Critique of Parvani's systematic review of breast self-examination

Systematic Research Review

Critique of Systemic Research (SRR) RELATED TO NURSING

Critique of a Systematic Research Review (SRR):

Breast self-examination, breast awareness, and practices of systemic review

Breast cancer is one of the most deadly and fastest-spreading cancers in the world today. To mitigate the tide of this epidemic should ideally include preventative measures as well as proactive treatments. The purpose of the literature review "Breast self-examination, breast awareness, and practices of systemic review" by Parvani (2011) was to assess the current research findings on the degree to which breast self-examination and more general breast self-awareness campaigns were useful in increasing the rates of early detection of breast cancer.

Research rigor of selected studies

Studies were not screened for specific levels of research rigor. General medical databases were searched for relevant studies using Medline, CINAHL, PubMed, Science Direct, and Cochrane using words such as "breast awareness," difference," "breast self-examination," breast cancer screening" and "breast screening" (Parvani 2011: 336). Only articles from the past five years of the authorship of the article (2005-2010) were selected. Date of publication vs. standards of rigor were the determining factors.

Clarity of study presentation and critique

One drawback of this research review is that the studies are not broken down and presented in a clear, segmented format. There is no table outlining the differences between the studies. The emphasis on study selection was clearly more upon quantity rather than individualistic research analysis. The results of the studies are presented in a more general format in terms of their results without extensive pagination being devoted to breaking down their methodology. The upside to this, however, is that the results of all the studies are presented fairly clearly, along with their implications for practice.

Overall finding of the selected studies

The overall finding of the selected studies stressed the relative inadequacy of current screening methods, including mammography and breast self-examination. Of a particular feature of interest was the overall lack of efficacy of breast cancer self-screening. Randomized control trials (RCTs are considered the 'gold standard' of rigor in terms of research analysis) in Russia and Shanghai yielded no apparent medical benefit to breast cancer self-examination. Research indicates that breast self-examination could only detect about 60% of breast cancers detected by mammography as well as some breast cancers not detected by mammography but there is no clinical significance in the size of the tumor and lymph nodes between those who engage in self-examination and those who do not (Parvani 2011: 336-337).

Review conclusions

Unfortunately, in the developing world, breast self-screening is the preferred method of breast cancer screening, due to limited healthcare resources in these nations. This review casts serious doubt both upon the positive 'spin' on self-examination in the developed world has been given as well as the lack of more formal detection procedures in the developing world.

Implications for future research

It is unclear, given the very wide range of studies, if the lack of a benefit from self-examination was due to the fact that women who exclusively relied upon self-examinations were from developing world countries with other affecting health issues. Future research is needed with more controlled variables.

Special areas of concern

Self-examination has been a critical component of breast cancer awareness campaigns amongst the public. Their ineffectuality raises serious concerns as to whether public funds are being well-spent and/or are encouraging too many biopsies being performed and resulting in greater psychological stress to women.

Reference

Parvani, Z. (2011). Breast self-examination, breast awareness, and practices of systemic review.

Professional Medical Journal, 18(2), 336-339.