At the community education program, Sandra learns that BSE is best performed 7 days after the start of the menstrual flow when the breasts are least engorged and tender. Since Sandra had a hysterectomy 5 years ago, she does not have periods. She asks the nurse if she still needs to perform BSE, and, if so, when.
What is the best response by the nurse?
A) "If you take hormone replacement therapy (HRT), you should perform BSE every week."
Although some forms of HRT place women at higher risk for breast cancer, weekly BSE is not necessary.
B) "Since you have had a hysterectomy, performing BSE twice a year is adequate."
A hysterectomy does not reduce the risk for breast cancer.
C) "Follow the same timing cycle you used when you had regular menstrual periods."
Ease in keeping track of a schedule is important to improve compliance. However, this routine is not the easiest to remember.
D) "Select whatever day you can best remember to perform BSE consistently every month."
Whatever day is best for Sandra will improve compliance and be easiest for her to remember. Suggesting the first day of the month is one easy approach.
Sandra demonstrates BSE technique for the nurse using a practice model. She uses her fingerpads and states that when lying down, her arm should be relaxed at her side.
What instructions should the nurse provide?
A) "You have demonstrated BSE successfully; practice this every month."
Sandra's technique was only partially correct. She needs further teaching.
B) "Use your fingertips rather than the pads of your fingers."
Use of the fingerpads is the correct technique, because the pads are more sensitive than the fingertips.
C) "When lying down, your arm should be positioned over your head."
Placing the arm over the head when lying down helps spread the breast tissue over the chest wall, making palpation more effective....