How we do it.

Abstract

We are all familiar with the statistic that one in 1'5 women will develop breast cancer sometime in her life. Many women's worry about the possibility of breast cancer has become actualized. At present about 95% of breast cancer is detected by the woman herself; however, these discoveries occur so late that 60% of those lesions have already spread resulting in a less than favorable prognosis. Upon closer questioning many women acknowledged that the lump was found by a boyfriend or husband. A Gallup survey found that three out of four women who had heard about breast self-examination did not practice it. These women identified their own ignorance of the technique as their reason for inaction.' To reduce the risk of breast cancer women need increased skills and knowledge to do effective breast self-examination. Effective breast self-examination skills are vital for early detection of breast cancer. Once women know how to do monthly breast self-examinations they find it reassuring t o discover they are indeed healthy. Reaching women to teach them these skills, however, is difficult. A community project was undertaken to incorporate breast self-examination into the curriculum of two high schools in a suburban community. The authors decided to direct their efforts to the high school population because they seemed to be the ideal population for learning these skills. First, they are easily accessible. Second, research has found that good health habits are best established at an early age.* t 3 Learning this skill early is important because breast cancer can, though rarely, occur in the high school population. Another benefit is that high school students might share this information with older female family members who are at higher risk. In the authors' experience in teaching breast self-examination it seems the younger generation is more comfortable with touching their own bodies and is more easily influenced to practice breast self-examination. Incorporating breast self-examination in the high school curriculum along with other health teaching might have the long range effect of reducing the barriers of fear, ignorance and embarrassment sometimes accompanying this practice. For these reasons the authors firmly believe that the high school population should be exposed t o breast self-examination knowledge. Those who are in the education and health fields are faced with a two-pronged challenge. Women need t o learn breast examination skills, yet at the same time they need help to reduce the barriers toward practicing what they have learned. The Wayne County branch of the American Cancer Society found that the public health nurses were the most viable teachers and the high school p o p ulation, the most appropriate population. In the 1974-1975 school year they began a project to teach breast self-examination to tenth-grade females in Detroit. They chose this grade because of the large number of dropouts in the eleventh grade. They accomplished this task by teaching the breast self-examination content t o the public health nurses whose services are utilized by the schools in Detroit. The public health nurses enjoyed teaching this and also reported adult behavior on the part of the students. This program continued in the 19751976 school year. However, as of this writing this program has not yet been evaluated. Thus, we implemented a project in a local high school.