الفهرس 
Embryology of the breastOnly 14 pages are availabe for public view
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Abstract
Breast cancer is the most common cause of cancer death among women worldwide. Incidence rates are high in more developed countries whereas rates in less developed countries and in Japan are low but increasing. In the United States of America (USA) each year more than 180 000 women are diagnosed with breast cancer. If current rates of increase remain constant, a woman born today has a 1 in 10 chance of developing breast cancer (Ries LAG et al, 2000).
In Egypt, breast cancer is the most common cancer among women, representing 18.9% of total cancer cases (35.1% in women and 2.2% in men) among the Egypt National Cancer Institute (NCI) series of 10 556 patients during the year 2001 (Elatar et al, 2004), with an age-adjusted rate of 49.6 per 100 000 population (Ibrahim AS et al, 2002).
However, the events leading to the transition from normal to cancerous epithelium are still not fully understood. So Population-based health programs for breast cancer screening are essential for detecting breast tumors in their initial stages. Developed countries and the majority of developing nations have implemented breast cancer screening strategies in order to detect and treat the disease in its earliest stages. The importance of early diagnosis for treating and possibly curing breast cancer patients has been demonstrated in many studies
Early detection means using an approach that allows earlier diagnosis of breast cancer. Early detection improves the chances that breast cancer can be diagnosed at an early stage and treated successfully. Breast cancer that is detected because of its symptoms tends to be relatively larger and is more likely to have spread beyond the breast. In contrast, breast cancer found during screening examinations is more likely to be small and still confined to the breast.
Attention has been focused on early ways of diagnosis of breast cancer as early management of the tumors markedly affects outcomes.
Current screening and education programs must include all women; the goal of beast cancer screening must be early detection of malignancy at a stage that will lead to a reduction in mortality.
Screening tests for breast cancer include:
A. Breast-self examination (BSE).
B. Clinical breast examination (CBE).
C. Mammograph
D. Breast U/S.
For many women, particularly those who depend on the National Health Service of a developing country and whom access to more modern diagnostic methods is more difficult, BSE may be an important tool against this disease (Jebbin, 2004 & Vahabi M, 2003).
The Cairo Breast Screening Trial showed that many women in the community may have early but palpable breast tumors and they may not be able to get proper health attention until their cancers are advanced. Hence, BSE and CBE may still have an important role (Boulos et al, 2005).
It is recommended that women begin BSE at age of 20 as an important screening practice for early breast cancer detection. Despite the benefits associated with it, few women regularly perform BSE and many do not even know how to perform it. There is also evidence that women are more likely to perform BSE effectively when taught by a physician or a nurse.
In 1998, a study pointed out that only 19% of nurses practiced BSE teaching, where the major reason for not teaching was the belief that it was not relevant to their work, their need for proper training first to themselves, and the lack of motivation to perform their own breast examinations.
Therefore, it is apparent that increased breast cancer awareness among physicians and nurses would most likely result in better education of higher number of women, and will motivate them for the adherence to screening recommendations.
The nursing role within screening for breast cancer focuses on breast awareness. According to the Royal College of Nursing (RCN) (2002) the nurse’s role is predominantly educative: encouraging women to be familiar with their breasts, offering both verbal and written information, being aware of the management of breast problems and informing women about the screening programme. Education for breast awareness follows a five-point plan:
• knowing what is normal,
• looking at and feeling the breasts,
• knowing what changes to look for
• and what to do if a change is found,
• as well as attending for screening if over 50
(Patnick 1995, CRC 2003).
Women, who are advised about breast awareness by a healthcare professional, demonstrate greater knowledge and confidence than when information comes from other sources. The role of the nurse, therefore, is to empower women by providing information, advice and support (Baily, 2000).
This is a cross-sectional study that was applied on (112) female healthcare workers who are employed in Ain Shams Maternity Hospital (94 female nurses and 18 female physicians) to know their knowledge, practice, and attitude towards breast cancer and BSE. Data were collected on a questionnaire form that was prepared based on information in the literature. The questionnaire had three sections: socio-demographic characteristics, health characteristics, and attitude and practice related to BSE. Data were analyzed using t test and chi-square test, and we found that almost all of female physicians and nurses knew how to conduct BSE but did not prioritize practicing it and that female physicians and nurses did not take enough care in proper timing of BSE (i.e., day 5 to day 7 after menstruation with the first day of menstruation being day 1) despite their knowledge about it.
Also we found that the effect of in-service training increases their knowledge, practice, and attitude towards breast cancer and BSE.
So Female physicians and nurses need to improve their knowledge and sensitivity concerning breast cancer and BSE if they are to improve and maintain their own well-being as well as carry out their professional roles