Journal List > Korean J Women Health Nurs > v.15(1) > 1037217

Korean J Women Health Nurs. 2009 Mar;15(1):54-63. Korean.
Published online March 31, 2009.
Copyright © 2009 Korean Academy of Women's Health Nursing
Development of an Integrated Breast Health Program for Prevention of Breast Cancer among Middle-aged Women
Hea Kung Hur,1 So Mi Park,2 Chang Hee Kim,3 Jong-Ku Park,4 Sang Baek Koh,5 and Gi Yon Kim2
1Professor, Department of Nursing, Yonsei University Wonju College of Medicine, Korea.
2Associate professor, Department of Nursing, Yonsei University Wonju College of Medicine, Korea.
3Full-time Instructor, Department of Nursing, Hyejeon College, Korea.
4Professor, Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Korea.
5Associate professor, Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Korea.

Address reprint requests to: Kim, GiYon (Corresponding Author). Department of Nursing, Yonsei University Wonju College of Medicine 162 Il San Dong, Wonju, Gang Won Do 220-701, Korea. Tel: 82-33-741-0390, Fax: 82-33-743-9490, Email:
Received December 15, 2008; Accepted February 28, 2009.



This study was done to develop an integrated breast health program for prevention and early detection of breast cancer, integrating primary and secondary prevention factors using cognitive-behavioral strategies.


This methodological study conducted as follows; Selection of components for the program through a literature review, survey to identify women's knowledge and risk perception of breast cancer and diet, and building prototype for the program using discussion based on findings. Using structured questionnaires, interviews were done with 130 women aged 40-59 who lived in a rural area.


Primary prevention (diet pattern, knowledge about breast cancer, and risk perception) and secondary prevention (early detection behaviors) factors were identified through the literature review. The survey showed that women lack knowledge and awareness about the risks of breast cancer, and have a low compliance rate for early detection behavior. Based on these results, a program was developed utilizing counseling and models to provide education and practice related to diet, breast cancer, and early detection behaviors.


Use of this integrated and tailored breast health program with women at risk will contribute to better breast health, but further study is needed to verify the effects.

Keywords: Breast neoplasm; Prevention; Program development


Figure 1
Framework of an integrated breast health program
Click for larger image


Table 1
Characteristics related to breast cancer (N=130)
Click for larger image

Table 2
Knowledge on breast cancer
Click for larger image

Table 3
Draft of an integrated breast health program
Click for larger image

1. Ahn S.H., Yoo K.Y. Chronological changes of clinical characteristics in 31,115 new breast cancer patients among Koreans during 1996-2004. Breast Cancer Res Treat 2006;99(2):209–214.
2. Andreeva V.A., Unger J.B., Pentz M.A.. Breast cancer among immigrants: A systematic review and new research directions. J Immigr Minor Health 2007;9(4):307–322.
3. Bergfeldt K., Nilsson B., Einhorn S., Hall P. Breast cancer risk in women with a primary ovarian cancer - A case-control study. Eur J Cancer 2001;37:2229–2234.
4. Choi K.O.. In: Effectiveness of teaching in accordance with the teaching program types for the breast self examination. Seoul: Kyung Hee University; 1996.
Unpublished Doctoral Dissertation.
5. Choi K.O., Suh Y.O. The effects of education on breast self-examination practices. J Korean Acad Nurs 1998;28(3):718–728.
6. Do M.H., Lee S.S., Chung P.J., Lee M.H. Relation of breast cancer risk with alcohol consumption and physical activity: A case-control study. J Korean Nutr Soc 2003;36(1):40–48.
7. Do M.H., Kim H.J., Lee S.S., Jung P.J., Lee M.H. Breast cancer risk and dietary factor: A casecontrol study. J Korean Surg Soc 2000;59(2):163–174.
8. Given C.W., Given B., Champion V.L., Kozachik S., DeVoss D.N. In: Evidence-based cancer care and prevention behavioral interventions. New York: Springer Publishing Com; 2003.
9. Katapodi M.C., Lee K.A., Facione N.C., Dodd M.J. Predictors of perceived breast cancer risk and the relation between perceived risk and breast cancer screening: A meta-analytic review. Prev Med 2004;38:388–402.
10. Kim C.I., Lee H.S., Chang Y.A., Lee Y.N., Lee H.J. The third Korea national health and nutrition examination survey (KNHANES III, 2005). [Retrieved January 15, 2007].
11. Kim Y.B. Analysis on cognitive and behavioral of factors associated with the stage of change on breast cancer screening behavior among women in a community. J Korean Soc Health Educ Prom 2006;23(2):77–89.
12. Kim S.H., Chae Y.S., Son W.J., Shin D.J., Kim Y.M., Chang M.C. Estimate of individualized probabilities of developing breast cancer for korean women. J Korean Surg Soc 2008;74(6):405–411.
13. Lostao L., Joiner T.E., Pettit J.W., Chorot P., Sandin B. Health beliefs and illness attitudes as predictors of breast cancer screening attendance. European J Public Health 2001;11(3):274–279.
14. Lee C.Y., Kim H.S., Ko I.S., Ham O.K. Evaluation of a community-based program for breast self-examination offered by the community health nurse practitioners in Korea. J Korean Acad Nurs 2003;33(8):1119–1126.
15. Lee S.D., Kim J.H., Song J.Y., Nam S.J., Yang J.H., Ko Y.H. A breast cancer in premenopausal women -pathologic findings and an analysis of prognostic factor-. J Korean Surg Soc 2001;61(6):567–571.
16. Lee S.R. A case-control study on related factors of breast cancer in Korean women. Health Sociol 2001;10:97–115.
17. Lee Y.H. A study for the health education of breast self-examination. J Korean Acad Adult 2000;12(4):717–726.
18. Luszczynska A., Schwarzer R. Planning and self-efficacy in the adoption and maintenance of breast self-examination: A longitudinal study on self-regulatory cognitions. Psychology and Health 2003;18(1):99–108.
19. National Cancer CenterNational cancer control program. 2006 [Retrieved April 1, 2006].
20. Park S.M., Hur H.K., Kim G.Y., Song H.Y. A descriptive study for developing a program to promote compliance with regular breast self-examination(BSE). Korean J Women Health Nurs 2007;13(2):88–97.
21. Park S.M. In: Factors related to continuous participation in the Pap smear screening among Korean women: using a structural model. Seoul: Yonsei University; 1999.
Unpublished doctoral dissertation.
22. Park NJ, Kang DH. Beast cancer risk and immune responses in healthy women. Oncol Nurs Forum 2006;33(6):1151–1159.
23. Prochaska J.O., DiClemente C.C. Stage and processes of self-change of smoking: Toward an integrative model. J Consult Clin Psychol 1983;51:390–395.
24. Quillin J.M., Fries E., McClish D., deParedes E.S., Bodurtha J. Gail model risk assessment and risk perceptions. J Behav Med 2004;27(2):205–214.
25. Richard K.C., Enderlin C.A., Beck C., McSweeney J.C., Jones T.C., Paular K.R., Roberson P.K. Tailored biobehavioral intervention: a literature review and synthesis. Res Theory Nurs Prac 2007;21(4):271–285.
26. Rothstein W.G. Dietary fat, coronary heart disease, and cancer: A historical review. Prev Med 2006;43:356–360.
27. Skinner C.S., Arfken C.L., Sykes R.K. Knowledge, perceptions, and mammography stage of adoption among older urban women. Am J Prev Med 1998;14(1):54–63.
28. Sung M.H. A study on knowledge and attitude about breast self examination and ability and practice among adult women. J Korean Soc Health Educ Prom 2004;21(2):187–198.
29. Thomas B., Stamler L., Lafreniere K.D., Delahunt T.D. Breast health educational intervention. AAOHN J 2002;50(10):460–467.
30. Tavani A., Giordano L., Gallus S., Talamini R., Franceschi S., Giacosa A., Montella M., La Vecchia C. Consumption of sweet foods and breast cancer risk in Italy. Ann Oncol 2006;17(2):341–345.