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Revised

Awareness regarding breast cancer among the female population in Wardha District

[version 2; peer review: 1 approved, 1 approved with reservations]
PUBLISHED 09 Nov 2023
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This article is included in the Datta Meghe Institute of Higher Education and Research collection.

Abstract

Breast carcinoma is the second-leading cause of cancer mortality in women and the most prevalent carcinoma in female worldwide. It is most often presented as a pain-free lump or thickening in the breast. Modern breast carcinoma screening and medication methods have increased survival rates, with 50% of females now surviving the disease. Breast carcinoma accounts for 10.4% of all instances of carcinoma among females each year, with more than 1.5 million present cases. According to a previous study in the year 2015, approximately 570,000 deaths occur due to breast cancer. Whereas in 2015 there were 2.3 million females diagnosed with breast carcinoma and 685000 deaths caused worldwide and 7.8 million were viable who were diagnosed with breast carcinoma in the past 5 years. This number continues to increase especially in more advanced countries. A cross sectional study will be performed among Wardha district women to assess the awareness of breast carcinoma. Awareness will be assessed using a questionnaire in the year 2023. The previous data shows 27% awareness among the female population in the year 2020, and we now expect the results of this study to be between 50%-60% in the year 2023 in the Wardha district female population.

Keywords

Breast cancer, Metastasis, Awareness, Risk factors, Gene mutations, Women's health, Prognosis, Biopsy

Revised Amendments from Version 1

The conclusion added more information and mechanism of breast carcinoma should be added

See the authors' detailed response to the review by Dong-Dong Wu

Introduction

A condition that involves immature cell development and the ability to invade or reach other parts of the body is known as carcinoma.1 These elements act mostly by changing the qualities of a cell.2 Carcinoma affected roughly 90.5 million people worldwide in 2015.3 In 2019, yearly disease cases were developed by 23.6 million individuals and there were 10 million cases around the world, addressing over the earlier ten years increments of 26% and 21%, separately.4,5 Following that, medical imaging and a biopsy are typically used to confirm the diagnosis.6 The World Carcinoma Research Fund International estimates that there were 18.1 million current cases of carcinoma worldwide in 2020.7 The world, addressing over the earlier ten years increments of 26% and 21%, separately.4,5 Following that, medical imaging and a biopsy are typically used to confirm the diagnosis.6 The World Carcinoma Research Fund International estimates that there were 18.1 million current cases of carcinoma worldwide in 2020.7

Worldwide, breast carcinoma is the most common carcinoma among females and the second leading cause of death among females from carcinoma.8 Fortunately, improvements in detection and treatment of breast carcinoma have enhanced survival rates, with 50% of females living 5 years following diagnosis.9 A focus on quality of life in carcinoma research, with a specific focus on sexuality, has resulted from the realisation that female sexuality can be particularly problematic following breast carcinoma.10 Breast carcinoma is the fifth most popular cause of carcinoma-related deaths worldwide, accounting for 10.4% of all female carcinoma incidences.11 Worldwide, 2.3 million females will be diagnosed with breast carcinoma in 2020, which will result in 685 000 fatalities. As of the end of 2020, 7.8 million living females had breast carcinoma discovered within the preceding five years, making it the most common illness globally. Breast carcinoma accounts for more disability-adjusted life years (DALYs) lost by females worldwide than any other type of cancer. After puberty, breast cancer affects females in every nation, with an increasing prevalence in later life.12 Worldwide, breast carcinoma affects over 1.5 million females annually, or 25% of all cancer patients.13 Sex, age, oestrogen, family history, gene mutations, and an unhealthy lifestyle are risk factors that might raise a female's likelihood of getting breast carcinoma.14

A destructive carcinoma that originates in the breast cells is called breast carcinoma. Like different tumors, there are a few factors that can raise the likelihood of getting breast malignant growths. Exposure to estrogen has been experimentally linked to DNA damage and hereditary alteration that can lead to breast carcinoma. Therefore, a higher chance of getting breast illness exists in people with a family history of ovarian or breast carcinoma.

Usually, the insusceptible framework seeks cancerous growth cells and cells with damaged DNA and destroys them. Breast carcinoma may develop if such an efficient immune defence and surveillance are not maintained.

There are many trillions of cells in the human body. These cells' development, maturity, division, and death are all governed by a strictly controlled cell cycle. During childhood, normal cells divide more quickly so that a person can grow. After reaching adulthood, cells divide to repair wounds and replace damaged ones. This cell division and development is constrained by the cell blue print or DNA and qualities that exist in the cell's core.

Cancer manifests itself when cells in a certain body component start to grow out of control. All forms of cancer, regardless of their origin, are caused by this unbalanced cell proliferation that gives rise to tumours and lesions. The carcinoma cells also exhibit rogue-like characteristics. These are a few frameworks for development factors and various intermediaries that allow stromal cells and epithelial cells to communicate. Breast cancer might potentially develop from changing them.15

Carcinoma cells have extended lives and, rather than dying, they continue to develop and produce aberrant new cells. Also capable of invading other tissues are carcinoma cells. Normal cells are unable to accomplish this. Metastasis is the name for this quality.

Tumours are created from carcinoma cells, and they are fed by a new blood vessel network. Angiogenesis is a unique process because it prevents cancer cells from gaining access to nutrients and blood.8

Causes

Each case of breast carcinoma has a unique cause, which is unknown. However, we do know a significant number of the factors associated with this disease.

For instance, risk factors related to your lifestyle, such as what you eat and how much exercise you do, might increase your likelihood of getting breast carcinoma. However, the precise mechanism through which some of these risk factors induce healthy cells to develop into carcinoma is unknown. Hormones also seem to have a role in a large number of breast carcinoma occurrences; however the exact process is still unclear.

We do know that gene changes or mutations can turn normal breast cells into carcinoma. While a woman with a family history of breast carcinoma may have inherited a defective gene that does not manifest on genetic testing, only around 10% of instances of breast carcinoma are associated with known aberrant genes that are inherited (passed down from parents). Most breast malignant growths (around 90%) are created from obtained (not acquired) quality changes.15

Study objectives To assess the knowledge of breast carcinoma amongst females in the urban and rural areas in Wardha district. To explore the quality of life among females with breast carcinoma and to investigate its relationship with self-efficacy in Wardha district.

Mechanisms of breast carcinoma

  • 1. Genetic mutations: Mutations in certain genes can increase the risk of breast cancer. Two well-known genes associated with breast cancer are BRCA1 and BRCA2. Mutations in these genes can be inherited and significantly increase a person's susceptibility to breast and ovarian cancers.

  • 2. Hormonal factors: Hormones play a crucial role in breast cancer development. Estrogen and progesterone, female sex hormones, can stimulate the growth of some breast cancer cells. Hormone receptor-positive breast cancers are those that have receptors for estrogen and/or progesterone, making them more responsive to hormonal therapies.

  • 3. Environmental and lifestyle factors: Various environmental factors and lifestyle choices can impact the risk of developing breast cancer. These include:

    • a. Diet: A diet high in saturated fats and low in fruits and vegetables may increase the risk.

    • b. Alcohol consumption: Heavy alcohol use is associated with a higher risk of breast cancer.

    • c. Physical activity: Regular physical activity may lower the risk of breast cancer.

    • d. Reproductive history: Women who have their first child at a later age or never have children may have a slightly higher risk.

    • e. Hormone replacement therapy (HRT): Long-term use of HRT, especially a combination of estrogen and progestin, can increase the risk.

  • 4. Radiation exposure: Exposure to ionizing radiation, such as radiation therapy used to treat other cancers, during a woman's younger years, can increase the risk of breast cancer later in life.

  • 5. Inflammatory conditions: Chronic inflammatory conditions in the breast, such as mastitis or certain benign breast diseases, may slightly increase the risk of breast cancer.

  • 6. Obesity: Obesity is associated with an increased risk of breast cancer, particularly in postmenopausal women, as fat tissue can produce estrogen, which can fuel the growth of some breast cancer cells.

  • 7. Family history: A family history of breast cancer, especially in close relatives like a mother, sister, or daughter, can raise an individual's risk. This may be due to shared genetic factors or common environmental factors within families.

  • 8. Age: The risk of breast cancer increases with age, with most cases occurring in women over the age of 50.

Breast cancer typically begins when cells in the breast undergo genetic changes (mutations) that cause them to grow and divide uncontrollably, forming a tumor. The tumor may be benign (non-cancerous) or malignant (cancerous). Malignant tumors have the potential to invade nearby tissues or spread to other parts of the body through the lymphatic system or bloodstream, a process known as metastasis.

Protocol

Breast Carcinoma is the most widespread disease currently,12 but few females are aware of the signs and symptoms of it and therefore it has poor prognosis, the purpose of this study is to assess the state of perceptions and beliefs specifically about breast carcinoma. My aim is to focus on the awareness of breast carcinoma among general females and make them aware of precaution and disease, with the support of this research results, the campaign and health professional bring awareness to people regarding breast cancer regarding breast carcinoma which will help in decreasing the rate of breast carcinoma among rural or urban area females or people. The population used in this study is part of a larger population that can be found in the upcoming study ‘Evaluating awareness of oral cancer and attitudes towards its screening practice in Vidarbha: A Cross-Sectional Study’ (Sweza. S. Bhaisare, Gaurav Mude).

Methods

This is a cross-sectional study (observational study) that will take place over four months. The structure of the study is as follows:

  • 1. A conceptual study of carcinoma and breast carcinoma will be conducted.

  • 2. A conceptual study of awareness of breast carcinoma will be conducted.

  • 3. Prior ethics committee permission will be obtained.

  • 4. The recruitment of the general population will be done independently from the Wardha district.

  • 5. Informed Consent forms will be taken from the participants who are willing to participate will be taken from the participants who are willing to participate.

  • 6. The awareness of breast carcinoma and perception of breast carcinoma screening will be measured using a standardized questionary tool.

  • 7. A face-to-face interview will be conducted to validate questionnaire responses to ensure accuracy

  • 8. Any questions that arise while filling out the questionnaires will be answered in the interview.

Study design

The observational cross-sectional study of awareness will be conducted using the standardized questionary tool.

Inclusion criteria

Age range

  • Subjects aged between 18 to 65.

Sex

  • Female

Location

  • Wardha district.

Exclusion criteria

  • Males will be not included in the study.

Participants

The subjects will be selected from the Vidarbha population and will include those who are willing to participate and fit the inclusion criteria. The researcher will recruit from the different regions of the Wardha district and will recruit from colleges, local resident hospitals and public places such as childcare centres.

Sample size

As per the study by Gangane et al. in Wardha on breast cancer, prevalence of awareness about breast cancer was 65%.19

Cochran formula for determining the sample size:

N=Z1α/2p1pE2

Where,

Z12- α/2 is the level of significance at 5% i.e., 95%

Confidence interval =1.96

P = proportion of awareness about breast cancer = 65% = 0.65 Gangane

E = Error of Margin = 5% = 0.05

N=1.9620.6510.520.052

N = 388

N= 308 subject needed in the study

Data collection

Face-to-face interviews will be used to gather data while using a standardised questionnaire. The questionnaire will include questions on demographics, breast cancer awareness, risk factors, and sources of information. The researcher will take the interview of participant at the same place as recruitment. The duration of the interviews will not be more than 15 minutes. A questionnaire form will be used as a tool to record data related to interview. The questionnaire will be pre-tested to ensure its validity and reliability. As part of the interview process, participants will be questioned about their overall experience in completing the questionnaire, with particular emphasis on identifying any items they found confusing or difficult to comprehend. Moreover, they will be encouraged to offer constructive feedback and suggestions for enhancing the questionnaire's quality. The interview will make sure that the questionnaire forms filled are carefully evaluated and refined.

Expected dates of data collection

The data will be collected in May 2023-August 2023.

Expected dates of recruitment

The first subject was recruited on 11 May 2023 and recruitment will continue until 11 September 2023. 308 participants will be recruited.

Data analysis

The statistical package for social sciences (SPSS) software will be used to analyse the questionnaire data. We will use descriptive statistics to summarise the data, including means, frequencies, and percentages. The chi-square test will be performed to determine the variables that influence breast cancer awareness.

Dissemination

The study will be published in an indexed journal.

Study status

The recruitment of participants started from May 2023. As participants arrive, we engage them and include them in the study. As of now, 120 participants have participated in the study.

Discussion

Those who use hormone replacement therapy (HRT) have a higher risk of breast cancer. Uncontrolled cell division frequently results in a benign or malignant tumour, which is known as a carcinoma. These tumours have the potential to spread to distant organs or tissues by infecting surrounding tissues.16 Breast cancer breast masses often have favourable features. Non-cancerous breast tumours are abnormal growths, but they do not spread outside the breast and pose no threat to life. However, some benign breast lumps can increase a woman's risk of breast cancer.17 Breast cancer spreads swiftly when the tumour cells enter the blood or lymphatic system. Carcinoma cells start to multiply when they are dispersed throughout the body. Age, family history, and personal history (having a diagnosis of breast carcinoma in one breast increases the risk of breast cancer) the risk of carcinoma in the other breast, early menstrual cycle or being menopausal, race (white women have a greater risk of growing breast carcinoma), having no children or having one’s first child are known risk factors which can cause breast carcinoma. Women with immediate relatives who have the disease as well as those who have more dense breast tissue are at much higher risk of developing breast carcinoma. Early menarche age, nulliparity, late first-birth age, inability to breastfeed, usage of oral contraceptives, menopausal status, and menopausal hormone treatment are all reproductive risk factors. 30% of breast carcinoma incidence has sharply increased in several LMICs due to changes in lifestyle, reproductive factors, and greater life expectancy.18

Breast carcinoma is the most common malignancy in women worldwide and the second major cause of carcinoma death in women.8 Fortunately, improvements in breast carcinoma detection and treatment have increased survival rates, with 50% of women still alive five years after diagnosis.9 Since it is now understood that female sexuality can be particularly problematic following breast carcinoma, there has been an increased focus on quality of life concerns in breast carcinoma research.10

Bias

Minimum bias will occur as patients will be randomly selected based on the exclusion and inclusion criteria.

Ethical considerations

The studies involving human participants were reviewed and approved by the institutional Ethics Committee of Datta Meghe Institute of Higher Education and Research (Deemed to be University) Wardha – 442107, Maharashtra, India.

Ref. No. DMIHER (DU)/IEC/2023/596

The study protocol will be explained to the participating subjects. Further, a written informed consent form will be obtained from the participants.

Expected outcome

We expect to find a low level of awareness of breast carcinoma among females in Wardha district, India. Factors such as age, education, and family history of breast cancer may be associated with breast carcinoma awareness. We also expect to find that the primary source of breast carcinoma information among females is healthcare professionals.

Implications

The findings of this study will provide insight into the level of breast cancer awareness among women in Wardha district, India. This information can be used to develop targeted health education programs to improve breast cancer awareness and promote early detection and treatment.

Conclusion

For early identification and treatment of breast carcinoma, which is a major public health issue in India, increased knowledge is crucial. Examining females’ knowledge about breast carcinoma in India's Wardha area is the goal of this study. The results will be valuable in creating strategies to increase breast carcinoma awareness and enhance female health outcomes. Breast carcinoma is the most common malignancy in women worldwide and the second major cause of carcinoma death in women. All forms of cancer, regardless of their origin, are caused by this unbalanced cell proliferation that gives rise to tumours and lesions. A destructive carcinoma that originates in the breast cells is called breast carcinoma. Cancer manifests itself when cells in a certain body component start to grow out of control.

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Banmare S and Mude G. Awareness regarding breast cancer among the female population in Wardha District [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2023, 12:1223 (https://doi.org/10.12688/f1000research.135123.2)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Open Peer Review

Current Reviewer Status: ?
Key to Reviewer Statuses VIEW
ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 2
VERSION 2
PUBLISHED 09 Nov 2023
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Reviewer Report 10 Apr 2024
Swagata Brahmachari, Department of Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India 
Approved with Reservations
VIEWS 3
Well-written article.
To summarise, the study protocol will assess the awareness of female patients in Wardha District regarding breast carcinoma in 2023. It is a cross-sectional observational study that will require a validated questionnaire filled out by the investigator ... Continue reading
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HOW TO CITE THIS REPORT
Brahmachari S. Reviewer Report For: Awareness regarding breast cancer among the female population in Wardha District [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2023, 12:1223 (https://doi.org/10.5256/f1000research.158630.r251479)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Reviewer Report 30 Nov 2023
Dong-Dong Wu, Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, Henan, China 
Approved
VIEWS 5
... Continue reading
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CITE
HOW TO CITE THIS REPORT
Wu DD. Reviewer Report For: Awareness regarding breast cancer among the female population in Wardha District [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2023, 12:1223 (https://doi.org/10.5256/f1000research.158630.r221785)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Version 1
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PUBLISHED 27 Sep 2023
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Reviewer Report 01 Nov 2023
Dong-Dong Wu, Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, Henan, China 
Approved with Reservations
VIEWS 15
The manuscript by Shraddha Banmare et al., “Awareness regarding breast cancer among the female population in Wardha District”, demonstrated that a cross sectional study will be performed among Wardha district women to assess the awareness of breast carcinoma. Awareness will be ... Continue reading
CITE
CITE
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Wu DD. Reviewer Report For: Awareness regarding breast cancer among the female population in Wardha District [version 2; peer review: 1 approved, 1 approved with reservations]. F1000Research 2023, 12:1223 (https://doi.org/10.5256/f1000research.148226.r218910)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • Author Response 18 Jun 2024
    Shraddha Banmare, Clinical Research, School of Allied Health Sciences, Datta Meghe Institute Of Higher EducationEducation And Research, Wardha, India
    18 Jun 2024
    Author Response
    respected sir/Madam
    I Given all response
    Competing Interests: No competing interests were disclosed.
COMMENTS ON THIS REPORT
  • Author Response 18 Jun 2024
    Shraddha Banmare, Clinical Research, School of Allied Health Sciences, Datta Meghe Institute Of Higher EducationEducation And Research, Wardha, India
    18 Jun 2024
    Author Response
    respected sir/Madam
    I Given all response
    Competing Interests: No competing interests were disclosed.

Comments on this article Comments (0)

Version 2
VERSION 2 PUBLISHED 27 Sep 2023
Comment
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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