Interventions to enhance breast self-examination practice: a review.

Breast self-examination (BSE) is an important component of any program for the early detection of breast cancer. Compared to clinical breast examination and mammography, BSE is relatively safe, low cost, offers monthly assessment, and does not require overcoming barriers associated with access to the medical care system (unless an abnormality is discovered). Over the past decade, considerable research has been directed at encouraging women to perform BSE. This paper reviews 33 intervention studies that vary in the type and intensity of strategies employed, and in the BSE behaviors assessed. In general, more-intensive interventions result in better outcomes. With regard to BSE frequency, the provision of information seems sufficient to obtain BSE initiation but not necessarily adequate to maintain practice or to establish proficiency. The addition of skills training and corrective feedback leads to significantly improved BSE proficiency. Prompts and reminder aids seem also to contribute to long-term frequency. The search should continue for motivational mechanisms regarding BSE frequency, and for creative approaches to teaching and maintaining proficiency.