MammaCare's Mission

MammaCare began as a scientific mission to find the most effective procedure for manual detection of small breast lesions.

In 1974, a research team at the University of Florida (UF), launched the first major breast examination project in the nation. The project was initiated and supported by the National Cancer Institute (NCI). It was known that women often detect their own breast cancer, frequently by accident. The result too often was large, advanced cancers averaging >3.5cm (about the size of a golf ball). NCI and the UF medical research team wanted to determine if there was a palpation procedure that could reliably detect small breast lesions and help to alleviate the sense of inadequacy that accompanies usual breast examinations. Fingers can read tiny Braille dots they reasoned, so detecting small palpable changes in breast tissue seemed possible. 

The research identified and validated a series of experimental procedures for detection of small breast lesions. The resulting evidence and practices, known as MammaCare, are now the medical quality standard for performance of manual examination. Clinical studies and reports continue to contribute to the robust body of evidence, effectively advancing the mission.  MammaCare Research Bibliography

The size of a breast cancer is one of the key factors associated with survival. Cancers found to be <2cm are associated with longer survival and are usually more treatable.

Breast cancers grow at different rates. The average time to double in size is 1.7 years. A small proportion (5%) of breast cancers can double in size within a month. According to a new study, breast cancers in younger women are more aggressive and grow faster. Breast cancer tumor growth estimated through mammography screening data

 Mission progress - 25 years of research        
 
The first scientific quest was to determine the smallest breast lesion that could be detected by human palpation. The research scientists worked with a laboratory team of material science polymer engineers to create a tactually accurate breast model with internal structures and textures closely approximating the feeling of the nodularity found in a woman's breasts. Within this model they placed a series of small simulated polymeric “lesions” that were formulated to tactually mimic the common solid lumps that surgeons report as “suspicious.”
 
They found that after skill training with the breast models, women, nurses and physicians could reliably detect 3mm simulated lesions (ten times smaller than the average lesion found by accident). This exciting result confirmed the sensitive detection threshold of human touch receptors suggesting ideal sensitivity properties for breast tissue examination. More research was necessary to learn how to minimize false positive detections through tactile discrimination training experiments and to determine the optimal search strategy, the procedure that produced thorough breast examination coverage.  
 
Another critical step in the extensive research protocol required investigating whether the skill acquired from practice on the breast models transferred to detection of lesions in women's breasts. Further studies confirmed the transfer of skill to actual breast lesions. Corollary studies provided valuable knowledge about  the differential (comparative) effects of various search patterns on detection of the smallest breast lesions (concentric circles vs. radial spoke vs. vertical strip). 

MammaCare is the result of all the cumulative knowledge gained from systematic investigations and the research mission continues. MammaCare scientists, in cooperation with colleagues at US and European teaching institutions, are currently conducting studies with medical and nursing students to provide the elements of MammaCare's clinical training protocols in didactic settings. Palpation skill training is self-paced in a university simulation center using MammaCare breast models specially adapted for interactive simulation technology. Grants and collaborations continue to be necessary  to conduct and participate in major research projects such as those described above so that knowledge may continue to advance.