A study on awareness of breast cancer and breast self-examination practices among women above 35 years of age in rural areas of Wardha District, Maharashtra: a protocol

Introduction

Cancer is a disease that causes the majority of fatalities worldwide.¹ Among women, breast cancer is a leading cause of death and a major health concern worldwide.² 2.1 million women globally are affected by this, the most prevalent cancer among women annually, and is expected to affect over 3.2 million new cases annually by 2050. Breast cancer is a disorder in which cells in the breast start locally and then spread, resulting in the development of a malignant tumor.^3,4 Self-examination of the breasts and research indicate that breast cancer is a widespread health issue and prevalent in all types of cancer and tumors in women worldwide, even in developed and undeveloped nations.^5,6

According to estimates, 8.3% of all fatalities in India are caused by cancer, which affects an estimated 2.25 million people. Between 1990 and 2016, the incidence and mortality of cancer more than doubled in India, significantly increasing the number of deaths and disability-adjusted life-years (DALYs).⁷

Breast cancer is the uncontrolled growth of unfavourable cells in the glands that produce milk in the breast or milk ducts, leading to the nipples.⁸ Breast self-examination (BSE), clinical breast examination, and physical examination of the breasts by a doctor or other licensed health care practitioners are some of the most important ways to detect breast cancer early. Mammography is one of the most important tools for this purpose. Breast self-examination is advised by the American College of Obstetricians and Gynaecologists (ACOG) for females, to report any changes and educate themselves on the benefits and limitations of breast self-examination (BSE). They also advised women to be conscious of their breasts.⁹ BSE is one of numerous screening techniques for the detection of breast cancer. Breast self-examination (BSE) can aid in the detection of lumps, tumours, cysts, and other abnormalities. Two or more are clinical evaluations and radiological analyses.¹⁰ is to reduce women’s breast cancer morbidity and mortality.¹¹ The most recent nationally available data indicate that breast cancer affects 100,000 women on average around the age of 33.21. If a woman lacks access to another screening technique such as mammography, it is helpful for her to self-examine her breasts before having a doctor look at them.¹² Women should begin self-examination of their breasts at the age of 20, even during pregnancy and beyond menopause.¹³

Women can use the BSE, a screening method at home. It is an easy, inexpensive, and straightforward technique. BSE enhances the likelihood that women will receive treatment, increasing their chance of survival for any physical or obvious changes, and allows women to examine their breast tissue using this simple, affordable, and simple procedure. Women may have received health information regarding the causes, prevention, and appropriate BSE treatment through hands-on seminars and handouts.¹⁴ Breast cancer at younger ages may be symptomatic of genetic abnormalities such as BRCA1/2. According to recent studies, BRCA mutations are more common than expected among African American 45 age group women, who are diagnosed with breast cancer. Women who seek genetic counseling can better understand their hereditary risk for breast cancer and decide whether genetic testing is necessary to identify hereditary linked genetic abnormalities.¹⁵

The breast self-examination gives each woman control over her health and awareness of how her breasts feel. BSE benefits women in two ways: first, it helps them become accustomed to how their breasts feel and appear, and second, it helps them identify any breast changes as soon as they can. According to research, 90% of the time, people learn that they have breast cancer. According to numerous studies, it is also possible to circumvent barriers to detection and treatment by taking advantage of and decreasing the awareness of breast cancer.¹⁶

Premenopausal women are frequently told to associate their “BSE day” with the beginning of their menstrual cycle. The only instruction given to postmenopausal women was to perform a self-examination on a specific date each month. The rules of the technique were established without considering the ideal.¹⁷ Therefore, increasing breast cancer awareness and breast self-examination (BSE) techniques can be effectively achieved in females through educational programs.¹⁸

Methods

Discussion

In 2015, Gangane et al. conducted a cross-sectional study on “Women’s Knowledge, Attitudes, and Practises about Breast Cancer in a Rural District of Central India” located in the Wardha district of Central India Maharashtra. The sample comprised 1000 women aged 13 to 50 years, and urban and rural women made up less than 7% of those who had heard about breast self-examination, according to the statistics, yet nearly two-thirds of these women knew about breast cancer. Women in both rural and urban areas have little understanding of breast cancer. Compared to their counterparts in rural areas, urban women exhibited more positive attitudes toward breast cancer screening treatments. Self-examination of the breasts is rarely done, although there is a lot of openness to learning. Positive screening attitudes offer the opportunity to encourage breast self-examination.²⁰

Akanksha Pal et al. Through their review-based study titled (2021) “Knowledge, Attitude, and Practise Towards Breast Cancer and Its Screening Among Women in India: A Systematic Review to learn how Indian women feel about breast cancer screening. Fifteen studies that included observational data were chosen, totaling 7545 women between the ages of 14 and 75 years. The study participants included medical professionals, women from rural and urban areas, and members of the public. The range of illiteracy among women was 5.6%–42.8%, and the majority of them were married. The estimated awareness of breast cancer is 62.99%. In the majority of studies under consideration, a connection was found between participants’ educational level, marital status, age, and knowledge of breast cancer.²¹

Dadzi R, Adam A (2019), A cross-sectional study on “Assessment of knowledge and practice of breast self-examination among reproductive age women in the Ghanaian Volta region’s Akatsi South area” 385 women between the ages of 15 and 49 made up the sample. Only 94 (37.2%) of the respondents practiced BSE and only 64.9% of those surveyed reported having adequate awareness of breast cancer, even though 88.3% of respondents knew about breast cancer. Over half of the interviewees were unable to execute the BSE.²²

Rumpa Sarker et al. (2022), “Effectiveness of educational intervention on breast cancer knowledge and breast self-examination among female university students in pre-post experimental research in Bangladesh,” This study evaluated the experiences of Bangladeshi young female students in the university. An educational intervention strategy was favorably received by people who were aware of breast cancer and had completed breast self-examinations. People who have conducted breast self-examinations and are aware of breast cancer react favorably to an educational intervention plan. After the educational intervention, there were discernible increases in the awareness and comprehension of BSE practices and breast cancer. The study’s results demonstrated that the study participants’ baseline knowledge and awareness were low; however, after receiving instruction, they significantly improved.¹⁸ Shubhangini Sachdeva et al. (2021). “Breast Self-Examination Knowledge, Attitude, and Practises Among Indian Women: A Pan-India Study” Despite becoming proficient with BSE, the respondents had a bad opinion of it and were reluctant to utilize it. In total, 54.4%, 15.1%, 21.3%, and 9.2% of respondents were from India’s north, south, west, and east regions, respectively.²³

Kumarasamy et al. (2017), The sample for the study, “Determinants of Awareness and Practice of Breast Self-Examination Among Rural Women in Trichy, Tamil Nadu,” consisted of 200 women. The study sample had a mean age of 36.9 ± 8.8 years. Literate individuals accounted for 80% of the total population. Of 178 women, 89% were aware of them knew about breast cancer.⁵