Breast cancer is said to be the commonest cancer and the most lethal malignancy in women across the world. Most of the cases are brought late to the hospital when the conditions are severe with multiple nodal involvements and poorer clinical pathological prognostic outcome. If breast changes are detected early and treatment commenced early enough, the survival rate of breast cancer will be increased. The purpose of this study was to investigate the breast cancer awareness and practice of Breast Self-Examination(BSE) among women in Ikere L.G.A. of Ekiti State. The research design for the study was descriptive survey. Ikere was purposively selected for the study. Proportionate sampling method was used to draw three hundred and forty nine (349) women in the ten villages in Ikere. Systematic sampling technique was used to the reach the respondents in the villages. A validated questionnaire which served as an interview schedule was used for data collection. Data derived from the questionnaire were analyzed descriptively using frequencies and percentages. Chi Square and Spearman’s Rank analysis were used to test for relationships between demographic data, breast cancer awareness and practice of BSE. The study revealed that the awareness of breast cancer and BSE among the women were low. The major source of information was healthcare providers. Majority of the women had inadequate practice of BSE despite the fact that a little above half (51.95) practiced BSE. Age, educational attainment and parity were associated with the practice of BSE. This implied that with increase in age and parity, the practice of BSE reduced while it increased with educational attainment. There were negative relationships between age, parity and awareness of BSE. This implied that BSE awareness increased as age and parity reduced. A positive relationship was established between BSE awareness and educational attainment. Findings further revealed that there is a positive relationship between breast cancer awareness and practice of BSE. Based on these findings, it was recommended that healthcare providers should embark on directed and focused health education awareness campaign to enhance the awareness of breast cancer. The importance of BSE as a key factor in the early detection of breast cancer should be stressed with special emphasis on regular practice of BSE and the proper steps of BSE.
Background to the study
Breast cancer is the commonest cancer as it continues to remain the most lethal malignancy in women across the world (Doshi, Reddy, Karunakar & Kulkarani, 2012). It constitutes a major public health issue globally with over one million new cases diagnosed annually, resulting in over 400,000 annual deaths and about 4.4 million women living with the disease (Globocan, 2008; Ganiy and Ganiyu, 2012). Breast cancer is the leading cancer among women but it can also appear in men (Tara, Agrawal & Agrawal, 2008). Although breast cancer is 100 times more common in women than in men, although men tend to have poorer outcomes due to delay in diagnosis (Fasoranti, 2010). Although breast cancer incidence rates are higher in industrialized countries, recent trends show that the largest increase in risk is occurring in developing countries. There is thus a geographical variation in the incidence of breast cancer with higher incidence in Europe and America compared to Asia and Africa (Otunne, 2008). According to Beiki, Hall, Ekbom and Moradi (2012), the incidence ranks highest in high income countries, with the exception of Japan. In Canada, for example, 19,000 new cases are diagnosed each year and 5, 300 Canadian women die from the diseases annually. Breast cancer is now the commonest cancer affecting women in Nigeria. In Nigeria, the number of women at risk of breast cancer increased steadily from approximately 24.5 million in 1990 to approximately 40 million in 2010 and is projected to rise to over 50 million by 2020 (Akarolo- Anthony, Ogundiran & Adebamowo, 2010).
Statistics from the Ministry of Health Nigeria showed that breast cancer had risen at least four times over the decade and accounted for 40 percent of women cancers (Onyebuchi, 2012). In the present scenario, roughly 1 in 26 women are expected to be diagnosed with breast cancer in their life time, majority of cases occurring in premenopausal women (Dosh et al, 2010). According to Salaudeen, Akande and Musa (2009) studies from various ethnic populations have reported the demographic profile of breast cancer especially from the Western and Northern parts of the country. A review of breast biopsies in the Lagos University Teaching Hospital showed 34 percent of all breast biopsies done over a 10-year period to be malignant. They also asserted that a report from Zaria described the mean age of presentation of breast cancer as 42 years with 30 percent occurring in women less than 25 years of age. Furthermore, at University College Hospital, Ibadan, 74 percent of breast cancer patients were pre-menopausal. A ten year review of breast cancer in Eastern Nigeria revealed that patients with breast cancer constituted 30 percent of all patients with breast disease and that 69 percent of these patients were pre-menopausal (Oluwatosin, 2010).
Statement of problem
Prognosis and survival rates for breast cancer vary greatly depending on the cancer type, stage, treatment and geographical location of the patient (Fasoranti, 2010). Survival rates of breast cancer in the western world are high as eight out of ten women in England diagnosed with breast cancer survive for at least five years. In developing countries, survival rates of breast cancer are much poorer. Lack of awareness of early detection measures and screening for breast cancer is common in developing countries (Hanna & Kangolie, (2010) Salaudeen, et al (2009) asserted that the black woman usually presents late for treatment of breast cancer with a bigger mass and seems afflicted with a biologically more aggressive tumour. Jebbin and Adotey (2009) reported that many cases of carcinoma of the breast they found in the clinic were advanced, with large tumours and multiple nodal involvements and have poorer clinical and pathological prognostic outcome. Jebbin and Adotey, 2009, believe that if women in Port-Harcourt are knowledgeable about BSE and practice it, this scenario may not be so. Similarly, at the surgical unit of Imo State Teaching Hospital, women with breast cancer are presenting with advanced stages of the disease. As a result of late detection of breast cancer, five women of Ikere died of breast cancer between March and June, 2010. Otunne (2008) acknowledged that following hospital records in Nigeria breast cancer is truly an epidemic among women, as it was estimated that 211,000 new cases of invasive breast cancer was diagnosed in 2007 and 43, 3000 patients died of this disease in Nigeria. Tara, et al (2008) noted that the earlier a woman is diagnosed of breast cancer, the better her chances of survival. Since there is increased mortality in Nigeria due to late detection and late presentation, one begins to wonder if women are aware of breast cancer and if they practice BSE. This study is therefore set to empirically ascertain the breast cancer awareness and practice of BSE among women in Ikere Local government area of Ekiti state