A cross-sectional study was conducted to examine the knowledge of breast cancer, attitudes toward breast self-examination (BSE), and practice of BSE among a sample of female health care workers in Tehran, Iran. Using a purposed questionnaire, a total of 410 women from seven health centers completed the questionnaire. The mean age of the respondents was 32.9 years (SD = 9.5), most (58%) were married, and family history of breast cancer was reported by 11%. Seventy-five percent of the women knew about breast cancer prevalence, but only 27% knew that breast pain is not a symptom of breast cancer. Although 73% of women did know that contact with a relative with breast cancer could not lead to development of breast cancer, the respondents' knowledge of risk factors of breast cancer was not satisfactory. With regard to women's attitudes toward BSE, the majority believed that it is not difficult and time consuming or troublesome (63% and 72%, respectively). Sixty-three percent of the respondents claimed that they know how to examine their breasts, but only 6% performed BSE monthly. The practice of BSE was significantly associated with age (p = 0.01), the level of education (p < 0.0001), personal history of breast problems (p < 0.0001), and knowledge of how to examine the breasts (p < 0.0001). The study findings suggest that the knowledge and behaviors of female health care workers concerning breast cancer is relatively poor and it needs to be improved. Considering the role that health care workers may play in communicating health behaviors to the general public, planning health education interventions for this group of females is essential.

This study was carried out to examine the factors that predicting the use of complementary and alternative medicine (CAM) among cancer patients in Tehran, Iran. Predicting factors included were patients' demographic characteristics, type of cancer, the knowledge of diagnosis, time since diagnosis, satisfaction with their care physician, fear of recurrence and measures of anxiety, depression and global quality of life. In total, 625 cancer patients were studied, and 35% (n=219) reported that they used or were using CAM. The most commonly used CAM was prayer and spiritual healing (n=178, 75.7% of responses). The results of logistic regression analysis indicated that the use of CAM among cancer patients was associated with the fear of cancer recurrence (OR=2.03, 95% CI=1.45-2.85, P<0.0001) and dissatisfaction with their care physician (OR=1.98, 95% CI=1.36-2.89, P<0.0001). The results indicate that apart from the prayer and spiritual healing, the use of the other common methods of CAM among Iranian cancer patients is unpopular. However, the findings suggest that the use of CAM is more common among cancer patients who suffer from fears, uncertainties and dissatisfaction, and these might be a marker of greater psychological distress in users as compared with non-users.

Background Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. Methods This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis. Results There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively. Conclusion Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies. Trial registration This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1). KeywordsSelf-management · Lymphedema · Quality of life · Fear of cancer recurrence · Breast cancer Abbreviations BCRL Breast cancer-related lymphedema QoL Quality of life FCR Fear of cancer recurrence GE Group-based education SNE Social network-based education CO Control group CDT

Background: Many women in Iran have a relatively high body mass index. To investigate whether the condition contributes to excess breast cancer cases, a case-control study was conducted to assess the relationships between anthropometric variables and breast cancer risk in Tehran, Iran.