title: Breast self-examination and breast awareness: a literature review.
abstract: OBJECTIVE
  To explore the literature on breast self-examination and breast awareness.
  
  
  OBJECTIVE
  To clarify the confusion surrounding breast awareness and breast self-examination. To critique the evidence for breast awareness as a health promotion tool.
  
  
  BACKGROUND
  Over 41,000 women are diagnosed with breast cancer each year in the United Kingdom. Compared with other European countries, women in England have poor survival prospects, for breast cancer, due in part to advanced disease at first presentation. In the United Kingdom, women are encouraged to be breast aware from the age of 18. However, the evidence suggests that women do not engage in breast awareness and are frightened and confused about their role in breast health promotion.
  
  
  METHODS
  Four databases were used: Medline, Ebsco including CINAHL and Sociological Abstracts and the Cochrane Database of Systematic Reviews. The search terms 'breast awareness' and 'breast self-examination' were used and combined with 'breast cancer', 'breast screening' and 'health promotion'.
  
  
  CONCLUSIONS
  The evidence on breast self-examination is clear, there is no benefit to breast cancer mortality and results suggest that breast self-examination may do more harm than good. Breast awareness provides women with some acknowledgement of the part they can play in being empowered to fight breast disease, not in terms of statistics used for mortality but on the qualitative effects of reductions in morbidity.
  
  
  CONCLUSIONS
  The Royal College of Nursing of The United Kingdom is actively encouraging all nurses to promote breast awareness along with clear guidelines for doing so. The United Kingdom National Health Service Cancer Plan: a plan for investment, a plan for reform, encourages preventive care, information giving, good communication as well as evidence-based practice. In breast care this can reduce confusion for women and encourage empowerment in breast health promotion.
authors.affiliation: Faculty of Health and Social Care, The University of Hull, Hull, UK. t.mccready@hull.ac.uk
authors.forename: Tracey
authors.initials: T
authors.lastname: McCready
authors.forename: Dot
authors.initials: D
authors.lastname: Littlewood
authors.forename: Jane
authors.initials: J
authors.lastname: Jenkinson
mesh_terms: D001294:Attitude to Health; D001364:Awareness; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D016504:Breast Self-Examination / Q000451:nursing / Q000523:psychology / Q000706:statistics & numerical data; D003142:Communication; D019317:Evidence-Based Medicine; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening / Q000451:nursing / Q000523:psychology / Q000706:statistics & numerical data; D024802:Nurse's Role; D010353:Patient Education as Topic; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology