on health and possible remedies that can be used for detecting and eliminating the cancer risk [NICE]. In spite of different criticism s, BSE is proved to be one of the most important cost-effective and easy techniques in detecting early stage of breast cancer for women, which may assist them to get basic information about their breast size, structure, overall texture and normal growth condition ((Nde et al. 2015).

Challenges associated with Breast Self-Examination:

Aside from the advantages of Breast Self-Examination (BSE), there are some disadvantages and drawbacks of this process (Nabi, 2016). Most of the NHS professionals have stopped recommending BSE as it is associated with some of the major drawbacks.

Misdiagnosis of a breast health condition:

A recent report from National Health Service shows that most of the breast lumps and tumours are non-cancerous. As stead by Lauby-Secretan et al. (2015), benign breast condition is common in the majority of the women, in which the symptoms and signs of this breast condition mimic with the malignant condition. World Health Organisation's report suggests that BSE is unable to detect whether the breast condition malignant or benign, which leading to the misdiagnosis [WHO, 2019]. As mentioned by Swain et al. (2015), cysts, mastitis and non-cancerous tumours are although have the risk of future malignancy, are often not life-threatening. National Health Service shows that many women admitted in NHS hospitals, suffer from the critical stage of breast cancer due to their misdiagnosis through using BSE. Most of today's health professional suggests mammography and screening test rather than using the self-examination process, in order to make authentic and appropriate detection of woman breast condition. On the contrary Amoran and Toyobo (2015) argued that many times, mammography and screening test can provide the actual results in detecting malignancy in breast tissue. World Health Organisation shows in reports that, MRI is one of the effective and highly authentic techniques in detecting any abnormalities in tissues and cells inside the breast.

Enhancement of unnecessary anxiety:

Breast examination leads to the unnecessary anxiety to most of the women, which poses an adverse impact on their physical, mental and emotional wellbeing (Finn et al. 2016). The report from National Breast Cancer Foundation shows that some women use BSE as a proactive measure in detecting early stage of breast cancer, which may enhance the tendency of depression, anxiety and restlessness, even when the lumps or abnormalities in the breast are non-cancerous and not life-threatening [WHO, 2019]. As stated by Akhtari-Zavare et al. (2015), database collected from NHS hospitals in the UK, the majority of women get emotionally and psychologically damaged due to finding out any abnormal condition in their breast through conducting self-examination. According to NICE, the inappropriateness of results is the reason why the majority of the health professionals recommend screening tests, MRI and mammogram to women in order to get authentic information about where they have any life-threatening breast condition [NICE, 2019].

Not beneficial as the MRI, screening test and mammogram:

According to Akhtari-Zavare et al. (2015), although Breast Self-Examination is effective in terms of conducting cost saving and easier method of detecting breast cancer at home, it can be compared with the authentic breast cancer diagnostic processes such as screening test, MRI and mammogram. A report from the World Health Organisation on Breast cancer shows that Breast Self-Examination is not as effective as mammogram due to its inability of differentiating between the cancerous cells and benign cells. Moreover Amoran and Toyobo (2015) mentioned in their articles that, BSE can be used to only in detection the physical characteristics of the breast such as skin, size, texture and colour of breast. National Health Service states that women sometimes are unable to examine any growths or lumps inside their breasts using the self-examination process [NHS, 2019]. On the contrary Finn et al. (2016) argued that sometimes MRI, mammogram is unable to detect the risk of breast cancer, as some of the benign cells can be mutated to malignant cells in future leading to the development of breast cancer. Although there is criticism regarding the comparative study on effeteness f BSE and other professional breast cancer examination process (mammogram, MRI and Screening tests], it is true that malignancy in the breast is an unpredictable thing that sometimes cannot be detected through using different techniques.

Search strategy (including databases, search terms and an identified framework of

Analysis:

Search process:

Take a deeper dive into Service Improvement for Youth Sexual Health with our additional resources.

A search strategy is used by the researcher in order to get relevant articles for conducting the research. Search has been conducted for collecting appropriate database that can assist research to meet research objectives and aims. Different authentic sources have been used by researcher such as Medline (provides Bibliographic papers), CINAHL (provide relevant and acceptable database), Psycarticles, British Education Index, Psycinfo and Boolean operator (AND or OR). Through using Boolean operator research is able to find out authentic and recent articles. Here researcher has used ‘Breast cancer’ OR ‘Breast tissue’ OR ‘breast benign condition’ AND ‘breast tumour’ OR ‘malignancy’. Through using these terms researcher has found out the relevant articles which assist this research to meet its objectives. Through using these terms and sources, the researcher has used PRISMA Tool in order to select relevant articles, here the researcher at first has selected a total of 450 articles. After using the exclusion and inclusion criteria, 150 articles are excluded and 300 articles are selected. The researcher has used the screening process in order to make a further selection of articles, in which 55 articles are rejected and 245 articles are selected. Then based on eligibility and accessibility of full-text articles,120 articles are excluded and 125 articles are selected. Through conducting the extended literature review process 50 articles are excluded and 75 articles are selected. Then again screening test is conducted which results in the selection of 60 articles and exclusion of 15 articles. Finally, again the screening proves is conducted based on the authentic database which results in the selection of 40 articles [Refers to Appendix 1].

Search terms:

Reference list:

Finn, R.S., Martin, M., Rugo, H.S., Jones, S., Im, S.A., Gelmon, K., Harbeck, N., Lipatov, O.N., Walshe, J.M., Moulder, S. and Gauthier, E., 2016. Palbociclib and letrozole in advanced breast cancer. New England Journal of Medicine, 375(20), pp.1925-1936.

Swain, S.M., Baselga, J., Kim, S.B., Ro, J., Semiglazov, V., Campone, M., Ciruelos, E., Ferrero, J.M., Schneeweiss, A., Heeson, S. and Clark, E., 2015. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. New England Journal of Medicine, 372(8), pp.724-734.

Rheinbay, E., Parasuraman, P., Grimsby, J., Tiao, G., Engreitz, J.M., Kim, J., Lawrence, M.S., Taylor-Weiner, A., Rodriguez-Cuevas, S., Rosenberg, M. and Hess, J., 2017. Recurrent and functional regulatory mutations in breast cancer. Nature, 547(7661), p.55.

Turner, N.C., Ro, J., André, F., Loi, S., Verma, S., Iwata, H., Harbeck, N., Loibl, S., Huang Bartlett, C., Zhang, K. and Giorgetti, C., 2015. Palbociclib in hormone-receptor–positive advanced breast cancer. New England Journal of Medicine, 373(3), pp.209-219.

DeSantis, C.E., Fedewa, S.A., Goding Sauer, A., Kramer, J.L., Smith, R.A. and Jemal, A., 2016. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women. CA: a cancer journal for clinicians, 66(1), pp.31-42.

Coates, A.S., Winer, E.P., Goldhirsch, A., Gelber, R.D., Gnant, M., Piccart-Gebhart, M., Thürlimann, B., Senn, H.J., Panel Members, André, F. and Baselga, J., 2015. Tailoring therapies—improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Annals of oncology, 26(8), pp.1533-1546.

DeSantis, C.E., Ma, J., Goding Sauer, A., Newman, L.A. and Jemal, A., 2017. Breast cancer statistics, 2017, racial disparity in mortality by state. CA: a cancer journal for clinicians, 67(6), pp.439-448.

Abolfotouh, M.A., Ala’a, A.B., Mahfouz, A.A., Al-Assiri, M.H., Al-Juhani, A.F. and Alaskar, A.S., 2015. Using the health belief model to predict breast self examination among Saudi women. BMC Public Health, 15(1), p.1163.

Akhtari-Zavare, M., Latiff, L.A., Juni, M.H., Said, S.M. and Ismail, I.Z., 2015. Knowledge of female undergraduate students on breast cancer and breast self-examination in Klang Valley, Malaysia. Asian Pac J Cancer Prev, 16(15), pp.6231-5.

Gadgil, A., Sauvaget, C., Roy, N., Muwonge, R., Kantharia, S., Chakrabarty, A., Bantwal, K., Haldar, I. and Sankaranarayanan, R., 2017. Cancer early detection program based on awareness and clinical breast examination: interim results from an urban community in Mumbai, India. The Breast, 31, pp.85-89.

Gupta, R., Gupta, S., Mehrotra, R. and Sodhani, P., 2019. Risk factors of breast cancer and breast self-examination in early detection: systematic review of awareness among Indian women in community and health care professionals. Journal of Public Health.

Lauby-Secretan, B., Scoccianti, C., Loomis, D., Benbrahim-Tallaa, L., Bouvard, V., Bianchini, F. and Straif, K., 2015. Breast-cancer screening—viewpoint of the IARC Working Group. New England journal of medicine, 372(24), pp.2353-2358.

Nabi, R.L., 2016. Laughing in the face of fear (of disease detection): Using humor to promote cancer self-examination behavior. Health communication, 31(7), pp.873-883.

Nde, F.P., Assob, J.C.N., Kwenti, T.E., Njunda, A.L. and Tainenbe, T.R.G., 2015. Knowledge, attitude and practice of breast self-examination among female undergraduate students in the University of Buea. BMC research notes, 8(1), p.43.

Oladimeji, K.E., Tsoka-Gwegweni, J.M., Igbodekwe, F.C., Twomey, M., Akolo, C., Balarabe, H.S., Atilola, O., Jegede, O. and Oladimeji, O., 2015. Knowledge and beliefs of breast self-examination and breast cancer among market women in Ibadan, South West, Nigeria. PloS one, 10(11), p.e0140904.

Ramakant, P., Singh, K.R., Jaiswal, S., Singh, S., Ranjan, P., Rana, C., Jain, V. and Mishra, A.K., 2018. A Survey on Breast Cancer Awareness Among Medical, Paramedical, and General Population in North India Using Self-Designed Questionnaire: a Prospective Study. Indian journal of surgical oncology, 9(3), pp.323-327.

Segni, M.T., Tadesse, D.M., Amdemichael, R. and Demissie, H.F., 2016. Breast self-examination: knowledge, attitude, and practice among female health science students at Adama Science and Technology University, Ethiopia. GynecolObstet (Sunnyvale), 6(368), pp.2161-0932.

Tiwari, A. and Naik, M., 2018. Effectiveness of structured teaching program on knowledge and practice regarding breast self-examination among college girls in a selected college of Bhilai, Chhattisgarh, India. International Journal Of Community Medicine And Public Health, 5(9), pp.4028-4036.

Yadegarfar, G., Salami, F., Mostajeran, M., Ansari, R., Rejali, M. and Aghdak, P., 2018. Factors Engaged With Women Performance in Doing Regular Breast Self-examination or Referring to Health Centers for Examination and Mammography. The Horizon of Medical Sciences, 24(1), pp.53-60.