Background and Context: Based on findings from a resource-stratification 1 of breast cancer care in Dominica 2, a 4 - year clinical research project on breast cancer detection and diagnosis was undertaken having identified late diagnosis as the main cause of the high breast cancer mortality-to-incidence ratio in Dominica 3 .
Aim:To assess the knowledge, attitudes, practice and behaviour (KAPB) of Government of Dominica Ministry of Health (MOH) primary care workers (HCW) and general practitioners (GPs) in order to improve early detection and diagnosis of breast cancer.
Strategy/Tactics:Programme/Policy Process:A 38-point questionnaire was administered by trained interviewers to identify the KAPB of Dominican MOH HCWs and GPs directly involved in breast care. Of 155 potential interviewees 98 responded. Data were analysed using Epi Info™ software. A workshop was conducted to reduce knowledge deficits about the early detection and diagnosis of breast cancer.
Outcomes/What was learned:The response rate was 63%. 86% of respondents were HCWs and 14% were GPs. 85 % knew the clinical features of breast cancer and 97% knew when to refer patients for further evaluation. Only 77 % felt that regular breast exams helped detect cancer earlier, and 57 % of respondents knew when to start screening asymptomatic low risk women with mammograms. 74 % felt that there were MOH guidelines for clinical breast exams CBEs). 91 % knew that breast self exams should be done monthly in post menopausal women, but only 39% performed routine CBEs annually on women over 40. Most primary health care workers in the public and private sectors in Dominica. , know the signs of breast cancer and when to refer patients. However CBEs were not performed routinely on women over 40.This is a good foundation on which to develop and implement guidelines for early detection and referral of potential breast cancer patients.