Breast Cancer Awareness and Detection of Asymptomatic Cases Using Breast Palpation and Fine-needle Aspiration in Bafoussam, Cameroon

Background: Breast cancer, the deadliest cancer in women worldwide, is often diagnosed at late stage in Cameroon, with high mortality and dire socioeconomic consequences. We investigated the reasons for breast cancer late diagnosis in Cameroon. Methods: Women (412) were randomly recruited in various locations in the city of Bafoussam, West Region, Cameroon. They self-administered a questionnaire assessing breast cancer awareness. Then, they underwent breast palpation, followed by fine needle aspiration (FNA) when a nodule was found. Results: 65% of the study participants were above 30 years; 80.9% had at least a secondary education; 94.4% had heard about breast cancer and the main source of information was the media (57.3%). Most participants were either uninformed or ill-informed (up to 72%) about breast cancer risk factors, signs, and screening methods, in particular breast self-examination (BSE). Of the 17 women with nodules and other suspect signs, only 6 accepted fine needle aspiration (FNA). Three of the 6 had malignant nodules indicative of Invasive ductal carcinoma low grade (one case) and high grade (2 cases).Conclusions: Women living in Bafoussam are poorly aware of breast cancer screening methods, in particular BSE, and of the importance of early detection. BSE followed by FNA in women with nodules is a simple, yet good screening method to improve early detection and reduce the burden of breast cancer.

Development of a Program to Educate Physician Assistant Students on Performance of a Comprehensive Breast Exam

Purpose: The purpose of this study was to develop a new program to educate physician assistant (PA) students on the performance of a comprehensive breast exam and to test its effectiveness as compared to the previous program. Methods: The preexisting educational program for the performance of a clinical breast exam was evaluated during the term prior to the start of clinical rotations for the class of 2015. Baseline data were obtained from this control group by evaluation of student competency using a skills examination, utilizing a Nasco Advanced Breast Exam Simulator, and using a female standardized patient. An innovative program educating the PA class of 2016 on the performance and interpretation of a comprehensive breast exam was instituted, incorporating a new palpation technique, new models, and simulated patients. Both classes were directly compared in terms of their breast examination skills at 5 months post-training by administering the same skills examination. Nested, mixed, generalized, and linear models were created to look for differences between the two classes. Each model was adjusted by covariates to account for variation in student ability. Results: The PA class of 2016 showed statistically better performance in breast inspection, lymph node palpation, breast palpation, breast mass detection, and documentation of findings compared to the PA class of 2015. Conclusion: The new educational program on the clinical breast exam using a well-organized laboratory session with subsequent skills testing was found to be very efficacious.

Multi-Fingered Haptic Interface Robot and its Application Systems

Haptic interfaces that represent force and tactile feeling have been utilized in the areas of telemanipulation, interaction with microscale and nanoscale phenomena, and medical training and evaluation, to mention only some applications. A multi-fingered haptic interface has greater potential for these kinds of applications than does a singlepoint haptic interface. We developed a five-fingered haptic interface robot named HIRO II, which consists of a hand with 15 dof and an arm with 6 dof. The following research issues are presented: the design method of mechanism, an interface control that takes the redundancy of the mechanism into consideration, physical simulation including frictional force and moment, a haptic rendering with a deformable object, the system architecture and two application systems--a future science encyclopedia and a VR breast palpation system.