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Breast Health CD, Web Site Attack Fear, Ignorance

By Douglas J. Gillert
American Forces Press Service

SAN ANTONIO, Texas, Dec. 7, 1998 – Susan Ford-Boles, national spokesperson for Breast Cancer Awareness Month, narrates an 11-minute video introduction. A glossary guides you through a 250-page text. A "decision tree" helps women assess their own cancer risks. "Do you want to know more?" is the most frequently asked question.

All these and everything else you probably ever wanted to know about breast cancer, but were afraid to ask, is on "Breast Health -- Your Decision," a new DoD-funded CD-ROM. The program is also available on the Internet by visiting http://www.tricaresw.af.mil/ and clicking on the "Breast Cancer Awareness" graphic.

Dr. Michael Freckleton, an Air Force Reserve major assigned to Wilford Hall Medical Center here, conceived and designed the multimedia package. His goal was to provide women, their family members and physicians a single, comprehensive package of information that would ease anxieties and promote early detection and treatment of breast cancer.

"Ignorance is the worst factor in breast cancer," Freckleton said. "If we educate people about breast cancer, they're going to be less fearful of it and may find it earlier. If we find the cancer early, we can better treat it."

The program uses a Victorian town theme with eight buildings, each containing information related to its name. For example, the visitor's center has information on the rest of the "town," and on each of the program's functions.

The medical text, written in both lay and medical terms, is the backbone of both the CD-ROM and Web site. You can follow the menu of topics or consult the glossary of terms. Each topic is layered, moving from basic information to as much detail as you want, Freckleton said.

At the town's gazebo, women relate their personal stories. You can listen to them discuss their experiences collectively, or click on any of them individually for more details. Many of the answers to your questions will lead again and again to the movie theater.

Three videos cover what Freckleton calls "the pillars of breast health care": personal examination, clinical examination and mammography. Videos combined with text, graphics and photographs cover radiation therapy, surgical procedures and reconstruction.

"You can choose how much information you want to know," said project coordinator LouAnn Caywood. "You may not be ready, for example, to watch a video on breast reconstruction if you've just learned you have breast cancer." That level of detail is there, however, as is information about various treatment regimens.

A last stop "in town" should be the general store, which contains information about resources, support groups, breast forms and clothing.

The DoD Breast Cancer Initiative funded development and distribution of the breast care CD, Freckleton said. The initiative is designed to heighten awareness of breast care among beneficiaries of the defense health plan; increase research into detection, treatment and prevention of breast cancer; and make mammograms and other breast health programs more accessible.

He said it took two years, more than 15 physicians and 75 people in all to produce the CD-ROM and Web site. Both products will be updated concurrently, with the first update due in December.

The first 2,000 disks TRICARE Southwest distributed in 1998 were an instant hit, Caywood said. "We showed it at a San Antonio health fair in May, and women who had been diagnosed with breast cancer were elated," she said. "One told me, 'I'm going to share this with my daughter.'"

Caywood said she wishes she'd had the CD-ROM 10 years ago, when her mother was diagnosed with breast cancer. "It would have greatly reduced my anxiety," she said.

"Anxiety creates an unnatural response, such as denial," Freckleton said. "If we alleviate fear, we're more likely to get a natural response, which is to go get help."

Although you can't get individual personal copies of the CD-ROM, Freckleton said, every military hospital and clinic received copies and will receive all future updates. The Contact your base hospital or clinic health benefits adviser or TRICARE service center for assistance. The Web site is open to the public.

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Click photo for screen-resolution imageThe above chart depicts the incidence rates of different cancers per 100,000 women, compiled by the American Cancer Society. As the chart reflects, breast cancer is the No. 2 cause of cancerous deaths in women, behind lung cancer. The cancer society estimates that one in every eight American women will develop breast cancer at some time during her life. Early detection is one of the keys to successful treatment and a major premise of "Breast Health -- Your Decision," a CD-ROM and Internet Web site created at Wilford Hall Medical Center, Texas, for distribution throughout DoD.  
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Click photo for screen-resolution imageThis diagram, taken from "Breast Health -- Your Decision," shows how to use your palm and fingers during a self-examination of your breasts. A new DoD-funded CD-ROM and Internet site offer hundreds of pages of text, graphics and photographs, and numerous videos depicting examinations and personal testimonies from breast cancer survivors. The CD-ROM was distributed to military hospitals and clinics last summer, and a revised version is scheduled to arrive by the end of 1998. Access the Web site at http://www.tricaresw.af.mil/.  
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