Estrategias para la enseñanza del autoexamen del seno a mujeres en edad reproductiva

Objective. To develop an effective strategy to inform Mexicanwomen between 12 and 47 years of age about breastcancer (BC) and train them to perform breast self-examination(BSE). Material and methods. Between April, 1996and July, 1998, two different strategies to teach BSE weredesigned and evaluated in Cuernavaca, State of Morelos,Mexico. These strategies included teaching materials andwere based on opinions of women participating in the firststage of this study. Both strategies consisted of the presentationof a leaflet and a video. The first strategy was deliveredby a public health nurse in charge of leading the session.The second one was presented by a BC survivor. This secondstrategy included slides and silicon breast models. Thesetwo strategies were then compared to a third one, consistingof a primary care nurse handing out a leaflet andshowing a video, based on Health Secretariat’s guidelines. Intotal, 149 women were trained. They were randomly assignedto any one of these three strategies. The effectivenessof the teaching strategies was determined by assessingthe changes in the women’s knowledge of BC and BSE, aswell as in their ability to identify the largest number of lumpson a natural size silicon breast, before and after training.Statistical analysis included Student’s t test, variance analysis,McNemar’s c2, Pearson´s c2 and multiple linear regression.Results. With all three strategies, there was an increaseof approximately 30% in women’s knowledge of BC andBSE as well as in their ability to detect lumps. Although atthe beginning of the training only one out of every 20 womenwere able to identify more than three lumps in the siliconmodel, by the end between 3 and 4 of every 10 womenwere able to do this, with values of p<0.05. Some factorsdetermine women’s learning of both BSE and informationabout BC as well as their ability to identify lumps. Conclusions.Teaching BSE with any of the strategies evaluated couldbe included in an integral program to educate Mexicanwomen on breast cancer prevention and early detection.The appropriate and monthly practice of BSE is linked bothto a decrease in the amount of time elapsing between theidentification of suspect signs and the demand for medicalcare, such as requesting a clinical breast examination, whichentails identifying small tumors when BC is present.