No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Knowledge and Practice of Breast Self-Examination Among Women of Reproductive Age Attending Meru Teaching and Referral Hospital, Kenya
Abstract
Globally, more than 2.3 million women of reproductive age were diagnosed with breast cancer in 2020 alone. Breast cancer can be detected early through breast self-examination (BSE) practice. The World Health Organization (WHO) recommends that women should start Breast Self-Examination (BSE) from the age of 20 years to detect breast cancer early. Early detection of the disease in the preclinical stage when the disease is localized and asymptomatic has greater chances of cure and survival. The objective of this study was to determine level of knowledge on breast self-examination among women aged above 20 years attending the Meru Teaching and Referral Hospital (MeTRH). Meru County has recorded an upsurge of breast cancer in the last five years. Methods: The study adopted descriptive cross-sectional study design. A sample of 423 respondents selected by systematic random sampling was interviewed using a researcher administered questionnaire, and an observation checklist. Data collection tools were pretested and validated at Githongo Sub-County hospital. Descriptive and inferential statistics were used for data analysis, using the Statistical package for Social Sciences (SPSS) Software Version 26. Results: The results showed that majority (57%) of the respondents had poor BSE knowledge (mean score 46.14±9.7SD). The majority (70%) had poor BSE practice with a mean score breast self-examination practice at 44.4±30SD. Conclusions: The study concluded that both the level of knowledge and practice of breast self-examination were poor. Recommendations: The study recommends that health care providers offer regular health education, and demonstrations on BSE procedure, using appropriate teaching aids. Key words: Cancer, Knowledge, Breast Self-Examination
ResearchGate has not been able to resolve any citations for this publication.
Regular breast self-examination is the most cost-effective method for early detection of breast cancer, especially in resource-limited countries. However, breast self-examination practice was low among reproductive-age women.
Objective
This study aims to evaluate breast self-examination practice and associated factors among women of reproductive age in southeast Ethiopia.
Methods
A convergent parallel mixed-methods study design was conducted on 836 women of reproductive age. An interviewer-administered questionnaire was used for the quantitative part of the study and supplemented by focus group discussions. A database was created using Epi-info version 3.5.3, and analyzed using SPSS version 20. Bivariate and multivariable logistic regressions were done to examine the effect of explanatory variables. Variables with p -value <0.05 during multivariable logistic regressions were considered as significantly associated with the dependent variable. Thematic data analysis was carried out for the qualitative study.
Result
Out of 836 total participants, only 20.7% had ever heard about breast self-examination practice. Also, only 13.2% of the mothers had practiced breast self-examinations. Even though the majority of the participants during focused group discussions had knowledge about breast cancer screening, most of them stated that breast self-examination was not practiced among them. Maternal age, mother’s level of education, and previous history of breast examination by health professionals were significant predictors of breast self-examination practices.
Conclusion
This study reported a low prevalence of breast self-examination practice. Therefore, enhancing women’s education and encouraging breast examination by health professionals are essential to increase the proportion of women performing breast self-examination.
Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at . 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer (). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.
1. Introduction
Breast-related diseases have become a topic of focus these days; one of such diseases is breast cancer. According to the World Health Organization (WHO), breast cancer is a leading cancer among women affecting about 2.1 million each year, causing the greatest number of cancer-related mortalities among women [1]. Breast hypertrophy, radial scars, breast cysts, fibroadenomas, intraductal papillomas, sclerosing adenosis, Phyllodes tumors and many more, are other breast-related diseases [2]. The early stages of some of these breast conditions cause some pains whilst others do not. There is therefore the need for a frequent breast examination so as to aid early detection of such conditions, especially the ones that are not painful at the early stages [3].
There are forms of breast examinations; the popular one is the breast self-examination (BSE). The BSE is a known technique that an individual uses to examine his/her breast tissues for any change whether palpable or visual. It is often used as an early detection method for breast cancers/tumors [4]. The BSE technique was developed over 67 years ago from an idea proposed by a chapter of the American Cancer Society to a standard of recommendation of many health care professionals [5]. For economic and other reasons, BSE has been very important and easily accessible technique for people who could not access the clinical breast examination (CBE) which is usually done by the clinicians [6, 7].
Breast imaging is a subspecialty of diagnostic radiology. It generally refers to ultrasonography, mammography, and magnetic resonance imaging (MRI) of the breast. [8, 9]. Other modalities that may be used include positron emission tomography (PET), scintimammography, electrical impedance-based imaging, thermography, optical imaging, and computed tomography (CT) [10]. Breast imaging has so much importance; it mainly helps to define an injury to living tissue and to screen the remainder of the breast for secondary lesions. In general, breast imaging is done before a biopsy because the artifact from the biopsy can interfere with the interpretation of the study [11]. It also helps to identify and characterize breast masses and calcifications. Differentiation of cystic masses from solid masses are done through ultrasonography which is the most available imaging modality in Ghana [12, 13].
The American College of Radiology has advanced a system named BI-RADS which stands for Breast Imaging Reporting and Data System. The BI-RADS was developed for reporting mammogram results using a common language, for standardization and for patients’ follow-ups. The radiologist assigns a single-digit BI-RADS score (ranging from 0 to 5) when the report of a person’s mammogram is created [13]. The details of the BI-RADS scores are shown in (Table 1).
BI-RADS score
Category
Detail
BI-RADS 0
Incomplete
Mammogram study is not yet complete.
BI-RADS 1
Negative
Mammogram was negative (no cancer).
BI-RADS 2
Benign
Mammogram was normal (no cancer) but other findings (such as cysts) are described in the report.
BI-RADS 3
Probably benign
Mammogram is probably normal/benign. Chances of breast cancer approximately 2%.
BI-RADS 4
Suspicious
Mammogram is probably malignant. Chances of breast cancer approximately 23%-34%.
BI-RADS 5
High malignancy
Highly suspicious for malignancy with 95% chance of breast cancer.
Footnote: American College of Radiology. Breast Imaging Reporting and Data System (BIRADS) [14].
Background:
Breast cancer accounts for 23% of all cancer cases among women in Kenya. Although breast cancer screening is important, we know little about the factors associated with women's breast cancer screening utilization in Kenya. Using the Andersen's behavioural model of health care utilization, we aim to address this void in the literature.
Methods:
We draw data on the Kenya Demographic and Health Survey and employ univariate, bivariate, and multivariate analyses.
Results:
We find that women's geographic location, specifically, living in a rural area (OR = 0.89; p < 0.001) and the North Eastern Province is associated with lower odds of women being screened for breast cancer. Moreover, compared to the more educated, richer and insured, women who are less educated, poorer, and uninsured (OR = 0.74; p < 0.001) are less likely to have been screened for breast cancer.
Conclusion:
Based on these findings, we recommend place and group-specific education and interventions on increasing breast cancer screening in Kenya.
Background
Breast self-examination is a widely accepted, inexpensive and non-complex screening method for breast cancer because it does not entail complex technical training and therefore a more practical approach in a resource limited setting. This study aimed to assess the knowledge and practice of breast self-examination among female clients at Mbale Regional Referral hospital.
Methods
A cross sectional study employing qualitative and quantitative methods was carried out among 386 women selected by simple random sampling. Data was analyzed using SPSS v 16.0 and presented in tables. Univariate and bivariate analysis was done and a P-value < 0.05 was considered statistically significant while the results with a P-value ≤ 0.2 were considered for multivariate analysis.
Results
Both the knowledge and practice of breast self-examination among the participants in this study were low. Less than 50% of the participants had ever heard about breast self-examination. Only 24% of those who had ever heard about breast self-examination correctly reported that it should be done monthly. Both knowledge and practice of breast self-examination were associated with living in the urban setting, high level of education, occupation and religion.
Conclusion
There was limited knowledge about breast self-examination among women in Mbale Regional Referral Hospital and this corresponds with the low practice of the same. Only a few participants reported practicing breast self-examination monthly.
Background
Breast cancer is the primary cause of cancer death among women globally, responsible for about 425,000 deaths in 2010. This study assessed the awareness, knowledge and practices of breast self-examination as a method of prevention and early diagnosis of breast cancer among reproductive aged women in Akatsi South district in Volta region of Ghana.
Methods
This study was a cross-sectional study involving 385 women between the ages of 15–49 years. Data were collected with a structured questionnaire and variables included socio-demographic characteristics, breast cancer knowledge, breast self-examination knowledge and practice. Descriptive statistics were used to analyze and present the data and chi square test of significance was used to determine association between socio-demographic variable and practice of breast self-examination.
Results
The mean age of the women was 24.54±7.19. Only 3.1% of women had no formal education and 58.9% were single. Although 88.3% of the respondents were aware of breast cancer, 64.9% of the respondents had good or sufficient knowledge of breast cancer and only 94(37.6%) practice BSE. Over 50% of the respondents did not know how to perform BSE. There was a significant association between knowledge on breast cancer and practice of BSE (χ2 = 36.218 p = 0.000). The higher the age of a participant, the lower practice of breast self-examination and this was significant (χ2 = 11.324, p = 0.003).
Conclusion
Breast self-examination is a key strategy to early detection of breast cancer and subsequently critical for effective treatment and cure of the disease. The findings in this study have shown significant low levels of awareness and practice of breast self-examination among women in Akatsi South district of the Volta region. This pattern may be similar to other rural communities across the region. The need to create awareness and to educate women, especially rural women, on importance of breast self-examination as preventive measure for breast cancer is paramount.
Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed each year which accounts 12% of all new cancer cases and 25% of all cancers in women. Breast self-examination offers women the best opportunity for reducing breast cancer deaths. From a total of 222 respondents about 190 (85.6%) heard about breast self-examination. One hundred forty-three (75.3%) had good knowledge about sign and symptoms of breast cancer and 47 (24.7%) had poor knowledge about the sign and symptoms of breast cancer. From total respondents of the study 120 (54.1%) practiced breast self-examination. Breast self-examination practice is relatively frequent problem in Bahir Dar University, health science students. Negligence, forgetfulness and lack of knowledge are the main factors for poor practice of breast self-examination. Public health education using the media, clubs and leaflet could significantly reduce poor practice of breast self-examination and increases early detection of breast lump.
Background
Breast cancer is the leading cause of cancer-related deaths among women globally including Tanzania. However, timely access to diagnosis remains a challenge due to lack of specialized facilities. Most patients presents with advanced stages of the disease making management impossible. This leads to an increase in breast cancer-related mortality. Little is known about knowledge and practices on breast cancer screening in Tanzania. This study described knowledge and practices on breast-cancer detection and associated challenges among women aged 35 years and above in Morogoro rural District in Tanzania.
Methods
This descriptive cross-sectional study was conducted in Lubungo, Newland and Fulwe villages at Mikese ward in Morogoro rural District from June and July 2017. A standardized questionnaire was used to obtain information from 130 study participants regarding breast cancer knowledge and practices. Data were analyzed using (SPSS) software version 23 and descriptive statistics were summarized in frequencies and percentages.
Results
One hundred and thirty women were studied, all participants have heard of breast cancer; 71.5% knew the effects of breast cancer; 37.7% knew about the signs and symptoms. The most frequently reported cause and risk factor of breast cancer were putting money under brassiere (30.8%) and fat diet (17.7%) respectively. The participants (73.8%) have never heard of breast self-examination (BSE) as an early detection method of breast cancer hence do not practice it. Lack of knowledge on early signs and symptoms of breast cancer was reported as the main challenge for breast cancer screening (73.8%). The frequently reported source of information about this disease was television/radio programs (83.1%).
Conclusion
Most of the women have heard of breast cancer but they lack adequate knowledge on its risk factors, causes, symptoms and effects. The majority of the women do not practice BSE due to lack of knowledge. Efforts to improve women’s knowledge on breast cancer is warranted.
Introduction
Breast cancer is one of the leading causes of cancer deaths among women in India today. Overall outcome of this disease is largely dependent on early detection and medical intervention. Breast self-examination (BSE) is an easy, cost effective, and safe method of screening for the same.
Materials and Methods
A cross-sectional descriptive questionnaire-based study was conducted among female IT professionals and their scores in the fields of knowledge, attitude, and practice were calculated. The scores were categorized linearly as good, fair, and poor, then analyzed in detail. The correlation between knowledge and attitude, attitude and practice, and knowledge and practice were ascertained using the Spearman's rank correlation coefficient.
Results
About 356 women spanning from 18 to 55 years of age were included in the study, out of which 44 women (12.35%) gave family history of breast cancer. The mean scores in knowledge, attitude, and practice fields were 18.17 ± 2.90, 27.07 ± 8.14, and 19.11 ± 5.08, respectively. Spearman's rank correlation coefficient revealed that knowledge and attitude were not correlated, attitude and practice were not correlated; but knowledge and practice were extremely correlated.
Conclusion
Educational programs to create awareness regarding breast cancer and its occurrence, risk factors, screening including BSE, symptoms, need for early help-seeking practices, diagnosis, and treatment modalities are the need of the hour.
BACKGROUND
Breast cancer is a leading cause of deaths worldwide. In Pakistan, one in every nine women develops breast cancer some time in her life. This high incidence of breast cancer and the poor socioeconomic conditions of Pakistan make breast self-examination (BSE) the best tool for the prevention and early diagnosis of breast cancer. Therefore, the aim of the study was to assess the knowledge, attitude, and practice of BSE among female college students of Karachi, Pakistan.
METHODS
A cross-sectional study was conducted on 1000 students from June to December 2016. Data were collected using a pre-piloted questionnaire, and SPSS (version 20) was used for data analysis. Chi-square test was used to determine the significance of the difference in knowledge and attitude among participants who had performed BSE and those who had not. A P < 0.05 was considered statistically significant.
RESULTS
The overall response rate was 90.9%. Although 71.4% of the women knew what BSE was, only 33.1% had performed it. Majority of the participants considered that BSE is important in the early detection of breast cancer. With 59.7% of the population having an adequate amount of knowledge, 87.2% had a positive attitude toward BSE. A medical background was found to be a significant predictor for adequate knowledge and a positive attitude toward BSE.
CONCLUSION
Despite a positive attitude found among the population toward BSE, its knowledge and practice were inadequate. Educational interventions are required in Pakistan to encourage young women to perform BSE regularly so that breast abnormalities can be detected early on and mortalities can be minimized.
Breast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia.
A cross-sectional study conducted among 810 female undergraduate students in Klang Valley, Malaysia between April–Jun 2012. Data was collected via self-administered questionnaire which was developed and pre-tested for this study.
The majority of respondents were Malay 709 (95.6 %) and single 719 (96.9 %) with a mean age of 21.7 (1.1). Only hundred eleven (15 %) of the participants had a family history of breast cancer. 70.5 % of the respondents do not practice breast self-examination, 70.5 % do not know how to do it, 64.7 and 61.5 % reported no symptoms of breast cancer and worries to detect breast cancer, respectively. Univariate analysis showed that age, marital status and personal history of breast disease were statistically associated with the practice of breast self-examination.
In this study, a high percentage of respondents were aware of breast cancer but do not perform breast self-examination. Knowledge, socio-cultural and environmental factors were identified as barriers; so it is recommended that knowledge among the public about breast cancer and promotion of public breast health awareness campaigns through the media should be carried out.
Context
Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery.
Method
A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, ‘therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’.
Study selection
Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review.
Data extraction
Included review year, study aim, total number of participants included, and results.
Data synthesis
Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes.
Conclusion
There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients’ self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years.
Background : It is projected that by 2030, 70% of all cancer related deaths will occur in low-middle income countries. However, data on the state of cancer in most African countries is scanty. Cancer estimates for Kenya are based on the Nairobi and Eldoret cancer registries, leaving most parts of the country unrepresented. Lacking national coverage, these data do not accurately reflect Kenya’s cancer burden. The paucity of reliable data impedes formulation of effective cancer control strategies and cancer research prioritization. Here, we report the findings of a retrospective study of the cancer state in Meru County, Kenya.
Methods : A retrospective analysis of patient files at Meru hospice was carried out. 2349 cancer cases seen at the Meru hospice between 2003 and 2018 were analyzed. Data abstracted from the records included patient age, gender and cancer type. The abstracted data was analyzed by descriptive statistics.
Results : Our results indicate that cancer is almost evenly distributed across genders, with men accounting for 49% and women 51%. Stomach cancer rates are strikingly elevated and equal to those in countries with the highest stomach cancer rates globally – making it the commonest cancer in this region (14%). Among men, the most common cancers affect the prostate (18%), stomach (17%), esophagus (14%), head & neck (12%), liver (8%) and colorectum (5%). Among women, the commonest are cancers of the breast (22%), cervix (20%), stomach (11%), esophagus (8%), head & neck (6%) and liver (5%). Breast cancer occurs at a notably early age, with 20% of those affected aged below 40. Lung cancer rates are notably low in this region (1.3%) relative to world estimates.
Conclusion : Cancer distribution in Meru is nearly even between sexes. Our analysis suggests that the Meru region is a stomach cancer hotspot and that it also experiences elevated esophageal cancer levels.
BACKGROUND
Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females’ worldwide. Pakistan has higher incidence of the disease than the neighboring countries and one in every nine Pakistani women suffers from breast cancer which is one of the highest incidence rate in Asia. Numerous risk factors such as nulliparity, family history, genetic mutations, increasing age, early menarche, and late menopause are associated with the development of breast cancer. Lack of awareness and the preexisting myths regarding this disease have led to the detection of breast cancer at a later stage.
OBJECTIVE
The main objective of this study is to determine the frequency of adequate breast cancer knowledge and its level among nonmedical women of Karachi coming to attend general surgery outpatient clinics.
METHODS
A cross-sectional Study was conducted in Outpatient Clinics, Department of General Surgery, Civil Hospital, Karachi. The sample of 250 females with nonmedical background was gathered from December 27, 2016 to June 26, 2017. Adequate breast cancer knowledge was divided into three criteria such as poor, fair, and good knowledge. Chi-square test was applied. P ≤ 0.05 was considered as statistically significant.
RESULTS
The mean age was 35.63 ± 9.56 years. Mean knowledge score was 5.24 ± 2.92. Overall, 42% of participants were found with adequate breast cancer knowledge whereas 58% of the participants had inadequate knowledge. Based on the study questionnaire, 38% had poor knowledge, 40.4% had fair knowledge, and 21.6% had good knowledge. Significant association was observed with age, monthly family income, education status, and occupation.
CONCLUSION
The results showed lack of adequate knowledge. A high proportion (58%) of nonmedical females had inadequate knowledge about breast cancer.
Introduction to Research Methods and Report Writing: A Practical Guide for Students and Researchers in Social Sciences and the Humanities
- E Mligo
- Shabani
Mligo, E. Shabani. (2016), Introduction to
Research Methods and Report Writing: A
Practical Guide for Students and
Researchers in Social Sciences and the
Humanities, Wipf and Stock Publishers:
ProQuest E-book Central.
National Guidelines for prevention and management of cervical cancer, breast and prostate cancers
- Moh-Kenya
MOH-Kenya (2015), National Guidelines
for prevention and management of
cervical cancer, breast and prostate
cancers.
Mapping evidence on women's knowledge and practice of breast self-examination in sub-Saharan
- R Udoh
Udoh R.et al., (2020), Mapping evidence
on women's knowledge and practice of
breast self-examination in sub-Saharan