The ability of trained nurses to detect lumps in a test set of silicone breast models

BACKGROUND. Screening for breast carcinoma is a Healthy People 2000 objective and physical examination is an important component of the screening process. However, many women do not have access to a high quality breast examination. To help address this problem for Native American women, the authors developed the Nurses Providing Annual Cancer Screening (NPACS) training program, a week-long training session conducted at the nurses' clinical site. The goal of the current study was to demonstrate that, after receiving training, the nurses can detect masses in breast models at acceptably high rates. METHODS. Thirty-four nurses who had completed the NPACS training program performed examinations of a test set of six silicone breast models. True-positive and false-positive rates of lump detection were calculated. RESULTS. The nurses were able to detect more lumps in the simulated breasts than both untrained and trained physicians tested in previous trials using the same methodology. On the average, nurses found 76% of the 18 lumps in the 6 breast models. However, their rate of false-positive detections also was somewhat higher. Although the modal number of false- positive detections for both physicians and nurses was 0, the median number of false-positive detections was 0 for the physicians and 1.0 for the nurses. CONCLUSIONS. In the current study, trained nurses were able to detect masses in breast models at high rates. This observation suggests that widespread training of nurses to perform screening breast examinations might be considered as a response to the breast carcinoma screening needs of adult women.