INTRODUCTION:

Breast cancer is the most common types of cancer; the most common malignancy afflicting women as well as it is considered as a major health-threatening factor to women's health in India 1:2 In 2013, 551 women were diagnosed with breast cancer; accounting for 31.8% of all female cancer cases and 16.6% of total cancers.

Moreover, about fifty percent of those diagnosed were aged 49 years or less and 70% had advanced cancer at the time of diagnosis. While the latest statistics from the National Cancer report, 864 females and 9 males were diagnosed with breast cancer in 2008, accounting for 18.8% of the total new cancer cases. Breast cancer ranked first among cancer in females, accounting for 36.7% of all female cancers, and is the leading cause of deaths among Jordanian women.

According to Tigka et al., the decline in breast cancer mortality rate during the period 1991 to 2000 in Europe could be attributed to both the improvement in early detection and the improvement of breast cancer treatment. Breast self-examination (BSE) is a recommended screening method for early detection of breast cancer, so it is essential to educate women about BSE as an early detection method for this fatal disease.

Okobia MN, Bunker CH, Okonofua FE, Osime U. (2016) reported that study participants had poor knowledge of breast cancer. Mean knowledge score was 42.3% and only 214 participants (21.4%) knew that breast cancer presents commonly as a painless breast lump. Practice of breast self examination (BSE) was low; only 432 participants (43.2%) admitted to carrying out the procedure in the past year. Only 91 study participants (9.1%) had clinical breast examination (CBE) in the past year. Women with higher level of education (X2 = 80.66, p < 0.0001) and those employed in professional jobs (X2 = 47.11, p < 0.0001) were significantly more knowledgeable about breast cancer. Participants with higher level of education were 3.6 times more likely to practice BSE (Odds ratio [OR] = 3.56, 95% Confidence interval [CI] 2.58-4.92). The results of this study suggest that community-dwelling women in Nigeria have poor knowledge of breast cancer and minority practice BSE and CBE.

Loh SY, Chew SL. (2015) recommended that breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of breast cancer detection. The report showed that 80% of the breast cancer survivors self-detected the breast lumps, despite a high 85% of these women reporting they were never taught about BSE. More than 70% of the women maintained that lack of knowledge/skill on the proper practice of BSE was the key barrier to a more regular BSE practice. After an educational intervention on BSE and breast awareness, we found an increase report from 17% (at pre-test) to 67% (at post-test) of self reported monthly BSE practices. Provision of self-management education incorporating BSE, a readily available cheap method, should be introduced at primary care and breast clinics. This strategy promotes women's self-efficacy which contributes towards cancer control and positive BSE behaviour

Nurses and midwives are the health care providers engaged in women through reproductive life. Thus, female nurses and midwives play an important role in educating women about the importance of breast self examination and understanding the risk factors of breast cancer. To secure these objectives effectively, women should be aware of breast self- examination and the risk factors of breast cancer and keep themselves updated with evidence-based practice concerning these issues.

STATEMENT OF THE PROBLEM:

A descriptive study to assess the awareness of Breast self-examination and risk factors of breast cancer among women in selected community area, Namakkal district

OBJECTIVES:

· To evaluate the knowledge and practices of breast self examination (BSE) among women

· To find out the knowledge about risk factors for breast cancer among women.

RESEARCH HYPOTHESIS:

· There is significant difference between pre and post test knowledge and practice scores of the women regarding breast self examination

· There is significant association between knowledge about risk factors for breast cancer and selected demographic variables.

THEORETICAL FRAMEWORK:

Modified Wiedenbach’s prescriptive Theory – “A Helping Art of Clinical Nursing”

METHODOLOGY:

Research Approach: Descriptive Approach

Design : Descriptive correlational research Design

Setting: Pachampalyam community area, Namakkal District

Population: Women in the age group of 30 - 50 years

Sample Size: 112 women

Sampling Technique: Convenient Sampling Technique

Sample Inclusion Criteria:

· Women in the age group of 30 -50 years

· Free from breast complaints/ problems

Method of Data Collection:

· Socio-demographic characteristics data included their age, level of education, marital status. age at menarche, duration of menstrual cycle, family history of breast cancer and source of information.

· Knowledge about breast self-examination

· Knowledge of risk factors of breast cancer.

Data collection Procedure:

· Questions regarding the practice of breast self-examination were also included: frequency of BSE; time of BSE; regularity of performing BSE and reinforcing factors for starting BSE. The reasons for not performing BSE and the source of information were also assessed. As well, BSE knowledge and breast cancer risk factors were assessed with questions.

Validity and Reliability:

· Split –half method was used to find the reliability of the Interview Schedule

Plan for data analysis:

Descriptive Statistics: Percentage, Mean and Standard deviation.

Inferential Statistics: Chi - Square test

RESULTS:

Section A:

The 112 women in the research, 90.1% were nurses and 9.9% were midwives. The mean age was 29.5; (SD8.3) years and ranged from 18 to 55 years. Slightly more than half of the respondents were married and less than half worked for more than 5 years. The overwhelming majority of the studied group (95.5%) not had any previous breast health problems. Twelve point five percent of the studied sample mentioned that they had a family history of breast cancer.

Women have ever performed BSE, 44.6% while, 55.4% of them reported that they had practice BSE. Of these, 9.7% perform BSE immediately before menstruation and an equal percent perform BSE at any time in month. On the other hand, more than thirty percent of them stated that they had performed BSE less than four times during the last year, while only 19.4% of them reported that they performed BSE regularly and the majority of them (80.6%) had performed BSE by irregular manner.

The women who performed BSE, 66.1% mentioned that it was due to fear from breast cancer, while almost three fifths (59.75) mentioned it gave them a sense of control over their own health by early detection of breast cancer, "having a close relative and friend with breast cancer" (11.3%). Less than third of participants (32.3%) felt reassured as announced in media that they may not have breast cancer after performing the BSE procedure.

Section B:

The findings revealed that the knowledge of BSE shows that, 34% of the samples had sufficient knowledge and 66% of them had insufficient knowledge regarding BSE.

Bar diagram showing the mean percentage of knowledge of BSE

Section C:

The participants who did not performing BSE, more than third reported: "I don't believe that it is beneficial", other reasons identified for "Not having time (too busy)" (36%), and for 30% of them, it was felt "Anxiety about the possibility of recognizing a breast mass". Other reasons were due to misbelieves as it is "Wrong to touch my breast" (12%), and they also thought, "BSE embarrasses me" (22%).

The risk factors of breast cancer show that, highest percentages were mentioned true answer for breast cancer. The majority of the participants (86.6%) known that the positive family history is a risk factors of breast cancer. An equal percentage of 83.9% of them replied correctly that the hereditary history and aging are risk factors. While radiation, consumption of contraceptive pills for a long period, smoking and alcohol consuming were considered correct knowledge as a risk factors for breast cancer mentioned by around two thirds of the participants. On the other hand, a lesser percentage 23.2% of the sample knew that the early menarche is a risk factor for breast cancer and the least percentage (18.8%) reported that cancer in one breast does not lead to cancer in the other one.

Section D:

There was a significant association between the knowledge of BSE scores and variables like age ( χ²= 4.51 , p > 0.05) and marital status ( χ²= 6.62 , p > 0.05). But there was no significant association with knowledge of BSE among women and other variables like age at menarche, duration of cycle, type of flow, family history of Breast cancer and source of information.

CONCLUSION:

· The findings revealed that the knowledge of BSE based on knowledge questionnaire, 34% of the samples had sufficient knowledge and 66% of them had insufficient knowledge regarding BSE.

· There was a significant association between the knowledge of BSE and risk of breast cancer scores and variables like age and marital status.

· There was no significant association between the knowledge of BSE and risk of breast cancer scores and variables like age at menarche, duration of cycle, type of flow, family history of Breast cancer and source of information

RECOMMENDATIONS:

1. A study can be conducted with large samples to generalize the findings.

2. A comparative study can be done between urban and rural women.

3. A comparative study can be done between married and unmarried women.

4. SIM can be developed based on the learning needs of the women regarding breast cancer and its self care management.

5. Intervention study can be conducted to know the effect of various treatment methods in reducing risk of breast cancer.

REFERENCES:

1. Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J Surg Oncol. 2016 Feb 21;4:11.

2. Loh SY, Chew SL. Awareness and practice of breast self examination among malaysian women with breast cancer. Asian Pac J Cancer Prev. 2015;12(1):199-202.

3. Jordanian National Cancer Registry (JNCR). Annual Report. Incidence of Cancer in Jordan. Jordan Ministry of Health, Amman MOH and JCR, 2008.

4. Alkhasawneh I M, Akhu-Zaheya L, and Suleiman S M. Jordanian nurses' knowledge and practice of breast self-examination. Journal of Advanced Nursing. 2009;65(2): 412-416.

5. Parvani Z. Breast self examination; breast awareness and practices of systemic review. Professional Med Journal. 2011; 18(2):336-339.

Received on 02.02.2017 Modified on 16.04.2017

Asian J. Nur. Edu. and Research.2017; 7(3): 413-416.

DOI: 10.5958/2349-2996.2017.00082.9