International Journal of Community Medicine and Public Health

Shipra et al. Int J Community Med Public Health. 2021 May;8(5):2609-2613

http://www.ijcmph.com

pISSN 2394-6032 | eISSN 2394-6040

Review Article

DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20211798

Awareness about the carcinoma breast and the practices related to self- breast examination among women in developing countries

Shipra1, Reema Kumari1*, G. N. Singh2

1Department of Community Medicine and Public health, King George’s Medical University, Lucknow, UP, India

2Department of General Surgery, King George Medical University, Lucknow, UP, India

Received: 16 February 2021

Accepted: 18 March 2021

*Correspondence:

Dr. Reema Kumari,

E-mail: reemak2015@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

The aim of this review article was to evaluate the awareness of carcinoma breast and practices related to self- breast examination among women in developing countries. The study included the exploration of databases and journal websites, pub med, google scholar, and medline. The articles studied for the review were focused on english language articles from the year 2013 to 2019. This review focused on knowledge of breast cancer and its risk factors among women. Fifteen articles were reviewed on this topic from the year 2013 to 2019 in which general awareness level of breast cancer was probably better than the knowledge of risk factor, sign and symptoms. It also shows that although awareness and knowledge regarding Breast cancer was satisfactory but the knowledge of self-breast examination was low and practice of self-breast examination was least in developing countries. So, awareness programs related to breast cancer should be planned, to ensure early detection and timely treatment for better outcome.

Keywords: Breast cancer, Knowledge, Risk factor, Breast self examination, Practices, Developing countries

INTRODUCTION

According to WHO, breast cancer is the most frequently found cancer in women, and millions of women are affected all over the world. On average annual estimation in 2012, there were 1.7 million cases of the 5,21,900 have resulted in death.1 According to Globocan, breast cancer is 25% of all cancer and 15% of all cancer related deaths among women. Breast cancer in developing counties is half of total brest cancer cases in world and around 60% of breast cancer death occurs in developing countries. The incidence in developing countries is low but mortality is high due to late presentation, due to lack of awareness of knowledge of risk factors, signs and symptoms, and various screening method.2

Early detection and timely treatment will be effective in reducing mortality and morbidity and improving the long-term survival of breast cancer cases. For early detection, there are screening methods like clinical breast examination (CBE), and mammography but the application of these methods is limited due to lack of infrastructure, trained manpower, and limited knowledge.3

So, breast self examination (BSE) is preferred in low-income countries as it is simple, easy, and cost-effective for early detection of lump4.

American cancer society (ACS) recommends BSE practice and education for women ≥20 years but it does not mention BSE as a tool to increase survival of breast cancer.

It involves inspection and palpation of the breast by the woman herself for any lumps, texture, size, and shape. It is done every month 7 days after menstruation. If women have attained menopause, they should do BSE on the same day every month.

BSE through simple and quick but the practice is low and varies in different countries, in one of the studies by Philip et al done in England, only 54% of women were practicing BSE. In Nigeria, about 19% to 43% 6 women and in India 0 to 52% 7 women practice BSE.

Many reasons were cited for not practicing BSE like lack of confidence and time, fear of detection of a lump, and embarrassment of doing it. To focus more on practices related to BSE which can be acceptable and achievable in developing countries this review article included various studies from different regions of developing countries emphasizing knowledge of risk factors, sign, symptoms, screening method, and practices related to self-breast examination.

DISCUSSION

In this review article we have assessed 15 articles discussing about knowledge of carcinoma breast its risk factors, sign and symptoms and practices related to breast self-Examination among women in developing countries. In one of the studies done in Indonesia, knowledge of risk factors was low but attitude and practices were better in an urban area.

In one of the studies done in Akatshi South district of Volta region of Ghana 88.3% of the respondents were aware of breast cancer, almost 64.9% of the respondents had sufficient knowledge of breast cancer, and 37.6% practice BSE. Around 50% of the respondents did not know how to perform BSE.9

Another study carried out in Wardha in India, most of the females believed that they don't have breast cancer even before screening test.10 In the study done on IT professionals in Silicon Valley in India findings showed knowledge and attitude were not correlated, attitude and practice were not correlated, but knowledge and practice were extremely correlated.11 In of the study conducted in Delhi, outline percentage of women who knew known risk factors of breast cancer was maximum for family history of breast cancer 59.5%. Around 41.4% of participants had done BSE atleast once a month.12

In the study done in Cameroon shows around 88.1% had heard about Breast Cancer. Around 21.4% had sufficient knowledge of its risk factors, signs, and symptoms. Some 47% had heard about BSE out of them, some 38.5% had ever practiced BSE.13

In one of the studies done in Bengaluru, India most of them were aware of breast carcinoma. Around 58% had knowledge of at least one of the symptoms and at least one of the risk factors for breast carcinoma. Almost 18% of women knew about BSE and around 107 women practice it.14 In one of the studies done in Mysuru in India, 99% of women were aware of breast cancer. Some, 63% were aware of breast self-examination. Around 66% had practiced BSE at least once.15 In the study done in the Gurdaspur district of Punjab shows that more than 80% of women had heard about breast cancer.

Around 70% of women had knowledge about symptoms, more than half of them had heard about the practice of breast self-examination, while only 8.9% women’s were practicing it.16 In the study done in Ibadan, Nigeria, majority of respondents around 70.8% did not know how to perform BSE.

Almost 61.7% of women believed that BSE is a method of screening for breast cancer.17 In the study conducted in Pokhara valley of Nepal showed poor awareness of signs and symptoms.18 In one of the study done in Gurgaon in India showed diverse levels of awareness on risk factors.19 In the study done in Nigeria showed that knowledge and practice for BSE were poor.20

Another study done among peripheral health workers in Shimla, India, which showed that knowledge was higher among males as compared to females. Around 43.3% of the participants had very good knowledge about risk factors.21 One of the study done in Nigeria summarizes that 56.8% women had poor knowledge of breast cancer, almost 75.6% had poor knowledge of BSE. Just about 10.1% of respondents had ever practiced BSE. Knowledge of BSE was significantly associated with BSE practice.22

Table 1: Studies showing awareness of risk factors, signs and symptoms, screening and practices related to breast self-examination among women in developing countries.8-22
Table reproduced from source PDF page 2, part 1 of 3
Table reproduced from source PDF page 3, part 2 of 3
Table reproduced from source PDF page 4, part 3 of 3

CONCLUSION

In all 15 studies (Table 1) done in developing countries, it was found that there is a need to educate women of all age group regarding breast cancer risk factors and screening practices, mainly BSE which is cost effective, easy that can help in detecting lump at an earlier stage so that timely treatment can be planned which can help in reducing mortality and morbidity from breast cancer.

Educational campaigns should be organized to increase breast cancer awareness to improve the knowledge of modifiable and non-modifiable, reproductive, and lifestyle factors among developing countries where though incidence is low but mortality is high, irrespective of their socioeconomic and educational background.

There is a need for awareness programs involving people and the health system, to help improve breast cancer literacy in developing countries.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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