ASSESSING THE KNOWLEDGE ON BREAST CANCER ATTITUDE AND PRACTICE OF BREAST SELF-EXAMINATION AMONG FEMALE UNDERGRADUATES OF THE UNIVERSITY OF YAOUNDÉ 1.

Abstract

Breast cancer is the most common female malignancy and is commonly associated with high levels of morbidity and mortality in developing countries due to late presentation. Breast self-examination is one of the non-invasive methods of screening in which a woman looks at her breast for any abnormal findings like lumps, distortions, or swellings.

Despite, realized effects of breast self-examination in detecting breast cancer earlier, the vast majority of the cases still present with an advanced stage. Though in controversy Breast self-examination (BSE) remains a useful tool in early diagnosis of breast cancer. Thus, this study sought to assess the knowledge, attitude and practices of breast cancer and breast self-examination among female undergraduates of the University of Yaoundé 1.

The study employed a cross-sectional survey design using convenient sampling techniques to select 94 participants from the University of Yaoundé 1. A self-administered structured questionnaire was used to collect data from the participants. Collected data from the field was analyzed descriptively using frequency and percentages and hypothesis testing using Chi-square test in SPSS (25.0).

Findings revealed that the mean age of the women was 23±0.1years. Majority of the females were single (84.4%), with half of the population been Christian by religious beliefs.. This study therefore reveals that most participants 84 (83.7%) have heard of breast cancer as a disease entity and have, a significant knowledge and understanding of the disease.

Furthermore, the awareness of cancer and attitude towards BSE was moderate, but however, the practice of BSE and other methods of early detection of breast cancer among students in University of Yaoundé 1 is average. Thus it was recommended that, improvement in the knowledge and practice rates of BSE would allow the detection of breast cancer at an early stage which could consequently lower mortality rates.

CHAPTER ONE
INTRODUCTION

1.1 Background

Benign and malignant conditions of the breast are of primary concern to women’s health worldwide. Breast cancer in particular is the most common cancer in women, with 2.2 million cases in 2020. Nearly 1 in 12 women will develop breast cancer in their lifetime. Breast cancer is the number one cause of deaths from cancer in women.

Approximately 685 000 women died from the disease in 2020. The majority of cases and deaths from breast cancer occur in low- and middle-income countries (LMICs).and one of the highest contributors to disability- adjusted life years (DALYs) in women (WHO, Breast cancer 2021).

Major progress has been made in breast cancer treatment since 1980; age-standardized breast cancer mortality dropped 40% between the 1980s and 2020 in HICs. These improvements are yet to be matched in LMICs (WHO, Breast cancer 2021).

Improved outcomes result from the combination of early detection followed by effective treatment using a combination of surgery, radiotherapy and medical treatments. Early detection can be achieved by breast self-examination which the cheapest and easiest way to screen for breast cancer.

Breast cancer arises in the lining cells (epithelium) of the ducts (85%) or lobules (15%) in the glandular tissue of the breast. Initially, the cancerous growth is confined to the duct or lobule (“in situ”).

Approximately half of breast cancers develop in women who have no identifiable breast cancer risk factor other than gender (female) and age (over 40 years). Certain factors increase the risk of breast cancer including increasing age, obesity, harmful use of alcohol, family history of breast cancer, history of radiation exposure, reproductive history (such as age that menstrual periods began and age at first pregnancy), tobacco use and postmenopausal hormone therapy.

Breast cancer most commonly presents as a painless lump or thickening in the breast. It is important that women finding an abnormal lump in the breast consult a health practitioner without a delay of more than 1-2 months even when there is no pain associated with it. Seeking medical attention at the first sign of a potential symptom allows for more successful treatment. (Desantis et al 2015)

Breast cancer treatment can be highly effective, achieving survival probabilities of 90% or higher, particularly when the disease is identified early. Treatment generally consists of surgery and radiation therapy for control of the disease in the breast, lymph nodes and surrounding areas (locoregional control) and systemic therapy (anti-cancer medicines given by mouth or intravenously) to treat and/or reduce the risk of the cancer spreading (metastasis). Anti-cancer medicines include endocrine (hormone) therapy, chemotherapy and in some cases targeted biologic therapy (antibodies). (Ginsburg et al 2020).

Though still clouded in controversy, breast self-examination (BSE) still has an important role to play in the early detection of breast cancer in resource-constraint settings where routine clinical breast examination and mammography may not be feasible. In such settings, BSE is recommended because it is free, private, painless, easy, safe, and requires no specific equipment.

It has also been shown to improve breast health awareness and thus potentially allow for early detection of breast anomalies (Suh et al, 2012). The American Cancer Society also recommends that women from the age of 20 years onwards should be educated on the benefits of performing BSE monthly (ACS, 20160. It had been demonstrated that factors related to women´s awareness, knowledge and perceptions about breast cancer may contribute significantly to medical help-seeking behaviours (HAdi et al).

1.2 Problem Statement

Despite the increasing treatment modalities of breast cancer worldwide, breast cancer incidence remains on a rise in low and medium economic countries like Cameroon, due to poor knowledge concerning preventive measures of breast cancer.

Yet early detection including BSE could be employed as a means of early detection so as to decrease the morbidity and mortality related to breast cancer. In our setting there is paucity of data and poor knowledge on these, therefore a study like this was sought among an active population, as a means through which information could be propagated to the general population.

1.3 Significance Of The Study

Breast cancer is becoming a cause for concern in Cameroon as more women lack a facility and financial means for screening and detection of breast cancer. Therefore determining the knowledge attitude and practices on breast cancer and breast self-examination, will go a long way to increase awareness of breast cancer and its preventive measures including cost effective and non-invasive means like BSE. This will lead to an increase in early detection of breast cancer thus decrease morbidity and mortality.

1.4 General Objectives.