Leverage of an Existing Cervical Cancer Prevention Service Platform to Initiate Breast Cancer Control Services in Zambia: Experiences and Early Outcomes.
Leverage of an Existing Cervical Cancer Prevention Service Platform to Initiate Breast Cancer Control Services in Zambia: Experiences and Early Outcomes.
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DOI：
10.1200/jgo.17.00026
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发表时间：
2018-09
影响因子：
--
通讯作者：
Parham GP
中科院分区：
文献类型：
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作者：
Pinder LF;Henry-Tillman R;Linyama D;Kusweje V;Nzayisenga JB;Shibemba A;Sahasrabuddhe V;Lishimpi K;Mwanahamuntu M;Hicks M;Parham GP
2005年，赞比亚实施了宫颈癌预防计划（CCPPZ），至今已为超过50万妇女提供了宫颈癌筛查和治疗服务。通过利用 CCPPZ 的成功和经验，我们打算建设乳腺癌早期检测和手术治疗的能力。我们的倡议旨在通过以下方式建设乳腺癌护理能力：(1) 组建乳腺癌宣传联盟以提高认识，(2) 为中高级医疗服务提供者制定资源适当的乳腺癌护理培训课程，以及 (3) 在两个主要医疗机构内实施早期检测和治疗能力。该计划完成六个月后，取得了以下成果： 乳腺健康教育和临床乳腺检查 (CBE) 服务成功纳入 CCPPZ 四个诊所的服务平台。开设了两个新的乳腺诊断中心，提供乳腺超声检查、超声引导的空心针活检和针吸活检。为 1,955 名客户提供了乳房健康教育和 CBE，其中 167 名客户在两个诊断中心接受了评估；其中 55 人接受了空心针活检，其中 17 人被诊断患有浸润性癌症。新培训的外科医生进行了 6 例前哨淋巴结标测、8 例前哨淋巴结清扫术和 10 例乳房保留手术（肿块切除术）。该举措在赞比亚成功建立了临床服务，这对于乳腺癌的早期发现和手术治疗至关重要。
In 2005, the Cervical Cancer Prevention Program in Zambia (CCPPZ) was implemented and has since provided cervical cancer screen-and-treat services to more than 500,000 women. By leveraging the successes and experiences of the CCPPZ, we intended to build capacity for the early detection and surgical treatment of breast cancer. Our initiative sought to build capacity for breast cancer care through the (1) formation of a breast cancer advocacy alliance to raise awareness, (2) creation of resource-appropriate breast cancer care training curricula for mid- and high-level providers, and (3) implementation of early detection and treatment capacity within two major health care facilities. Six months after the completion of the initiative, the following outcomes were documented: Breast health education and clinical breast examination (CBE) services were successfully integrated into the service platforms of four CCPPZ clinics. Two new breast diagnostic centers were opened, which provided access to breast ultrasound, ultrasound-guided core needle biopsy, and needle aspiration. Breast health education and CBE were provided to 1,955 clients, 167 of whom were evaluated at the two diagnostic centers; 55 of those evaluated underwent core-needle biopsy, of which 17 were diagnosed with invasive cancer. Newly trained surgeons performed six sentinel lymph node mappings, eight sentinel lymph node dissections, and 10 breast conservation surgeries (lumpectomies). This initiative successfully established clinical services in Zambia that are critical for the early detection and surgical management of breast cancer.