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									AWARENESS AND EARLY DETECTION OF
         BREAST CANCER
    AMONG WORKING WOMEN
      IN TRIVANDRUM CITY




            2005-06 PROJECT REPORT




                        Medical College
                         Trivandrum.




      Government of India – WHO Collaborative Programme
  AWARENESS AND EARLY DETECTION OF BREAST CANCER
     AMONG WORKING WOMEN IN TRIVANDRUM CITY




                       2005-06 PROJECT REPORT




Principal Investigator

      Dr. P.R.Sasindran
      Prof. & Head
      Dept. of Radiotherapy & Oncology,
      Medical College Hospital
      Trivandrum.

Co-Investigators

      Dr.C.Karthikeyan
      Prof. of Surgery
      Medical College Hospital
      Trivandrum.


      Dr.Annie Belthazar
      Prof. & HOD, Pathology
      Medical College Hospital
      Trivandrum.




2005-06 BCA Project Report                         1
                             TABLE OF CONTENTS

                                                 Page No.

Acknowledgements                                   3

Foreword                                           4

Executive Summary                                  5

Breast Cancer Awareness & Screening

   1.    Introduction                              7

   2.    Institutional profile                     9

   3.    Early Breast clinic                      18

   4.    Sensitization Camps                      20

   5.    Community programmes                     21

   6.    Mass Media & Printed Media Coverage.     21


Data tables

   1.    Breast Cancer Awareness Analysis         22

   2.    Breast Cancer Screening Analysis         33


Appendix

           I Data elements                        36

         II. Methods                              42

         III. IEC Materials                       43

         IV. Programme Notifications              49

         V. Photographs                           56

         VI. News paper Reports                   61




2005-06 BCA Project Report                                  2
Acknowledgements


The project team would like to acknowledge the following contributors:

   1.     The Ministry of Health & Family Welfare, Government of India for
          providing Breast Cancer Education and screening opportunities to the
          working female population of Trivandrum city.

   2.     The    World     Health     Organisation,    &     Dr.Cherian     Varghese,
          Co-ordinator, Non Communicable diseases & Mental Health, Office of
          the WHO Representative to India, New Delhi for his continued support
          and encouragement for making this project successful.

   3.     Our Principal Investigator, Dr.P.R.Sasindran for rendering academic &
          medical expertise to the project and for his valuable guidance through out
          the period.

   4.     Co-investigators, Dr. C.Karthikeyan & Dr.Annie Belthazar for their
          continued interest in providing the surgical & pathological services to the
          project.

   5.     The Heads of institutions who are considered as nodal officers, for their
          organization of programmes & motivating the co-workers to attend the
          awareness classes & screening camps.

   6.     The participants who have attended the awareness classes, camps &
          Breast Clinic for effectively utilizing the service for clearing their doubts
          and got rid of their unnecessary worries.




2005-06 BCA Project Report                                                           3
Foreword
By Dr. Sindhuja.N.S Project Medical Officer

       The women today play multifaceted roles ranging from that of an efficient
homemaker to a powerful decision maker. She manages and takes care of
everything from hearth to workplace, with ease and élan. In the midst of all these,
what gets ignored is her own well being. In an expression of its concern for
women’s health and appreciating the need for gender specific health services, the
WHO, in collaboration with the Ministry of Health & Family Welfare, Govt. of
India has organized the project “Awareness and Early Detection of Breast Cancer
Among Working Women In Trivandrum City” in the Department of Radiotherapy
& Oncology, Medical College Hospital, Trivandrum.

        This project was designed to improve the quality of breast cancer awareness,
screening and early detection services and to ensure access to them for women who
for a variety of reasons would otherwise not receive these services. The participants
have discrete income and most of them have health insurance that covers screening.
They are not culturally or geographically isolated from the existing services. Most
of them are over 40, but not over 60 years, working and caring for their family and
have good social support. Educating and motivating these women to want
screening, ensuring that these services are convenient, accessible, and provided in a
respectful and culturally competent manner, effectively communicating the results,
assisting women who need additional services, were among the main
responsibilities. Quality assurance, development of a data review process to
identify problems and developing a model for workplace intervention of cancers
were among the main components.

       This report summarizes the ten months work of project team. During this
period, we could serve hundreds of women each month.

      A strategic evaluation plan will guide the assessment of program components
and outcomes.

      This report demonstrates our growing capacity to accomplish that goal.




2005-06 BCA Project Report                                                         4
                         EXECUTIVE SUMMARY

       Early detection of cancer is based on the observation that treatment is more
effective when the disease is detected earlier in its natural history, prior to the
development of symptoms, than in an advanced state. The working population can
be benefited of an early awareness, as they can be easily motivated since they are
easily reachable at their workplace. The aim is the progressive control and cure of
breast cancer through programmes in education, screening, patient care and
research.

       Prior to attend the class, the participants complete a detailed questionnaire on
their background information and family history. In the class we provide current
and relevant information regarding breast issues and risk of breast cancer. We
provide instructions on Breast Self Examination and encourage them to practice it
monthly and our goal is to alleviate any barriers to its practice. Women are advised
on the appropriate interval for mammogram. After the class, detection camps are
conducted were the Medical Officer examine the breasts and axilla for lumps or
anything else unusual. It recommended that every woman should see a healthcare
professional for this kind of exam every year. Counselling is given on their risk and
discuss current concepts in prevention and early detection. Women are motivated to
do Breast Self Examination which is a simple and at home examination of their
breasts every month.

       Mammogram is the most widely used method for detecting breast cancer.
The patients who are suspected to have lump or anything unusual are advised to do
mammogram or tests like fine needle aspiration cytology, trucut biopsy or imprint
cytology.

       Patients are followed up in the Early Breast Clinic at Medical College,
Trivandrum. If the test results are normal, patients are advised to return for follow
up visits for routine cancer screening in a year. If the risk is high, they are advised
to come to follow up sooner. The referral services are also made to Surgery
department for any excision biopsy and the cases are reviewed.

       Training programmes have been offered to various nodal officers to help
them to motivate their co-workers. The success of our programme has been in the
participation of the people and the organization of programme, which are
effectively arranged by the efforts of various nodal officers.

        Providing awareness programmes to mass media and publishing descriptive
articles in magazines and news paper have been done during this period.




2005-06 BCA Project Report                                                           5
       It has been found that the participants belong to the urban areas mostly and
are doing desk job. Most of them have income Rs. 5000-10000/- and have a degree
and the majority of participants are Hindus. Periodical examination of breast is
done mostly by people doing technical job and having income less than Rs.5000/-,
who have SSLC as qualification and more by Muslims. Very few of the
participants have noticed a lump or nipple discharge or skin change. Awareness of
Breast Cancer and treatment is more among people doing desk job and income more
than Rs.15,000/- and having a Post graduation. The fact that Breast Cancer is
treatable if detected early is known by people doing desk job and among the high
income and high education groups. Only a minority of the participants think that all
lumps are cancer. Awareness of Mammography is also more among the highly
educated and high income groups.




2005-06 BCA Project Report                                                        6
   BREAST CANCER AWARENESS & SCREENING


                             I. Introduction

Inauguration of Project


              Our project ‘AWARENESS AND EARLY DETECTION OF
BREAST CANCER IN WORKING WOMEN IN TRIVANDRUM CITY’ was
launched on 28th December 2005 with the inauguration by Hon. Minister for Health
and Family Welfare, Kerala, Shri.K.K.Ramachandran Master. The function was
held on Surgery lecture hall,”Sushrutha’, Medical College Hospital at 11.30 am.
After the prayer, Dr.P.R.Sasindran, Prof. and HOD, Radiotherapy and Oncology,
MCH,          Trivandrum           gave       the         welcome         address.
Dr.Cherian Varghese, Co-ordinator, Office of the WHO Representative to India,
New Delhi gave a brief introduction of the project. The function was presided by
Adv. K.Mohankumar MLA.          Felicitations were given by Shri.M.Ajithkumar,
Councillor,   Medical    College    ward,   Dr.Meenu     Hariharan,   DME     and
Dr.A.V.Remadevi, Principal, Medical College, Trivandrum. Our Vice Principal,
Dr.Salil Kumar, Heads and Professors of various departments, PG students and
others were present for the function. We also had brief media coverage of the
function. The function ended with vote of thanks by    Dr.Sindhuja.N.S.

       The news regarding the inauguration of project was published in all leading
dailies. ‘THE HINDU’ gave an exclusive coverage of the news and stressed the
importance of early detection of breast cancer cases as illustrated by
Dr.Cherian Varghese.




2005-06 BCA Project Report                                                      7
       Our next mission was to prepare the brochures and questionnaire required for
our study classes. Questionnaire study was intended to test the current knowledge
of women regarding       the problem. As per advice of Dr.Cherian, a
sample questionnaire was prepared and a sample test was conducted with 10 female
staff of our Medical College Office. Necessary changes were made and they were
finalized for printing. The information on the brochures was obtained from various
sources.   Our Principal Investigator Dr.P R Sasindran and all other staff our
department were very helpful in making the study materials. The brochures and
questionnaire were ready by last week of January. We have also made an identity
card to issue to the patients coming to the Breast Clinic.


       By February 1st week we were all prepared to conduct classes. Next we went
to various institutions to sensitize them regarding the problem of breast cancer. In
the invitation letter, we include a brochure and a newspaper report.     In spite of
their busy schedule, the Heads of various institutions gave a warm welcome to us
and they readily agreed for the awareness class. Our 1st class was conducted at
St.Mary’s Higher Secondary School, Pattom on February 21st 2006. Our Principal
Investigator. Dr.P.R.Sasindran gave a brief introduction of the topic.          The
awareness class was taken by our Medical Officer Dr.Sindhuja.N.S. Doubts
participants regarding the topic were clarified by Dr. P.R Sasindran and our
 Asso. Professor Dr.Jayakumar. Around 150 teachers attended the class. They
wanted the detection camp to be conducted as early as possible. Before the class,
we had our questionnaire got filled.




2005-06 BCA Project Report                                                        8
                        II. Institutional Profile

The details of Awareness classes conducted in various institutions are listed below:

1. ST.MARY’S HIGHER SECONDARY SCHOOL PATTOM


St.Mary’s Higher Secondary School Pattom is one of the largest schools in Asia. It
has the credit of having maximum number of students. It is the only school in Asia
were maximum number of students appear for SSLC examination. It has a primary,
high school, and Higher Secondary section. It has a total over 250 female staff. We
have conducted two classes each, for High school and Primary school teachers. A
detection camp was also conducted there where majority of the teachers attended
and we could detect a few cases of nipple discharge and breast lumps.

Class conducted on 21-02-2006, 4-07-2006.
Camp conducted on 4-10-06
No. Of Participants- 200

2.   AG’S OFFICE


The Office of Accountant General (A & E), Kerala, Thiruvananthapuram is part of
the Indian audit and Accounts Department under the Controller and Auditor General
of India (CAG), The main duties and powers of the CAG of the India includes audit
of receipts and expenditure of the Union and the State Governments and
compilation and consolidation of the Civil Accounts of the Governments of States
and Union Territories.

       The main Office of the Accountant General (A &E) Kerala is located in
Thiruvananthapuram.It has four branches situated in the towns of Kottayam, Kochi,
Trissur, and Kozhicode.

      The class was conducted at the AG’S Office; Trivandrum.The class was
organized under the Welfare Department of the Office.

Class conducted on 27-02-2006
No. Of Participants—50




2005-06 BCA Project Report                                                             9
3.   COTTON HILL GIRLS HIGHER SECONDARY SCHOOL


Located at Vazhuthacadu, Cotton Hill GHSS is one of Asia’s largest and oldest
schools for girls. It has primary and High school section managed by two Principals.
We have conducted a class for teachers and a camp is yet to be conducted.

Class conducted on 28-02-2006.
No. Of participants—52


4.   UNIVERSITY OFFICE, PALAYAM

The University of Kerala is an affiliating university located in Trivandrum, which
was established in 1937. This institution has played a significant role in the social,
cultural and educational history of Kerala State. The University Office at Palayam
Trivandrum is the seat of Vice Chancellor, Pro- Vice Chancellor, the Registrars and
various staff involved in the administrative activities of the University.

Class conducted on 8-3-06
No. of participants-50

5.   GOVT. SECRETARIAT, TVM


        Secretariat is the apex of the State administration and it is mainly concerned
in assisting the Council of Ministers in framing of policies, approval of plans,
programmes and activities for overall development of the State, the work concerned
with Legislation laying down rules and procedures, financial control, general
direction and monitoring and evaluating the work done by the implementing
Departments/ agencies. Each department of Secretariat consists of Secretary to
Government, who is the official head of the dept. and such other officers and staff
subordinate to him/her as the Government may determine from time to time. The
dept. is further divided into sections, each of which is under the charge of a Section
Officer. Apart from the general sections, dealing with the subjects allotted to them,
there will be an office section, assigned with specific duties.

       The awareness class at Secretariat was organized by Secretariat Vanithavedi,
which functions for the welfare of female staff. An early detection camp was also
organized were a good number of staff participated. Another class was also
organized under Secretariat Staff Association, where a good number of staff
participated..



2005-06 BCA Project Report                                                         10
Class conducted on 9-3-06,6-10-06
Camp conducted on 9-5-06
No of participants for class : 160
No of participants for camp: 100

6.    COLLEGE OF AGRICULTURE, VELLAYANI

College of Agriculture, Vellayani, which comes under Kerala Agricultural
University, is a pioneering institution of its kind, which offers various activities for
the education research and development in the field of Agriculture.

      The class was conducted in Instructional farm Vellayani, for the female
labourers. A camp was also organized under KAU employer’s society.

Class conducted on 29-03-06
Camp conducted on 27-04-06
No of participants—110

7.    FOOD CORPORATION OF INDIA


The Food Corporation of India was set up under Food Corporation and 1964,in
order to fulfill the following objectives of the food policy.

     • Effective price support operations for safe guarding the interests of the
       farmers.
     • Distribution of food grain through out the country for public distribution
       system: and
     • Maintaining satisfactory level of operational and buffer stocks of food grains
       to ensure national food security.

       In its forty years service to the nation, FCI has played a significant role in
India’s success in transforming the crises management oriented food security in to a
stable security system.

The class was conducted the Regional Office FCI, Kesavadasapuram. A camp was
also conducted were a good number of staff participated.

Class conducted on 21-04-06
No. of participants –45
Camp conducted on 25-04-2006

2005-06 BCA Project Report                                                           11
8.    JALA BHAVAN


The responsibilities of the Water Authority include design, construction, execution,
promotion, operation and maintenance and financing of schemes for the supply of
water for the collection and disposal of waste water, establishment of standards for
water supply and waste water services, fixation an revision of rates for water supply
and sewerage, maintenance with the approval of Govt.etc. The Class was organized
in Jala Bhavan, Vellayambalam by Mrs.Rajam, Asst. Executive Engineer, who had
breast cancer and had undergone treatment for the same. As a result of her
motivation, we had a good number of participants and we could carry out the
programme successfully.

Class conducted on 25-04-06
No. Of participants-50


     9.   FOREST OFFICE


The Ministry of Environment and forests is the nodal agency in the administrative
structure of the central government, for the planning, promotion co-ordination and
overseeing the implementation of environmental and forestry programmes. The
principal activities undertaken by Ministry of Environment and Forests, consist of
conservation and survey of flora and fauna, forest and wild life, prevention and
control of pollution, afforestation, and regeneration of the guarded areas and
protection of environment, in the framework of legislation The organizational
structure of the Ministry covers number of divisions, directorate, board, subordinate
offices, autonomous institutions, and public sector undertakings.


       The class was organized by Mr.Xavier, PRO, at the Vanasree Auditorium,
located at Forest office premises.

Class conducted on 28-04-06
No. Of Participants—50




2005-06 BCA Project Report                                                        12
10.    BSNL OFFICE PATTOM


We have conducted a class at BSNL office, Pattom. This Office has over 50 female
staff. Almost all the staff participated in the class. A camp is yet to be organized.
Also class at main BSNL office, Statue is yet to be organized.

Class conducted on 05-05-2006
No.Of.Participants—50

11.    VIKAS BHAVAN

The various Departments of Government of Kerala is located at Vikas Bhavan.We
have conducted four classes, at Agricultural dept, Economics & Statistics
Department, Local fund Audit , Animal Husbandary and Fisheries . A camp was
conducted after the class in Economics Department and Dr.Bhavana, Chief
Statistical Officer, organized it. Mr.Sanal organized the class at Agricultural
Department under Recreation club, Dr. Rani, was very helpful to organize the class
at Animal Husbandary and Fisheries department.

Class conducted on 25-05-06,31-05-06.28-8-06,19-9-06
No. Of participants—200

      12. STATE PLANNING BOARD PATTOM


The Economic Planning and Review of the State Government of Kerala is done at
State Planning Board Pattom.The class was organized under cultural forum at the
conference hall.

Class conducted on 26-05-2006.
No. Of Participants—50


13. PUBLIC OFFICE TRIVANDRUM

The Administrative activities of Government of various Departments of Kerala is
held at Public Office Trivandrum.We have conducted two classes at PWD &
Revenue Department. The class at PWD was conducted at Arts and Sports
recreation center, and class at Revenue Department at Conference hall. A detection
camp and class in other Departments is under consideration.

Class conducted on-29-05-2006, 03-06-2006.
No. Of Participants—100
2005-06 BCA Project Report                                                        13
14. VIKRAM SARABHAI SPACE CENTRE (VSSC)


Lead center for rocket and launch vehicle projects. The activities cover avionics,
aeronautics, materials and mechanical engineering, solid propulsion and
composites, propellants, polymers and chemicals, systems reliability and computer
and information. Achievements include development of sounding rockets, ISRO
launch vehicles, SLV 3 ASLV, and PSLV.

       VSSC has 3 centres at Veli,Thumba and Vattiyoorkavu. The class was
organized by Mrs.Manjari, the Secretary of WEB, the women’s association of
VSSC.,at the Vattiyoorkavu center.Dr.Indira ,Medical Officer inaugurated the
session, and gave a brief speech which stressed the importance of early detection
and treatment. A camp was also organized in the health center after the class. A
good number of staff including the Medical Officer attended the camp.

Class & Camp conducted on 30-05-06
No.of participants-50


15.   KELTRON

In Trivandrum, Keltron has three centers, Vellayambalam, Karakulam and
Monvila.The center at Vellayambalam is carrying out the Administrative and
Management activities. The centers at Karakulam and Monvila are manufacturing
units of electrical equipments. We have conducted classes at Vellayambalam
branch and Karakulam factory, where a good number of staff participated..

Class conducted on 01-06-06
No. Of participants-190

16. JILLA PANCHAYAT OFFICE PATTOM


Jilla Panchayat Office located at Pattom is the Head Office of the Panchayat
Secretary and other staff under the Department .The class was inaugurated by
Health Standing Committee Chairman at the conference hall. The participants
include the office staff, resource persons for various projects social workers etc.
A camp is yet to be organized.

Class conducted on 06-06-2006.
No.Of.Participants—50

2005-06 BCA Project Report                                                      14
17. CENTRE FOR DEVELOPMENT AND ADVANCED COMPUTING
    (C-DAC)

        The center for development and advanced computing is primarily a R&D
institution involved in the design, development and deployment of advanced
information technological based solution, which was established in March 1988, as
a scientific society of the Ministry of Information technology, Govt. of India.

         Swaram, the cultural forum of this institution, organized the awareness class
in this institution. We have also proposed to conduct an early detection camp soon.

Class conducted on 8-3-06
No of participants: 40



18. POLICE HEAD QUARTERS


Police Head Quarters located at the Vazhudacadu is the seat of Director General of
Police and various other offices under the Department. The Administrative and
Management activities are carried out here. The class was conducted under staff
recreation club and welfare society at the recreation club.

Class conducted on 03-07-2006.
No. Of Participants—40


19. GOVERNMENT G.H.S.S. PATTOM


In this institution we have conducted two classes, one for primary and High school
teachers, and other for Higher Secondary teachers. A camp was organized for
higher secondary teachers after the class. Another camp was also organized for the
teachers who have not attended the previous camp

Class conducted on-06-07-06, 04-08-06
Camp conducted on 4-8-06, 22-9-06
No. Of. Participants—75




2005-06 BCA Project Report                                                         15
20. TRAVANCORE TITANIUM PRODUCTS Ltd.


The largest manufactures of and suppliers of Titanium dioxide pigment in India
with ISO 9001 certification, TTP Ltd. is a public limited company under state
public sector, with Govt. of Kerala owing 80.94% of shares, KSIDC hold 7.91%
and balance held by public. The total manpower employed at present is account
1300.

        The class at Titanium was organized by M.S.Abdul Majeed, training
manager, at the conference hall. We have conducted a camp there where majority of
staff attended .Dr Mohandas, Chief Medical Officer was very helpful to organize it.

Class conducted on 07-07-2006
Camp conducted on 9-8-06
No. Of Participants—70

21. DIRECTORATE OF TOURISM


       Tourism is today recognized as a social phenomenon, which brings mankind
closer to different to social value, cultural heritage and customs. Successful Tourism
Development in imbibes of valves of recognizing the sustainability of natural
resources and socio-cultural ethos of the land.

       Directorate of Tourism, Government of Kerala is located at Park View , the
heart of Trivandrum city. An awareness class was conducted there and a camp is
under proposal.

Class conducted on 12-07-2006
No. Of Participants-25.


22.    HINDUSTAN LATEX LTD.

       HLL is a Govt.of India company under Ministry of H & FW.HLL today is
one of the world’s largest manufactures of condoms with an annual production
capacity of 800 million pieces. The manufacturing unit at Peroorkada, Tvm, was set
up by HLL in 1969 with the technical collaboration using Japanese technology. It
has an annual production of 650 million pieces condoms and is equipped with
modern production, inspection and quality control machines in international quality
norms.



2005-06 BCA Project Report                                                         16
       In Trivandrum, HLL has 3 centres, at Pujappura, Peroorkkada and
Akkulam.The class was conducted at Peroorkkada factory, which is the largest
manufacturing unit of condoms. A well organized class and camp was arranged
under Counselling and Guidance center of the company. There were classes for 3
days in 2 sessions each. After the class, detection camp was also conducted.

Class & camp conducted on 27-7-06, 1-8-06, 2-6-06
No of participants- 310

23.   OFFICE OF THE CHIEF POST MASTER GENERAL


        Department of Post, Government of India is located at Office of the Chief
Post Master General at PMG Junction. The class was conducted at the conference
hall at Circle Office it was organized under Welfare Section of Departments.

Class conducted on 28-07-2006
No. Of Participants-50




                      Total no of institutions covered-23
                        Total no of classes taken- 35
                            Total no. of camps-15
                       Total no. of participants- 2067




2005-06 BCA Project Report                                                    17
                       III. Early Breast Clinic

       An Early Breast Clinic has been functioning in Medical College, TVM since
the launching of the project. It is conducted along with the Radiotherapy OP on all
Saturdays from 9 am to 12pm. The patients who are visiting the clinic are offered
with all services including OP registration, direct access to consultants etc. We
make necessary checkups and investigations done once they visit the clinic. There
has been an increase in the no. of patients attending the clinic, after the awareness
class programmes in various institutions. Here they are free to come and can get rid
of their unnecessary worries with the expert advice by our clinicians. At times, the
patients who attend the breast clinic may feel overwhelmed with issues regarding
their increased risk of breast cancer or other life issues.        We are offering
psychosocial support to assist women in their risk of breast cancer.
       Studies show that nutritional habits may reduce the risk of many diseases
including breast cancer. Nutritional education and counseling is also provided.

        The aim of our project is to provide reliable information about breast
cancer and its early detection to working women so that they may be empowered to
take charge of their own breast health.     A women’s fear of breast cancer is such
that     they do not consult their doctor immediately when             they discover a
lump/discharge/any other abnormality, because fear of breast cancer overcomes
them. Even the educated working women find it very difficult to reveal their
findings related to breast. Unfortunately, fear does not help the lump/any




2005-06 BCA Project Report                                                         18
abnormality go away and women lose their precious time should the lump turn out
to be cancer. There are even a group of ladies who fear that attending a class and
being aware may lead to know that they have got cancer. Some are afraid what
others think if they are diagnosed to have cancer.

       Every women needs to know that early detection of breast cancer saves lives.
Despite lack of specific prevention measures, we can help ourselves by detecting
breast cancer early as this offers the best chances of survival and a normal lifestyle.


       The cases detected in the Breast clinic include 9 Fibroadenoma, 7 of which
were excised, a sebaccous cyst., I proliferative lesion breast with atypia, 2 cases of
fibrocystic disease and calcification, one case of ductal ectasia, 4 cysts and one
case of c/c granulomatous lesion breast.         There were many cases of nipple
discharge, which were sent for cytology.




2005-06 BCA Project Report                                                           19
                      IV. Sensitization Camps


       A sensitization camp was conducted for the nodal officers of various
institutions regarding Breast Cancer awareness and the importance of screening.
The function was presided by Dr. P.R.Sasindran & Dr.Cherian Varghese gave a
detailed presentation of incidence and risk factors of all common cancers. They
could clear a few doubts of participants. The aim of this programme was to
sensitize the institutional heads and to motivate them to conduct awareness class in
their institutions.


       We hope this programme helped the participants to get rid of unnecessary
worries & doubts and motivated them for conducting awareness classes and
screening camps in their institutions.




2005-06 BCA Project Report                                                       20
                         V. Community Programmes

       We were receiving proposals to conduct awareness programmes in places
outside the city limits.   In view of the continued request to help them create
awareness to their local residents, we conducted two classes – one in Nettayam &
other in Powdikonam. A detection camp was also conducted after the class where a
large no. of people participated. The programme was found very useful to those
who attended. More over they were also helpful to report these programmes in the
newspapers.


              VI. Mass Media & Printed Media Coverage

       The news regarding the inauguration of project was published in one of the
leading dailies ‘The Hindu’ Dr. Cherian Varghese, illustrated the importance of
early detection of breast cancer and the methods used to create breast cancer
awareness among the working women. Dr. Cherian also stressed the importance of
breast self examination in women over 30 years, to diagnose any changes in their
breasts.
       We are proud to inform that Asianet, the leading Satellite channel of Kerala
has invited the entire project team as expert panel in their programme ‘Nammal
Thammil’, which is viewed by a large number of Malayalees world wide.         This
programme is viewed by a large number of families of Trivandrum city and the
topic was ‘Stanarbudam Varunna Vazhi’.        The aim of this programme was to
create Breast cancer awareness and to teach the importance of early detection and
treatment. Through this programme, we could teach the importance of Breast self
examination regularly.

       The news regarding the awareness classes in various institutions has been
published in almost all the leading newspapers.       A detailed report has been
published in ‘Deepika’ daily regarding the importance of early detection &
screening.

2005-06 BCA Project Report                                                      21
DATATABLES

1.         BREAST CANCER AWARENESS ANALYSIS


FIGURE- I

PIE DIAGRAM SHOWING PERCENTAGE DISTRIBUTION                               OF
PARTICIPANTS ACCORDING TO OCCUPATION.




     T EC HN IC A L JOB
            4 1%




                                                          D ESK JOB
                                                             59 %




DESCRIPTION


59% of participants belong to desk job and 41% belong to technical job.




2005-06 BCA Project Report                                                22
FIGURE- 2

BAR DIAGRAM SHOWING AWARENESS OF BREAST CANCER
AMONG THE PARTICIPANTS ACCORDING TO THEIR OCCUPATION.




      Aware of M ammography



          All Lumps are Cancer



 Aware that Cancer is Treat able
      if Det ect ed Early



    Aware of Cancer Treat ment



            Aware of B.Cancer



  Lump/Skin Change/ Discharge


     Periodically Examinaton of
               Breast


                                   0   10     20      30      40      50       60       70      80         90   100

                                       Desk Job-Yes   Desk Job-No   Technical Job-Yes   Technical Job-No




DESCRIPTION

      30% of people doing desk job periodically examine their breasts and
35% of people doing technical job examine their breasts periodically. 7.75%
of people doing desk job and 6% of people doing technical job have noticed a
lump or skin change or nipple discharge. 66.05% of people doing desk job
and 50 % of people doing technical job are aware of breast cancer 52% of
people doing desk job and 37% of people technical job are aware of cancer
treatment. 77.4% of people doing desk job and 73.68% of people doing
technical job are aware that cancer is treatable if detected early. 6.67% of
people doing desk job and 7.97% of people doing technical job think that all
lumps are cancer. Awareness of mammography among the two are 42.23%
and 30% respectively.


2005-06 BCA Project Report                                                                                            23
FIGURE- 3

PIE DIAGRAM SHOWING PERCENTAGE DISTRIBUTION                                          OF
PARTICIPANTS ACCORDING TO THEIR MONTHLY INCOME.




                                                          +20000
                          150 0 0 - 2 0 0 0 0               0%
                                 7%
                                                                    U p t o 50 0 0
                                                                         2 7%
     10 0 0 0 - 150 0 0
           20%




                                                50 0 0 - 10 0 0 0
                                                     46%




DESCRIPTION


      46% of the participants belong to the income group 5000-10,000 , 27%
belong to group having income upto 5000 and 20% belong to group 10,000-
15000, 7% is having income 15,000-20,000.




2005-06 BCA Project Report                                                           24
FIGURE- 4

BAR DIAGRAM SHOWING AWARENESS OF BREAST CANCER AMONG THE
PARTICIPANTS ACCORDING TO THEIR MONTHLY INCOME.


            Aware of M ammography




               All Lumps are Cancer



    Aware that Cancer is Treatable if
            Detect ed Early



         Aware of Cancer Treatment




                 Aware of B.Cancer




       Lump/Skin Change/Discharge




   Periodically Examinat on of Breast



                                    0.00     10.00    20.00     30.00   40.00    50.00     60.00    70.00    80.00   90.00   100.00

                  Upt o Rs. 5000-Yes       Upt o Rs. 5000-No      Rs. 5000-10000-Yes     Rs. 5000-10000-No    Rs. 10000-15000-Yes
                  Rs. 10000-15000-No       Above Rs.15000-Yes     Above Rs.15000-No




DESCRIPTION

       Periodical examination of breast is done mostly by people having income less
than 5000 (40.9%) followed by people having income 10,000- 15,000 (32%) Less than
10% of all the income groups have noticed a lump/ skin change/discharge.
Awareness of breast cancer is more among the group which receive income
more than Rs . 15000.(82%) and is least among the income group less than
5000.(38.4%) Awareness of cancer treatment is also more for high income
group (75%) and less for lowly paid(28%) 82% of people having income more
than 15,000 and 73.05% of people having income less than 5000 , know that
cancer is treatable if detected early. 9% of people who think that all lumps are
cancer belong to income group 10,000-15,000.. Only very few percentage of
other income groups think that all lumps are cancer. 63.57% of the people
who have income more than 15,000 are aware of mammography and the
awareness is least among the lowly paid.(20.8%)
2005-06 BCA Project Report                                                                                                            25
FIGURE-5

PIE DIAGRAM    SHOWING DISTRIBUTION OF PARTICIPANTS
ACCORDING TO THEIR EDUCATIONAL QUALIFICATION.




           Po st Gr ad uat i o n                        U p t o SSLC
                  20%                                         3 1%




               D eg r ee                                    Plus T wo
                 34%                                           15%




DESCRIPTION


The educational qualification of the participants are degree(34%), upto

SSLC(31%) , post graduation (20%) and plus two (15%).



2005-06 BCA Project Report                                              26
FIGURE- 6

      BAR DIAGRAM SHOWING THE AWARENESS OF PARTICIPANTS
            ACCORDING TO EDUCATIONAL QUALIFICATION




DESCRIPTION

       Mostly people who have studied upto SSLC do periodical examination of
breast (38.07%), and does people who have a degree do-least (27.8%). The
people who have a post graduation have noticed a lump/skin change/nipple
discharge more (8%) and least by people who have studied upto SSLC (4.9%).
Awareness of breast cancer is more among the postgraduates (79.05%) and
least among the people who have studied upto SSLC (34.97%). Awareness of
cancer treatment is also more among the postgraduates (66.2%) and least
among the people who have studied upto SSLC (23.58%). Almost all the
groups are aware that cancer is treatable if detected early. Only a minority of
the people belonging to different educational qualification thinks that all lumps
are cancer. Awareness of mammography is more among the postgraduates
(55.59%) and least among the people who have studied upto SSLC(13.11%).



2005-06 BCA Project Report                                                    27
FIGURE-7

PIE DIAGRAM SHOWING PERCENTAGE DISTRIBUTION                             OF
PARTICIPANTS ACCORDING TO THEIR RELIGION




                 C H R I S TI A N              M U S LI M
                      26%                         6%


                                                            OT H ER S
                                                               0%




                                    HINDU
                                     68%




DESCRIPTION


Majority of participants are Hindus (68%) followed by Christians (26%) and
Muslims(6%).




2005-06 BCA Project Report                                               28
FIGURE– 8

BAR DIAGRAM SHOWING AWARENESS OF BREAST CANCER OF THE
PARTICIPANTS ACCORDING TO THEIR RELIGION.




   100.00

    90.00

    80.00

    70.00

    60.00

    50.00

    40.00

    30.00

    20.00

    10.00

     0.00
             Periodically    Lump/Skin Aware of B.Cancer Aware of Cancer Aware that Cancer All Lumps are      Aware of
            Examinaton of Change/Discharge                 Treatment      is Treatable if      Cancer      M ammography
               Breast                                                     Detected Early


                         Hindu-Yes   Hindu-No   Christian-Yes   Christian-No   M uslim-Yes   M uslim-No




DESCRIPTION


       Among the Hindus, the people who practice periodical examination of
breast are 32%, Christians-29% and Muslims-36%. The participants who
have noticed a lump/skin change /discharge are less than 10%. The awareness
of breast cancer among the Hindus, Christians and Muslims are 57%, 63%
and 64% respectively. The awareness of cancer treatment among the three are
43.5%, 50% and 54.4% respectively. Almost all of the participants belonging
to different religion are aware that cancer is treatable if detected early. Only a
minority of participants belonging to different religion thinks that all lumps
are cancer. Among the Hindus, 34.24%, among the Christians, 43.49% and
among the Muslims, 50% are aware of Mammography.




2005-06 BCA Project Report                                                                                                29
FIGURE- 9

PIE DIAGRAM SHOWING DISTRIBUTION OF                           PARTICIPANTS
ACCORDING TO THEIR REGION OF RESIDENCE.




                                                      Rural
                                                       39%




      Urban
       61%




DESCRIPTION

Majority of the participants belong to urban area (61%) and the remaining
39% belong to rural areas.




2005-06 BCA Project Report                                                  30
FIGURE-10

BAR DIAGRAM SHOWING AWARENESS                                                                                    OF       PARTICIPANTS
ACCORDING TO THE REGION OF RESIDENCE.




10 0 %
                                                                                                         21.82
 90%                                                            37.11
                                                                                     50.51
               66.39                                                                                                                             57.83
 80%
                                      92.91                                                                                  92.91

 70 %                                                                                                    78.18
                                                                62.89
                                                                                     49.49
 60%           33.61                                                                                                                             42.17

                                       7.09                                                                                   7.09
 50 %
                                                                                                         27.65
 40%                                                            46.63
                                                                                     60.06
               70.97                                                                                                                             69.94
 30%
                                      94.28                                                                                  92.67

 20%                                                                                                     72.35
                                                                53.37
 10 %                                                                                39.94
               29.03                                                                                                                             30.06
                                       5.72                                                                                   7.33
  0%
          Per io d i cal ly       Lump / Skin       A war e o f B .C ancer A war e o f C ancer        A war e t hat     A l l Lump s ar e      A war e o f
         Exami nat o n o f    C hang e/ D i schar g e                         T r eat ment             C ancer i s            C ancer       M ammo g r ap hy
            B r east                                                                                 T r eat ab le if
                                R ur al - Y es   R ur al- N o     U r b an- Y es   U r b an- N o   D et ect ed Ear ly




DESCRIPTION


       33.61% of urban people and 29.03% of rural people periodically
examine their breasts. Only 7.09% of urban people and 5.72% of the rural
people have noticed a lump/skin change/discharge. 62.89% of urban people
and 53.37% of rural people are aware of breast cancer. 49.49% of urban
people and 39.94% of rural people are aware of cancer treatment. 78.18% of
urban people and 72.35% of rural people are aware that cancer is treatable if
detected early. Only 7.09% of urban people and 7.33 % of rural people think
that all lumps are cancer. 42.17% of urban people and 30.06% of rural people
are aware of Mammography.




2005-06 BCA Project Report                                                                                                                               31
FIGURE - 11



BAR DIAGRAM SHOWING AGE-WISE DISTRIBUTION OF
PARTICIPANTS




                                     AGE-WISE DISTRIBUTION OF PARTICIPANTS
                        25                                                                        2 2 . 16    2 1. 7 1




                        20

                                                                                      14 . 4 1

                                                                          13 . 11
                        15
           Percentage




                                                           11. 0 2



                        10                                                                                                 7.52

                                                   6.27



                        5                 2.77

                               1. 0 2


                        0
                             Below                                                                                       Above
                                        20-25    25-30    30-35         35-40       40-45        45-50       50-55
                               20                                                                                          55

       Percentage             1.02      2.77     6.27     11.02         13.11       14.41        22.16       21.71        7.52
                                                                     AGE (Years)




DESCRIPTION

      Majority of participants belong to age group 45-50 yrs(22.16%) , 50-55
yrs (21.71%), 40-45 yrs(14.41%), 35-40yrs (13.11)%, 30-35 yrs (11.02%) ,
above 55 yrs(7.52%) , 25-30 yrs (6.27%) , 20-25 yrs(2.77%) and the least
belong to age group below 20 yrs(1.02%)




2005-06 BCA Project Report                                                                                                        32
II.    BREAST CANCER SCREENING ANALYSIS


FIGURE – 1

BAR DIAGRAM SHOWING THE INVESTIGATIONS DONE FOR THE
PATIENTS ATTENDING THE BREAST CLINIC.



           54.17




                                20.83


                                                          11.11
                                                                          9.72

                                                                                              1.39                2.78




        M ammogram        Cytology of nipple              Fnac            Biopsy          Serum prolactin       CT aspirat ion
                              discharge
                                                             INVESTIGATION

                                    Cyt ology of nipple
                     M ammogram                                   Fnac           Biopsy      Serum prolact in    CT aspirat ion
                                         discharge

      Percent age       54.17              20.83                  11.11            9.72              1.39            2.78




DESCRIPTION


      54.17% of the patients who have attended the Breast Clinic have done
Mammogram, 20.83% of patients have done cytology of nipple discharge,
11.11% of the patients have done FNAC, 9.72% of patients have done biopsy,
2.78% have done CT aspiration and 1.39% of people have done Serum
Prolactin.




2005-06 BCA Project Report                                                                                                        33
FIGURE – 2

BAR DIAGRAM SHOWING MAMMOGRAM FINDINGS OF PATIENTS
ATTENDING THE BREAST CLINIC.




                       35.00
                                                                                                                                                                30.77


                       30.00

                                                                                                    23.08
                       25.00
          PERCENTAGE




                       20.00

                                                                                                                              12.82
                       15.00
                                                               10.26


                       10.00
                                     5.13                                    5.13

                                                    2.56                                 2.56                    2.56                      2.56         2.56
                        5.00


                        0.00
                                                   C/ c
                                                                       Fibrocyst ic   Ductal    Fibroadeno   Lobulated                 Hypoechoic
                               Calcificat ion granulomat o   Cyst s                                                      Lymph nodes                Scarring   Nad
                                                                         disease      ectasia       ma       carcinoma                    areas
                                                us lesion

             Percent age           5.13          2.56        10.26         5.13        2.56       23.08        2.56         12.82         2.56        2.56     30.77

                                                                                              MAMMOGRAM




DESCRIPTION

30.77% of patients do not have an abnormality in their mammogram.
Mammogram detected a fibroadenoma in 23.08%, lymph nodes in 12.82%,
cysts in 10.26%, calcification and fibrocyctic disease in 5.13% and 2.56% each
for c/c granulomatous diseases, ductal cctasia, lobulated carcinoma,
hypoechoeic areas and scarring.




2005-06 BCA Project Report                                                                                                                                              34
FIGURE – 3

BAR DIAGRAM SHOWING MAMMOGRAM Vs. BIRADS CATEGORY.




                             45.00                                                40.74
                                                                     37.04
                             40.00

                             35.00

                             30.00
                Percentage




                             25.00

                             20.00                     14.81

                             15.00
                                                                                                7.41
                             10.00

                              5.00
                                          0.00
                              0.00
                                     Cat egory-0   Cat egory-1   Category-2   Category-3   Category-4

                Percentage              0.00          14.81        37.04        40.74         7.41

                                                                 BIRADS




DESCRIPTION

40.74% MAMMOGRAM DETECTED BIRADS CATEGORY - 3, 37.04%
DETECTED CATEGORY – 2, 14.81% CATEGORY-1 AND 7.41%
CATEGORY – 4.




2005-06 BCA Project Report                                                                              35
        APPENDIX – I
        DATA ELEMENTS

        1.          QUESTIONNAIRE ANALYSIS




        Excel Files attached.



        2.          EARLY BREAST CLINIC


                     DETAILED REPORT OF PATIENTS WHO HAVE ATTENDED
                                     BREAST CLINIC




Sl.      Name                  Presenting     Past          Examination           Investigations      Treatment
No                      Age   Compliant       History       Findings
1     Pushpalatha       37    Pain left       Nil           NAD                   Mammogram           C.Evion 1-0-0
                              breast- 4                                           fibrocystic d/s     for 1 month
                              months                                              left breast         follow up
                              cyclical                                                                after 3 months
                              mastalgia
2     Vasantha kumari   51    Discharge       H/o FNAC      Clear discharge,b/1   Cytology-foamy      USS guided
                              nipple R        6 yrs back-   nipple                macrophages         aspiration and
                              breast-9 yrs.   atypical                            only.               cytology
                              cyclical        ductal                              mammogram-          c,evion,
                              mastalgia       cells                               hypoechoeic         T serronak
                                                                                  areas R breast CT   T Rantac
                                                                                  aspiration-blood
                                                                                  only
3     AnnammaMathew     45    Discharge       Nil           Clear d/d b/I         Cytology-foamy      Follow up
                              nipple b/1                                          macrophages         after 2 months
                                                                                  giant cells         sandocal
                                                                                  mammogram-           1-0-0
                                                                                  NAD
4     Reena George      46    Cyclical        Nil           NAD                   Mammogram-          Evion 1-0-0
                              mastalgia,                                          NAD,tiny cysts L
                              pain breast R                                       breast
                              side
5     Radha             53    Pain L          Nil           Nil                   Mammogram-          nil
                              breast-3                                            NAD,lymph
                              months                                              nodes present
                                                                                  both axilla

         2005-06 BCA Project Report                                                                         36
6    Sulochana          46   Nipple          Nil          Milky d/d,b/I           Cytology-            C Evion 1-0-0
                             discharge-                                           macrophages
                             10yrs                                                only
                                                                                  Mammogram-
                                                                                  NAD
7    Leelamma           54   D/dnipple L     H/o abcess   Yellowish nipple        Cytology-foamy       Follow up
                             side-5yrs       R breast     d/d-L side Firm         macrophages          after 3 months
                                                          lymph nodes L axilla    Mammogram
                                                                                  NAD
8    Sarojam            51     Nipple        Nil          Yellowish nipple        Cytology-            Follow up
                             discharge,b/I                d/d,b/I                 scattered
                                                                                  macrophages
                                                                                  only
                                                                                  mammogram-
                                                                                  NAD
9    Anitha             37   Lump L          Nil          Firm lump,3*2cm,        FNAC-                Excision/LA
                             breast-3                     upper outer quadrant    fibroadenoma         Pathology
                             months                       L breast                mammogram-           report-
                                                                                  Irregularnmass L     fibroadenoma
                                                                                  breast,upper outer
                                                                                  quadrant
10   Leena              39   Lump L          Nil          Firm lump               Mammogram-           Excision/LA
                             breast –1yr                  1*1cm,upper medial      occult lesion seen   Pathology
                                                          quadrant L breast       on USS in 11’o       report-
                                                                                  clock position- L    fibroadenoma
                                                                                  breast USS
                                                                                  guided aspiration-
                                                                                  blood only
11   Girijakumariamma   40   For             Nil          NAD                     Mammogram-           c.evion 1-0-0
                             screening                                            NAD                  follow up
12   Valsalakumari      47   For             Nil          Nad                     Mammogram            Follow up
                             screening                                            Benign cyst-
                                                                                  8mm*6mm R
                                                                                  breast
13   Safiya             35   Lump R          Nil          NAD,axillary pad of     Mammogram            Follow up
                             axilla-1yr.                  fat+                    NAD
14   Prasannakumari     50   Swelling R      Nil          Sebaceous cyst,R        Nil                  Excision/LA
                             breast-5yrs.                 breast
15   Lalitha            42   Pain both       Nil          B/I tender breast b/l   Cytology-foamy       TOflox200mg
                             breasts-4yrs                 milky d/d+              macrophages          1-0-1 for 5
                             b/I nipple                                           only.                days
                             d/d                                                  Mammogram            Evion 400mg
                                                                                  NAD                  1-0-0 for 1
                                                                                                       month



16   Radha              57   Lump R+         Nil          Fat deposition + R      Benign               Follow up
                             axilla-25yrs                 axilla                  calcification in     after 6 months
                             size                                                 the upper outer
                             increasing-                                          and central
                             1yr                                                  quadrant of R
                                                                                  breast




        2005-06 BCA Project Report                                                                          37
17   Nalinakumari           50   Lump L          Nil          Multiple small lumps    Mammogram            Follow up
                                 breast-4yrs                  felt both breasts       multiple small
                                                                                      fibroadenomas
                                                                                      both breast



18   Saleela                49   Lump            Nil          Dense breast             Mammogram-          Biopsy
                                 breast-L side                tissue,irregular mass   fibroadenosis
                                 3 months                     both breasts+           both breasts
                                                                                      Possibility of
                                                                                      lobulated
                                                                                      carcinoma upper
                                                                                      inner quadrant of
                                                                                      L breast. FNAC-
                                                                                      proloferative
                                                                                      lesion breast with
                                                                                      atypia L side
                                                                                      benign
                                                                                      proliferative
                                                                                      lesion R side
19   Prasannakumary         48   Lump and        Nil          Lumpiness+L breast      Cytology-loosely     Follow up
                                 heaviness L                  b/I clear nipple d/d    cohesive sheets      every 3
                                 side,                        bl+tenderness+lower     of ductal            months.
                                 15 yrs                       lateral quadrant L      epithelial cells,    T Emanzen-D
                                                              breast                  multinucleate        1-0-0 for 3
                                                                                      giant cells,         days
                                                                                      &macrophages.
                                                                                      Ductal cells show
                                                                                      mild atypia
                                                                                      Mammogram-
                                                                                      small
                                                                                      fibroadenoma in
                                                                                      either breasts.
20   Sheela little flower   43   For             Nil          Nad                     Mammogram-           Follow up
                                 screening                                            NAD
21   Girijakumary           48   For             Family       Mild watery d/d R
                                 screening       h/oca        breast                  Mammogram
                                                 breast+                              NAD-cytology
                                                                                      not taken
22   Jayakumari             46   For             Family       Milky d/d+R breast      Mammogram-           Follow up
                                 screening       h/o+ of ca                           NAD small
                                                 breast                               fibroadenoma
                                                                                      both breasts
                                                                                      cytology



23   Jasmine                33   Lump L          Nil          Firm irregular lump     FNAC-loose           Follow up
                                 breast-3                     L breast upper outer    clusters of foamy
                                 months                       quadrant                macrophages
                                                                                      only
24   Jayakumary,            46   For             Breast       Milky nipple d/d + R    Cytology- no         Follow up
                                 screening       cancer for   breast                  cells seen           Mammogram
                                                 father’s     Small lymph node +      Mammogram-           after 3 months
                                                 sister       R axilla                Dense mammary
                                                                                      tissue with no
                                                                                      mammographic
                                                                                      evidence of

         2005-06 BCA Project Report                                                                             38
                                                                                malignancy.small
                                                                                fibroadenoma
                                                                                both breasts.
25   Bindhu           34   Lump R          Nil           Firm lump R breast     FNAC-                c.Ampiclox
                           breast-4                      just above nipple,     suggestive of c/c    1-1-1 for 7
                           months                        2*1cm, mobile          granuulomatous       days
                           Increasing                    Clear nipple d/d +     lesion and           T rantac 150
                           size since 2                  Lside.                 suppureation.        mg 1-0-1 for
                           weeks                                                Mammogram-No         7 days
                                                                                abnormal mass,       C becosules
                                                                                lymph nodes +        1-0-0
                                                                                Laxilla              Follow up
                                                                                                     after 10 days
26   Ganakumary       42   Came for        Nil           Irregular mass both    Mammogram-           c. evion 1-0-
                           screening                     breasts                dense breast         0for 1 month
                                                         Firm breast tissue     tissue with no       Regular BSE
                                                                                evidence of
                                                                                malignancy

27   Leela bhai       47   For             H/O Fibro     nil                    Mammogram-           C.Evion
                           screening       adenoma –                            mixed glandular      Follow up
                                           operated in                          and fatty breast
                                           2000                                 tissue. Small
                                                                                cystic lesions and
                                                                                multiple enlarged
                                                                                lymph nodes in
                                                                                both axilla
28   Prasannakumary   54   C/o Lump        Nil           No lump palpable.      Mammogram-           Follow up
                           and                           B/L clear nipple d/d   Small                after 3 months
                           heaviness L                                          Fibroadinoma in      Emanzen –D
                           breast-15 yrs                                        either breast No     1-0-1 for 3
                                                                                evidence of          days
                                                                                malignancy
                                                                                Cytology-Shows
                                                                                loosely cohesive
                                                                                sheets of ductal
                                                                                cells,
                                                                                multinucleate
                                                                                giant cells,
                                                                                macrophages,.
                                                                                Ductal cells show
                                                                                atypia
29   Ramani Devi      46                                                        FNAC-No cells
30   Omana Amma       66                                                        Mammograme-
                                                                                Category-
                                                                                1,BIRADS. Early
                                                                                vascular
                                                                                calcifications
                                                                                noted.LN in both
                                                                                axillae
31   Sarojini         44                                 NAD                    Mammogram-           Follow up
                                                                                axillae appear
                                                                                clear
32   Indira           53   Screening       H/o breast    Dense breast tissue    Mammogram-No         Follow up,
                                           cancer for                           foci of              BSE
                                           sister                               malignancy,
                                                                                opacities
                                                                                suggestive of
                                                                                lymph nodes are

         2005-06 BCA Project Report                                                                       39
                                                                                in both axillae
33   Leela J.K        55   Screening      H/o Cyst      Clear Nipple            Mammogram-          Follow up
                                          aspirated     Discharge R side        NAD, Cytology-
                                          R axilla in                           foamy
                                          2002.                                 macrophages
                                                                                only.
34   Thankamony       55   Screening      1*6 lump      Scar+ R breast          M-Post op           C.Ampiclox -
                           c/o pain R     excision 6    Tendenen + R breast     scarring &          5 days
                           breast on &    years back    Nippled/d L breast      qua……               Follow up
                           off                                                  distortion in
                                                                                upper linier
                                                                                quandrant
                                                                                Cytology- benign
                                                                                ductal cells &
                                                                                macrophages
35   Ammini           54   Screening      H/o           D/d                     M-Benign nodes      Follow up
                                          B.lump –L     R-Brownish              in both axille      C-Evion 400g
                                          side-         L-Serous                Cytology-           1-0-0*2 M
                                          Operated-                             anucleate
                                          8 months                              squames only
                                          back.
36   Sarika           27   C/o swelling   H/o           Lump breast 2*2 cm      FNAC-               Excision,
                           L Breast –8    excision      lower quadrant          Fibroadinoma        Follow up
                           months,        lump 4        freely movable, Firm
                           Increasing     years back
                           size           - L side
37   Lalitha Bhai     57   Screening      Nil           Milky d/d+ both         Cytology-benign     Follow up
                                                        nipple CN+ 1 cm         dctal cells &
                                                        mobile L axills         macropahages
                                                                                B/l M-NAD
38   Manju            37   Screening      Nil           Milky d/d + both        Cytology-Foamy      Follow up
                                                        nipple                  macrophages,
                                                                                inflammatory
                                                                                cells, anucleate
                                                                                squamous cells in
                                                                                a background of
                                                                                amorphous
                                                                                eosinophilic
                                                                                material
39   Sudharma Devi    54   Screening      Nil           Fatty breast tissue     FNAC-few dutal      Follow
                                                                                cells only          up,Regular
                                                                                                    BSE
40   Vimala           51   Screening      Family        NAD                     M-dense breast      Ampiclox1-1-
                                          H/o B.Ca.                             tissue.Lymph        1*7 days
                                                                                nodes in both       Rantac
                                                                                axillas             C.Becosules
                                                                                USS axilla          USS.Axille-
                                                                                No nodes,           after 2 weeks.
                                                                                Axillay A&vain      Follow
                                                                                Nil                 up,Regular
                                                                                                    BSE
41   Deepa Krishnan   40   Screening      H/o B         Firm irregular breast   M-Dense             Follow up
                                          abcen L       tissue L side           mammary tissues
                                          side-                                 with no evidence
                                          Operated,4                            of malignancy.
                                          yrs back                              Two tiny cyst in
                                                                                R Breast



        2005-06 BCA Project Report                                                                       40
42   Anarkali         45   Sreeming,      H/o          Breast-nad,             M-NAD, small          Biopsy
                           b/1 nipple     fibroade     yellowish nipple d/d    fibroadenoma in
                           d/d +, pain    noma                                 the upper outer
                           both breast.   operated                             qua. L breast,
                                          -at 18 yrs                           Cytology-R-
                                                                               eosiniphilic
                                                                               material and
                                                                               scattered
                                                                               macrophages, L
                                                                               no cells seen
43   Rani Joseph      42   Screening                   b/1 nipple d/d, dense   M-nad, fe linear      Oflox-200 mg
                                                       brease                  flame shaped          1-0-0 for 7
                                                       tissue-L                opacities in the      days
                                                                               retroareolar          Emanzen-d 1-
                                                                               region of both        0-1 for 7 days
                                                                               breast-periductal     Becosules 1-
                                                                               mastitis(ductual      0-0 for 10
                                                                               ectasia), birads- 2   days
                                                                               nipple d/d no
                                                                               cells seen
44   Saramma George   43   Screening      Family       Lump 1*1cm L            M-Birads-3            Ciplox 500mg
                                          h/o bc+      breast, upper outer     fibroadenoma          1-0-1 for 5
                                                       quadrant firm mobile    upper outer           days
                                                                               quadrant FNAC-        Emanzen d 1-
                                                                               fibroadenoma          0-1 for 5 days
                                                                                                     Becosules 1-
                                                                                                     0-0 for 10
                                                                                                     days Biopsy


45   Meenakshy        45   C/o milky                   Milky d/d both          Prolactin 37.8        Endocrin-
                           d/d both                    nipple, breast-nad      Ng/ml                 ology
                           nipple                                              Cytology of           consultation
                                                                               nipple d/d –
                                                                               macrophages
                                                                               only




        2005-06 BCA Project Report                                                                        41
APPENDIX-II
METHODS

       Breast cancer awareness analysis is done with the participants attending the
awareness classes conducted at various institutions. The institutions where the
classes are to be conducted is chosen from the Corporation area of Trivandrum. The
institutions include schools and public sector institutions – 13%, state government
institutions 43.4%,   central government Institutions 26% and private sector - 4.3%
Initial proposals are made to conduct awareness classes and camps, and on getting
their notification, classes are organized. Prior to attend the class, the participants
complete a detailed questionnaire on their background information, family history
and their current awareness regarding breast cancer. Statistical analysis is made and
awareness measured in terms of nature of work, educational qualification, income,
religion and region of residence.

       Breast cancer screening analysis is done with patients attending the Breast
Clinic. The relevant investigations are done and patients who need additional
services are referred and are followed up. The investigations done, the findings on
mammogram and the mammogram Vs BIRADS category are measured.




2005-06 BCA Project Report                                                         42
APPENDIX-III
IEC METERIALS

1. Brochure




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2. Questionnaire




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APPENDIX-IV

PROGRAMME NOTIFICATIONS

1.




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2.




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3.




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4.




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5.




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6.




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7.




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APPENDIX –V
PHOTOGRAPHS

1.    Mr. K.K.Ramachandran Master Hon. Minister for Health and Family
Welfare Kerala, inaugurating the project.               Dr.A.V.Ramadevi,
Dr.P.R.Sasindran and Dr. Cherian Varghese standing near by.




     2. The project team – Dr.Sindhuja.N.S, Anju Thomas, and Leena.R with
        compliments received from C-DAC.




2005-06 BCA Project Report                                             56
3.    Awareness class conducted at Police Head Quarters, Trivandrum.




4.    Awareness class conducted at Keltron, Trivandrum.




2005-06 BCA Project Report                                             57
  5.     Awareness class conducted at Jilla Panchayat Office, Trivandrum.
         Hon. Health standing Committee Chairman inaugurating the class.




  6.     The Class conducted at Hindustan Latex Ltd. Trivandrum




2005-06 BCA Project Report                                             58
7.    Awareness class conducted at St.Mary’s School, Pattom, Trivandrum.




8. Dr.P.R.Sasindran giving the Presidential address at the awareness class
conducted at Secretariat, Trivandrum.




2005-06 BCA Project Report                                                 59
9.      Awareness class conducted at Public Office, Trivandrum




     10. Detection Camp conducted at College of Agriculture, Vellayani




2005-06 BCA Project Report                                               60
APPENDIX- VI

NEWS PAPER REPORTS

1. ‘ THE HINDU ’ Dce. 29, 2005




2.                                 3.




‘Malayala Manorama’ July 10 2006        ‘Deepika’ July 31 2006

2005-06 BCA Project Report                                       61
 4.




‘Deepika’ August 23 ,2006




2005-06 BCA Project Report   62

								
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