Breast cancer is the proliferation of cancerous mostly occurring at the milk ducts or lobule. The cause is not exactly known but there are predisposing risks features which include gender, family history, age over 50 and hormonal factors such as prolonged estrogen exposure [1-4]. In 2020, WHO reports (BC) as the most common type of cancer worldwide occurring in 2.3 million cases 685,000 deaths in 2020. The control of BC in many developing counties including Nigeria is under the guidance of WHO which involves education and screening young women for clinical manifestation of BC [5-8]. BC screening includes BSE, clinical Breast Exam (BSE) and mammography. BSE is recommended for developing countries because it’s easy, cheap, private convenient early detection and intervention is not often done by many women. Women diagnosis of BC has been clearly demonstrated to reduce mortality and improve survival [9-14]. The knowledge and practice of breast cancer was reduced by more than one third. Thus, knowledge and practice of BC screening and prevention measure therefore is critical in the reduction of BC morbidity and mortality. Poor awareness and knowledge of BC screening methods have been reported by several structures to address this menace of BC healthcare professionals and planners must know the current level understanding. Thus, leading to the need for their study.

Aim

To assess the awareness, knowledge and practices of BSE as a method of prevention and early diagnosis among final year medical student.

This study assessed the awareness, knowledge and practices of breast self-examination as a method of prevention and early diagnosis of breast cancer among final year medical student and their potential patients.

Settings and Design

This study was done in a teaching hospital in Jos Plateau State known as (BHUTH) with volunteered final years female medical students. The calculated sample size adjusted for  size was 184. 

The age range was between 18-30 years

All participant met this eligibility criteria. The exclusion criteria are the non-medical female and those not willing to participate.  Jos is located 4000m above sea level giving the highest elevation in Nigeria.

Data Collection

A structure validated close-ended questionnaire was used for the data collection. The questionnaire is consisted of two sections. Section A consisted of socio demographic data. Section B was on question related to knowledge of BSE.

Data Analysis

Data obtained were coded and entered into a spread –sheet. Analysis was performed using the statistical package for social science, version 20. Descriptive statistics such as frequency counts, percentages, were used to summarize and present the results. Student’s identity awareness and level of utilization of breast self-examination was studies. Only anonym zed data were collected to ensure patient confidentiality and compliance with ethical study.

RESULTS

Demographic variables and their association to knowledge of breast cancer.

DISCUSS

Knowledge and practice of breast self –examination

BSE knowledge and practice assessment were the major objectives of this study. This study aimed to determine the proportion of respondents who were aware of and had comprehensive knowledge of and skill to perform BSE and are practicing BSE. The findings show that knowledge of BSE was generally low among the 385 women who participated in this study. Only 165[43.3%] of the respondents knew what self-breast examination was whilst majority 217[56.7%] reported not knowing anything about it or having not heard about it. Out of the 385 respondents surveyed, majority 235[61.0%] reported not knowing anything about BSE and were never taught how to perform it.

Discussion

This discussion shows the main findings of this study and how those findings compare with findings from similar studies conducted on the breast cancer and breast self-examination. This current study breast cancer awareness was high for rural population in that 81.5% of the respondents were aware of breast cancer but only 18.4% of the respondent demonstrate adequate knowledge. This finding of low awareness and knowledge of BSE is similar but lower compared to the findings in Nigeria in which 81.5% reported over hearing BSE and only about 50% reported adequate knowledge on BSE. It is also similar to finding of poor knowledge of BSE in Ibadan, Southwest Nigeria where 70% of 603 market women, that is buying and selling various commodities. Another major objective in this study was to examine the practice of breast self-examination among the women. Where the result indicates that only 106 of the 385 women (81.5%) reported practicing or ever practiced BSE the sample in this study. This finding is consistent with the finding of similar studies in other parts of the world whereby the practice of BSE is generally low. In Cameroon, only 15% of 200 women who reported basic knowledge of BSE actually practiced BSE.

The variables found to be significantly associated with and predicted practice of BSE are knowledge of breast cancer and age of woman. The current work reported a significant association between knowledge of breast cancer and practice of BSE (x2=36.218p=0.000). There is a significant association between age group and practice of breast self-examination (X 2=11.324,p= 0.0003) as the age increased level of participant practice of BSE was lower. Among respondent who reported practicing BSE. Some respondents (17.4%) also said they did not practice BSE because they didn’t have breast cancer problems. Lack of privacy at home was also mentioned by 7.3% of the respondents as reason for not practicing BSE. About 3.4% of the respondents did not think they need self-examine their breasts and another 3.4%  said they did not feel comfortable to self-examine them. These findings were consistent with other researchers who stated that, knowledge not having symptoms and being afraid of a breast cancer diagnosis were the main barriers to practicing BSE (20.3%, 14.3%, 4.4% respectively).

Conclusion

In conclusion, the findings in this study show an overall lack of comprehensive knowledge of breast cancer and BSE. Also practice of BSE, which is an important of early diagnosis of breast cancer especially in resource limited. The findings did show that knowledge of breast cancer and BSE as well as age of woman are strong predictors of BSE. The implication for public health practice is that there is the interventions to form and train rural women on BSE targeting all women. There is the need to improve knowledge of breast cancer and BSE and to target all age groups in future breast cancer awareness programs.

REFERENCES

1. Rita Dadzi, Awolu Adam. Assessment of knowledge and practice of breast examination among reproductive age women in Akatsi South district of Volta region of Ghana PMC 2019 Dec 30;14(12):e226925.doi:10.137/journal.pone.0226925.
2. Mohammed Alshafie, Anas B., Massa Alfawal, Mhd Basheer A., Dima A., Maher Saifo. Breast Self-Examination Among Female Medical Students at Damacus University. www.cell.com/heliyon.
3. Leena Mohammed Khonji, Zoohour I. Rashwan, Rasha S. Eweida, Gayathripriya Narayanan, Enas M Darwish, Magda Mohammed Bayoumi. Assessment of University Students Knowledge Attitude and Practice Regarding Breast Self-Examination in Bahrain: A gel for action. The open public health journal 06 May 202.
4. Yilma TM, Inthiran A, Reidapth D, Name SOO. Health Information seeking and its associated factors among university students: acase in a middle-income setting. Sorcietal transformation through IS/IT. PACIS 2017.
5. Ameer K, Abdulie SM, Pal SK, Arebo K, Kassa GG. Breast cancer awareness and practice of breast self- examination among female medical students in Haramaya University, harar Ethiopia. Ethiopia. IJIMS. 2014;2[2]:109-9.
6. Azubuike S. Okwuckei S. Knowledge attitude and practices of women toward breast cancer in Benin City Nigeria. Anal Medical health science research. 2013(2):155-160.
7. Adebamowo CA, Ajayi OO. Breast Cancer in Nigeria. West African Journal of medicine 2000:19(3): 179-91
8. Mark K, TEmkin SM, Terplan M. Breast self-awareness: the evidnce behind the euphemism Obestet Gnynecol, 2014 Apr;123(4):734-6
9. Johnson OE. Awareness and Practice of Literature. Niger Med. J. 2019 sept-Oct;60(5):219-225.
10. Bonsu AB, Ncama BP, evidence of promoting prevention and the early detection of breast cancer among women, a hospital based education and screening interventions in low
11. Thornton H, Pillaarisetti RR. ‘breast awareness and breast self examination are not the same what do these’ mean? Why  are they confused? What can we do? Eur J cancer, 2008.
12. Mac bride MB, Pruthi S.BeversT. The evolution of breast self-examination to breast awareness. Breast J. 20212 Nov-Dec;18(6)-3
13. Panieri E. Breast Cancer screening in developing countries. Best prac rest Clin Obset Gynaecol 2012 Apr;
14. Husna PH, Marni Nurtanti S. Handayani S. Rantsary NY, Ambrwati R, Susanto T. Breast self-examination education for skill and behavior, Educ Health (Abingdon), 2019 May August32(2): 101-102.