Breast Cancer Awareness: A Business Resource Kit Train the Trainer Materials received from Susan G. Komen for the Cure and Johns Hopkins Medicine International

Lesson Plan Outline Common Breast Conditions Program Purpose Risk Factors Signs & Symptoms Early Detection Treatments Takeaway Lessons Q&A Session Program Purpose Program Goals Learning Objectives Course Delivery Breast Cancer Snapshot Breast Cancer Statistics What Is Breast Cancer?

Purpose of Program Increase the number of women who follow recommended guidelines for early detection Reduce the number of women diagnosed with late stage breast cancer Increase the number of women surviving breast cancer diagnosis Adapted from materials created by Johns Hopkins Medicine International.

Program Goals Conduct lunchtime breast health awareness sessions for female employees in a corporate setting Teach the 3-step approach to early detection during lunchtime session Teach the steps on how to perform a breast self exam during lunchtime session After the lunchtime session, disseminate breast health materials and referral information to local clinical resources and services

Learning Objectives Be able to discuss the materials provided in Breast Cancer Awareness: A Business Resource Kit Be able to discuss the value of: Annual mammograms Annual clinical breast exams Monthly breast self-exams Adapted from materials created by Johns Hopkins Medicine International.

Learning Objectives Be able to organize and conduct a Breast Health Awareness Program within your own setting Promote breast cancer awareness to your customers and in your community Adapted from materials created by Johns Hopkins Medicine International.

Course Delivery Be familiar with the content Target presentations to particular workplace setting and audience Practice before presenting Ensure that ample time remains for questions and answers Adapted from materials created by Johns Hopkins Medicine International.

Course Delivery Cultural Sensitivity Use visual aids and handouts Attend to logistics—room setup, quiet environment, no distractions, privacy Provide a list of resources for women to get more information about breast health and breast cancer Provide resources for getting help with a breast health question or problem Cultural Sensitivity Be knowledgeable about your audience Be sensitive to cultural and religious concerns Ensure privacy and discretion Adapted from materials created by Johns Hopkins Medicine International.

Breast Cancer Snapshot Breast cancer is the most common type of cancer among women. When diagnosed early, the chance of survival is greater. When the cancer is confined to the breast, the 5-year survival rate in the U.S. is more than 95 percent. Although more common among women over 40, younger women also can develop the disease. All women are at risk for breast cancer. Adapted from materials developed by Susan G. Komen for the Cure

Breast Cancer Statistics Worldwide, breast cancer is the leading cause of cancer deaths for women aged 15 to 64. Worldwide, one person is diagnosed with breast cancer every 30 seconds. Worldwide, one person dies of breast cancer every 90 seconds. Adapted from materials developed by Susan G. Komen for the Cure.

Adapted from materials developed by Susan G. Komen for the Cure What Is Breast Cancer? The light circles represent normal breast cells, while the dark-shaded circles represent cancerous breast cells. As the cancerous cells grow and multiply, they develop into a malignant tumor within the breast. Adapted from materials developed by Susan G. Komen for the Cure

Common Benign (Not Cancer) Breast Conditions Fibrocystic breasts Cysts Fibroadenomas Intraductal papillomas Mastitis Adapted from materials developed by the National Cancer Institute.

Adapted from materials developed by Susan G. Komen for the Cure Risk Factors Factors that may increase your risk of breast cancer: Getting older — the older you get, the greater your risk of breast cancer Having an inherited mutation in the BRCA1 or BRCA2 breast cancer genes Having a previous biopsy showing hyperplasia or carcinoma in situ Family history of breast cancer Having high breast density on a mammogram Being exposed to large amounts of radiation, such as having very frequent spine X-rays during scoliosis treatment or treatment for Hodgkin’s disease at a young age Personal history of breast or ovarian cancer Starting menopause after age 55 Never having children Having your first child after age 35 High bone density Being overweight after menopause or gaining weight as an adult Having more than one drink of alcohol per day Currently or recently using combined estrogen and progesterone hormone replacement therapy (HRT) Being younger than 12 at the time of your first period Current or recent use of birth control pills Adapted from materials developed by Susan G. Komen for the Cure

Adapted from materials developed by Susan G. Komen for the Cure. Signs & Symptoms Lump, hard knot or thickening Swelling, warmth, redness or darkening Change in the size or shape of nipple or breast Dimpling or puckering of the skin Itchy, scaly sore or rash on the nipple Pulling in of your nipple or other parts Nipple discharge that starts suddenly New pain in one spot that does not go away Pain or tenderness not associated with menstrual cycle Adapted from materials developed by Susan G. Komen for the Cure.

Early Detection Three Steps Annual screening mammogram beginning at age 40 Clinical breast exams at least every 3 years at age 20 and every year at age 40 Monthly breast self-exams by age 20

Mammography Mammography is the best method available for diagnosing breast cancer at a stage when it can be most effectively treated. Mammography can identify breast cancer several years before it can be felt during a physical examination.

Preparing for a Mammogram Schedule several days after your menstrual period ends Wear no perfume, powder, or deodorant Bring previous mammograms if they were performed at another mammography facility Adapted from materials created by Johns Hopkins Medicine International.

Screening Mammography Mammography will detect about 90 percent of breast cancers in women who have no outwardly visible symptoms. Mammography is highly accurate, but like most medical tests, it is not perfect. Adapted from materials created by Johns Hopkins Medicine International.

Screening Mammography Have a mammogram every year starting at age 40 If under 40 and have family history of breast cancer or other concerns, talk to your doctor Adapted from materials developed by Susan G. Komen for the Cure

Screening Mammogram Includes two sets of low dose x-rays Detects breast cancer while still at an early stage when most treatable Used for annual screening Used to look at structure of breast tissue when no symptoms present Adapted from materials created by Johns Hopkins Medicine International.

Diagnostic Mammogram Used to evaluate a woman with a breast problem or symptom of an abnormality found on a screening mammogram Usually includes additional x-rays of one or both breasts Focuses on a particular area Adapted from materials created by Johns Hopkins Medicine International.

Clinical Exam Doctor or nurse will look and feel breasts and under arms for changes. Sometimes breast cancer will not show up on a mammogram but can be felt.

Clinical Exam Have breast exam at age 20 Have breast exams at least every 3 years between age 20 and 39 Have breast exams every year at age 40 and over

Performing Breast Self-Exam Be sure to completely examine all the breast tissue Apply firm pressure Know what your breasts normally feel like– remember you are looking for a change

What to look for when performing Breast Self-Exam A change from last month A lump or thickening A change in the size or shape of breast Nipple discharge Dimpling, puckering, or severe dryness of skin or nipple Localized breast pain

Adapted from materials developed by Susan G. Komen for the Cure Step One: Lying Down Lie down on your back with a pillow under your right shoulder Use the pads of the three middle fingers on your left hand to check your right breast Press using light, medium and firm pressure in a circle without lifting your fingers off the skin Follow an up and down pattern Feel for changes in your breast, above and below your collarbone and in your armpit Repeat on your left breast using your right hand Adapted from materials developed by Susan G. Komen for the Cure

Step Two: In Front of Mirror Hold arms at your side Hold arms over your head Press your hands on your hips and tighten your chest muscles Bend forward with your hands on your hips Adapted from materials developed by Susan G. Komen for the Cure

If something is found… Most signs and symptoms are harmless but still need to be checked Don’t ignore them The doctor needs to determine if a problem exists

Treatments Surgery—mastectomy, lumpectomy, sentinel lymph node, lymph node removal, breast reconstruction Chemotherapy Radiation Hormonal therapy Targeted biologic therapy Adapted from materials created by Johns Hopkins Medicine International.

Takeaway Lessons Feel less fearful and more hopeful about breast cancer Incorporate breast health habits into a total wellness program Perform a breast self-exams competently and with confidence Be assertive about reporting a breast change to health care provider, promoting early detection Adapted from materials created by Johns Hopkins Medicine International.

Q&A Session