Breast Cancer

Behavioral Change Techniques Promote Screening Among Relatives of Breast Cancer Survivors

Jessica Nye, PhD
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Breast cancer cells. Coloured scanning electron micrograph (SEM) of breast cancer cells. The cells shows numerous processes and microvilli (fine surface extensions). These features are characteristic of highly mobile cells, and enable cancerous cells to spread (metastasis) rapidly round the body, and invade other organs and tissues. Cancer cells divide rapidly and chaotically, and may clump to form malignant tumours. The tumours often invade and destroy surrounding tissues. Breast cancer is the most common form of cancer in women. Treatment involves surgical removal of the tumour, often combined with radiotherapy and chemotherapy. Magnification: x1500 when printed 10cm wide.
A literature review identified effective approaches for increasing breast screening among first-degree relatives of women with breast cancer.

Researchers identified several interventions that may promote use of breast self-examination (BSE), clinical breast examination (CBE), and/or mammography among women whose first-degree relatives (FDRs) had breast cancer in a systematic review published in Public Health Nursing.

Women whose FDR had breast cancer are at increased risk for developing the disease; however, screening uptake remains low. The aim of this review was to assess interventions that improve breast cancer screening uptake in this population.

Investigators from Nanjing Medical University in China searched publication databases through November 2022 for relevant studies. A total of 13 studies published between 1991 and 2022 were included in this review.

For BSE, CBE, and mammography, a total of 10, 7, and 12 studies evaluated these outcomes and 9, 6, and 8 studies reported positive results, respectively.

Overall, 21 behavioral change techniques were described. Using a visualization of the co-occurrence network approach, 7 behavioral change techniques (BCTs) were determined to be promising, ie, they were statistically significant in the source study: prompts or cues, credible sources, instructions, information about health consequences, demonstrations, social support, and adding objects to the environment.

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The most promising techniques were information about health consequences, prompts or cues, and credible source.

This review was limited by not evaluating effect sizes and by including studies without control groups.

“We recommend that [breast cancer] screening behavior interventions include some of these promising BCTs in combination, especially those we find to be the most promising BCTs,” concluded the study authors.

Reference

Shi Y, Ma Z, Yao S, Lu N, Wu Y, Cheng F. Effects of interventions on the screening behavior in female first-degree relatives of breast cancer patients: a systematic review. Public Health Nurs. Published online September 15, 2023. doi:10.1111/phn.13252

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