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					European Journal of Social Sciences – Volume 7, Number 3 (2009)



    Knowledge and Attitudes to Breast Cancer and Breast Self
         Examination Among Female Undergraduates
                     in a State in Nigeria

                                        A. G. Salaudeen
           Department of Epidemiology & Community Health, College of Health Sciences
                       University Of Ilorin, P.O. Box 4465, Ilorin, Nigeria
                             E-mail: adekunlesalaudeen@yahoo.com
                                      Tel: +2348036708106

                                         T. M. Akande
           Department of Epidemiology & Community Health, College of Health Sciences
                               University of Ilorin, Ilorin, Nigeria

                                           O. I. Musa
           Department of Epidemiology & Community Health, College of Health Sciences
                               University of Ilorin, Ilorin, Nigeria

                                               Abstract
     The incidence of breast cancer is rising more rapidly in population groups that enjoyed a
     low incidence of the disease. This is a descriptive epidemiological study on knowledge and
     attitudes towards breast cancer and breast self examination. The study was conducted at the
     University of Ilorin and Kwara State Polytechnic, Ilorin in Northern Nigeria. Systematic
     random sampling technique was adopted for subject selection. Self administered
     questionnaire was used as the data instrument. Seven hundred and fourty respondents were
     recruited for the study; however seven hundred respondents completed and returned the
     questionnaires and were analyzed.
             Six hundred and eighty two (97.2%) respondents had ever heard of breast cancer.
     Electronic and print media were the commonest first source of information on breast cancer
     mentioned by the respondents. The knowledge of the respondents about breast cancer was
     assessed and scored. Only two hundred and fifty seven (36.7%) had good knowledge of the
     cause of breast cancer among the respondents. Less than half (45.5%) of respondents had
     good knowledge of symptoms of cancer of the breast. Five hundred and twenty seven
     (75.3%) respondents viewed breast cancer as a frightful disease. Five hundred and seventy
     three (81.9%) respondents had heard of breast self examination. Most respondents did not
     know what to look for during breast self examination. Only 38.9% and 37.4% of
     respondents knew that during breast self examination it is necessary to check the size of the
     breast and colour. On the attitudes of respondents to breast self examination, only one
     hundred and twenty eight (18.3%) respondents care to seek for knowledge about breast self
     examination. Even though more respondents had heard of breast self examination, only two
     hundred and nine (29.8%) respondents claimed they know how to perform it.
             This study has demonstrated that majority of respondents were aware of breast
     cancer as a disease entity, but their knowledge and understanding of the disease was very
     low. Breast cancer awareness campaign is therefore necessary to improve early breast
     cancer detection.

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                                     European Journal of Social Sciences – Volume 7, Number 3 (2009)


     Keywords:       Knowledge, attitudes, breast cancer, breast self examination

Introduction
Carcinoma of the breast is one of the leading causes of death in women aged 30 years and above.1 It
reduces the life expectancy of the population at risk especially those between 31 and 50 years.2 Breast
cancer is becoming more common worldwide.1 The incidence of breast cancer is rising more rapidly in
population groups that enjoyed a low incidence of the disease.2 Breast cancer has become the
commonest malignancy (excluding skin cancers) in women worldwide.1 It has unfavorable prognosis
in women aged fourty years or younger.1 The knowledge and attitude towards breast cancer is so low
that majority of the affected patients present late in the hospital when little or nothing can be done
again.1
        Caucasians especially of North American descent seem to have the highest incidence of breast
cancer 3; however, reports from other parts of the world indicate an increasing incidence as the women
presumably adopt a “Western” lifestyle. In multi-ethnic societies, the incidence and mortality differs
among the various races giving the impression of certain constitutional or genetic factors. The black
woman presents late for treatment with a bigger mass and seems afflicted with a biologically more
aggressive tumour.
        There are a lot of epidemiological variation in the occurrence of breast cancer in the developed
and developing countries. The peak age of incidence of the disease in Nigeria is at least a decade
earlier compared to the Caucasians. Breast cancer is rare in men, being of the ratio of 1:100 compared
to women.4 It also tends to occur in hypogonadic males, and those with chromosomal abnormalities. In
Nigeria, 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 per cent of all breast biopsies done over a 10-year
period to be malignant.5 A report from Zaria described the mean age at presentation of breast cancer as
42 years with 30 percent occurring in women less than 25 years of age.6 At University College
hospital, Ibadan, 74 percent of breast cancer patients were pre menopausal.2 A ten year review of breast
cancer in Eastern Nigeria revealed that patient with breast cancer constituted 30 per cent of all patients
with breast disease and that 69% of these patients were pre-menopausal.7
        There is a lot of concern as to what to do for a woman once breast cancer is detected. In a
country like Nigeria, where the coverage of the population with health facilities is in a disequilibrium
state, and where radiotherapy is available in only a few centres. There is the need to address cancer
prevention strategies as we plan to check the communicable and nutritional diseases. Mammography as
a screening technique for breast cancer appears to have a more limited role in younger women with a
sensitivity of only 76%. 8 More so, this facility is not readily available in developing countries and the
cost of mammography for screening breast cancer is beyond the reach of most women in developing
countries especially in Nigeria.
        Studies have shown that breast self examination have a positive effect on the early detection of
breast cancer.9 The current recommendations by American College of Obstetricians and Gynaecologist
(ACOG) and the American Cancer Society are for breast self examination to be performed monthly
beginning at the age of twenty years and clinical breast examination annually beginning at age of
eighteen years.9
        This study assessed the knowledge and attitudes towards breast cancer and breast self
examination among female undergraduates in a State in Nigeria.


Methodology
This is a descriptive cross-sectional study on knowledge and attitude towards breast cancer and breast
self examination. The study was conducted at the University of Ilorin and Kwara State Polytechnic,
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European Journal of Social Sciences – Volume 7, Number 3 (2009)

Ilorin in Kwara State Nigeria. The female students of the two institutions living in the hostels were
considered for the survey. The total population of female students living in the hostels were 2000 and
800 at the University of Ilorin and Kwara Polytechnic respectively. The sampling frame was obtained
from the Chief Porter of the two institutions. Students were identified by names, number on the
sampling frame, room numbers and the hall of residence. Systematic random sampling technique was
adopted for subject selection. The sampling fraction and sampling interval were determined. Consent
was sought for participation in the survey. Those students who declined participation were replaced by
the next person in the sampling frame. Seven hundred and forty were recruited for the study. In all a
total of 700 students responded for the study.
         Self administered questionnaire was used as data instrument for the survey. The data instrument
contained relevant questions on socio-demographic characteristics, knowledge and the attitudes of the
respondents towards breast cancer and breast self examination. The questionnaire was pre–tested at
Kwara State College of Education, Ilorin where the questionnaires were administered on 30 students
and necessary corrections were done thereafter.
         Questions to assess the knowledge about breast cancer were asked and the total maximum score
for the knowledge questions was 12 and the scores were categorized as follows:
         0-4 marks = poor knowledge
         5-8 marks = fair knowledge
         9-12 marks = good knowledge
         The data generated on the questionnaires were numbered and validated manually for errors and
entered in to the computer for analysis using Epi-Info version 6.4 software package on the computer.


Results
The age of the respondents ranged from 16 years to 28 years with the mean age group of 20-21 years
and the modal age group was 20-21 years. One hundred and sixty nine (24.2%) respondents were
married and five hundred and thirty one (75.8%) were single. Two hundred and twenty one (31.5%)
were in their first year of study, one hundred and sixty one (23.0%) in second year of study while one
hundred and seventy five (25.0%) and one hundred and forty-three (20.5%) were in third and final year
respectively.
        Six hundred and eighty-two (97.2%) had ever heard of breast cancer, while eighteen (2.6%) did
not hear of it. On the first source of information about breast cancer 221 (31.6%) of respondents
mentioned television, 166 (23.7%) mentioned print media and only 102 (14.6%) identified health
workers as first source of information on breast cancer. Ninety respondents (12.8%) mentioned radio,
75 (10.7%) identified friends and 28 (4.0%) reported relation as first source of information on breast
cancer.
        The knowledge of the respondents about breast cancer was assessed and scored. About the
cause of breast cancer, 200 (28.6%) had poor knowledge, 243 (34.7%) had fair knowledge while 257
(36.7%) had good knowledge of the cause of cancer of the breast. Two hundred and eighty nine
(41.3%) of the respondents scored poor, 145 (20.7%) scored fair and 266 (38.0%) had good knowledge
about the age of occurrence of breast cancer. On symptoms of breast cancer, fifty nine (8.4%) had poor
knowledge, three hundred and twenty three (46.1%) had fair knowledge and three hundred and
eighteen (45.5%) had good knowledge of symptoms of cancer of the breast. Assessment and scoring of
respondents on treatment options available for patients with breast cancer was done. Ninety-five
(13.6%) respondents had poor knowledge, one hundred and fourty seven (21.0%) had fair knowledge
and four hundred and fifty eight (65.4%) had good knowledge of treatment modalities available for
patients with breast cancer.
        Four hundred and ninety-five respondents (70.7%) knew that there are warning signs of breast
cancer, one hundred and sixty-one (23.0%) did not know, while fourty-four (6.3%) mentioned that
there are no warning signs of breast cancer. Five hundred and thirty-seven (76.7%) respondents had

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                                    European Journal of Social Sciences – Volume 7, Number 3 (2009)

heard of mastectomy (removal of breast by operation) previously and one hundred and sixty-three
(23.3%) did not hear of mastectomy. Five hundred and twenty-two (74.6%) respondents knew that late
presentation of breast cancer to hospital can lead to death, however ninety-nine (14.1%) of them did
not know, while seventy nine (11.3%) mentioned that late presentation to hospital could not cause
death.
        Five hundred and twenty seven (75.3%) respondents viewed breast cancer as a frightful disease,
one hundred and twenty nine (18.4%) did not agree that breast cancer is a frightful disease and fourty-
four (6.3%) did not know whether it is a frightful disease or not. Two hundred and ninety-six (42.3%)
respondents believed that there is no cure for breast cancer while four hundred and four (57.7%) of
them believed that it is a curable disease. Six hundred and fourty-nine (92.7%) respondents mentioned
that they will consult health worker or doctor if breast lump is detected, thirty-two (4.6%) of them will
see traditional healer, while nineteen (2.7%) respondents will engage in prayer. Two hundred and
twelve (30.3%) respondents were willing to undergo mastectomy if required, two hundred and eighty
five (40.7%) will not undergo mastectomy if required and two hundred and three (29.0%) were
undecided on willingness to undergo mastectomy. Two hundred and seventy-nine (39.9%) respondents
were willing to undergo mastectomy if it is the only treatment option for them to remain alive, four
hundred and twenty-one (60.1%) will not undergo mastectomy even if it is the only treatment option
available.
        Five hundred and seventy-three (81.9%) respondents had heard of breast self examination,
while one hundred and twenty-seven (18.1%) never heard of breast self examination. On the first
source of information about breast self examination 165 (23.6%) respondents mentioned television,
105 (15.0%) mentioned print media and 130 (18.6%) identified health workers as first source of
information on breast self examination. One hundred and twenty eight respondents (18.2%) mentioned
radio and 45 (6.5%) identified friends as first source of information on breast self examination. Many
respondents knew that one of the thing to look for during breast self examination is the presence of
lump in the breast, this was the view expressed by 447 (63.8%) respondents. Two hundred and
seventy-two (38.9%) respondents mentioned changes in the nipple as one of the things to look for
during breast self examination. Checking the size of the breast and discolouration were mentioned by
two hundred and sixty-two (37.4%) and two hundred and sixty-seven (38.1%) respondents
respectively. On the attitudes of respondents to breast self examination, only one hundred and twenty-
eight (18.3%) respondents care to seek for knowledge about breast self examination, others 572
(81.7%) did not bother to know more on breast self examination. Even though more respondents had
heard of breast self examination, only two hundred and nine (29.8%) respondents claimed they know
how to perform it. Three hundred (42.8%) respondents believed that it is necessary to perform breast
self examination but only one hundred and eighty (25.7%) respondents thought there is need to find
time for breast self examination.


Discussion
The age of the respondents ranged from 16 years to 28 years. The mean and modal age group was 20-
21 years. This age pattern is consistent with the 6-3-3-4 educational system in Nigeria. The study was
appropriate in this age group as most of them were young adults who should find out more information
on breast cancer and breast self examination before they reach the age of common occurrence of the
disease. Most of the respondents (97.2%) in this survey were aware of breast cancer. Similar findings
were reported in studies conducted in other regions of Nigeria where 97% and 92% of the respondents
were aware of breast cancer as a disease entity.10. 11, 12 The awareness of breast cancer among the
respondents could be attributed to the level of education of the respondents who are in tertiary
institutions and are opportuned to obtain information from various sources.
         The major source of information about breast cancer was electronic media in the study. Of
these electronic media, television (31.6%) was the commonest first source of information. Similar

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observation was reported in Eastern state of Nigeria where 38.8% of the respondents’ first source of
information on breast cancer was the electronic media.10 The respondents had opportunity and access
to these electronic media and watch television while in school and at home. The least reported primary
source of information on breast cancer in the study was relation of the respondents (4.0%). This is one
of the gaps existing in family life education as parents and care givers have no time to discuss pertinent
health issues with their children. It might also be due to the fact that some of the parents have no
information or knowledge on some of these topics and as such have little or nothing to discuss. These
findings differ from what is reported on family communication among higher school students in Ilorin
where 79.7% had family communication on HIV/AIDS.13 The observed difference in communication
is influenced by educational levels of parent and the pandemic nature of HIV/AIDS. Few (14.6%)
respondents mentioned health workers as first source of information. One would have expected more
respondents to know about breast cancer from health workers and other studies have shown that
doctors and nurses are in a better position to discuss screening with women, but they were not
effectively using the opportunities to educate women to increase their knowledge and change their
attitude towards breast cancer screening.14, 15 However, it is possible that the respondents in these
studies might not consider the profession of the personnel giving the information in some of these
sources.
        The knowledge of respondents about the cause of breast cancer was low. Only 36.7 percent of
the respondents had good scores on knowledge of the cause of breast cancer. Some of the respondents
had poor scores because of the belief that breast cancer was caused by infectious agents. This
observation is consistent with study conducted in Eastern Nigeria where 35.5% of respondents could
not tell whether or not cancer of the breast was infectious and 7.0% actually thought it was.12 This
showed that awareness is different from knowledge as many respondents were aware of the disease.
        The knowledge of respondents about presence of warning signs of breast cancer was high as
majority of them in this survey (70.7%) were aware of the presence of warning signs of breast cancer.
This finding is at variance with the study conducted in Port Harcourt, Nigeria where only 48.2% of
respondents knew about the presence of warning signs of breast cancer.16 The difference in the
knowledge of presence of warning signs of breast cancer between the two studies could be explained
by the educational level of the respondents in this study who were mainly University students whereas
the respondents in Port Harcourt study were lower in educational status.
        Despite the fact that majority of respondents in the study were aware of breast cancer, the
knowledge and understanding of the respondents about the disease was very low. Majority of
respondents did not know the common age of occurrence of the disease. Only 38.0% of the
respondents had good scores on knowledge of common age of occurrence of breast cancer and
identified that the disease commonly occur in adult age. More than two-fifth (41.3%) of respondents
had poor scores on knowledge of common age of occurrence as they wrongly believed it could occur at
childhood and any age. This demonstrated the need for health education programmes on breast cancer
in the study population.
        Early presentation of breast cancer to hospital not only increases chances of survival and better
prognosis but patient could be cured of the disease. Among the respondents in the study, 57.7%
believed that breast cancer could be cured at late stage. This finding was similar to the study conducted
in Port Harcourt, Nigeria where 66.4% erroneously believed that the disease was curable at any stage
of presentation.16 Most patients believed that as long as pain is not present in the course of an illness
then there is no problem. The knowledge of symptoms of breast cancer such as breast lump, breast
ulcer, breast swelling and nipple discharge was assessed. Less than half of respondents (45.5%) had
good scores on the knowledge of symptoms of breast cancer. This further strengthened the need for
breast cancer educational programmes. However, this observation differ from what Nwagbo and
Akpala10 observed in a study of attitude of women to breast disease in Eastern Nigeria where only
30.0% of respondents knew that breast cancer can present with a lump. The discrepancy could be
explained by the low educational level of the respondents in Eastern Nigeria study compared to the

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respondents in this study, as they are mainly literate population and able to obtain information about
breast cancer from various sources. Knowledge of symptoms of breast cancer is important in ensuring
that women present early at health care facilities for diagnosis and treatment. The findings in this study
in which less than half of respondents had good knowledge scores of symptoms of breast cancer is
corroborated in another study.16
        The respondents’ knowledge about the treatment options of breast cancer showed that some of
the respondents were aware of treatment modalities of breast cancer. Surgery, chemotherapy and
radiotherapy were the treatment options identified by respondents. About two-third of respondents
(65.4%) had good scores of knowledge of treatment options of breast cancer. The respondents’
knowledge in this study was high compared with report from Oyeka and Ezeama in Nigeria where
26.7% of the study group believed that mastectomy is the only treatment option and 54.9% remained
silent on the treatment option12. This finding was anticipated because respondents in this study are
literate and able to obtain information from electronic and print media and friends who are also
educated.
        Among respondents, about three-quarters (75.3%) viewed breast cancer as a frightful disease.
However, in another study conducted in Nigeria only 41.8% of the study population believed the word
breast cancer portrayed a frightful disease.16 The disparity in this study can be explained by the age of
respondents in the two studies as younger age group was involved in this study and as such they might
have not being exposed to a lot of challenges in life. Predictably, many of respondents (92.7%) would
report to doctor or other health care professionals if lump were detected in the breast. The observation
was because respondents are literate, informed and educated enough to take actions for their health.
Less than 5.0% of them would result to alternative therapy and prayers.
        Information about what mastectomy is was high among the respondents in this survey, as
76.7% of them had heard of mastectomy previously. In a similar and comparative observation, a study
conducted in Nigeria revealed that 65.2% of the respondents had heard about mastectomy.16 This
observation will not be unconnected with educational level of respondents who are undergraduates and
well informed. The challenge to undergo surgery is not readily accepted in our society especially
mastectomy which involves loss of body parts, therefore it is not unexpected that only 30.3% of the
respondents were willing to undergo mastectomy if affected by breast cancer. However, this finding
was contrary to observation reported in another study where 62.9% of respondents agreed to accept
mastectomy for possible breast cancer12. The age group of the subjects could explain the variance in
observation. The respondents in another study were older than the respondents in this study and the
young ladies in this study who are in active sexual age may find it difficult losing their breast and
therefore will not readily agree with loss of breast at surgery.
        Similar observation was recorded even when the respondents were asked whether they would
be willing to undergo the surgery if mastectomy is the only treatment option. Among the respondents,
39.9% indicated ‘yes’. Of course it is not surprising that some respondents considered it non-feminine
to have one breast or lose both, few considered it unacceptable in the society while others emphasized
on the psychological effect after surgery.
        Breast self examination is one of the screening technique for early breast lump and cancer
detection. Majority of respondents (81.9%) in the survey had heard about breast self examination.
Similarly, in a study conducted in Port Harcourt, Nigeria 73.3% of the studied population had heard
about breast self examination.16 Twenty three point six percent of the respondents in the study first
heard of breast self examination from television while 18.6% and 18.2% first heard of breast self
examination from health workers and on radio programmes respectively. This is expected, as the study
population is literate and listens to radio programmes, watch television and interact with health
workers when confronted with problems.
        About what to look for on breast self examination, majority of the respondents who had heard
of breast self examination in the study knew that lump (63.8%), changes in size (37.4%), changes in
the nipple (38.9%) and colour (38.1%) will be checked during breast self examination. This revealed

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the low level of knowledge of respondents on breast self examination. It is apparent from this finding
that practice of breast self examination is not done or done wrongly by many respondents because of
the knowledge gaps on what to do. Again, this further revealed that although many respondents are
aware of breast self examination, the necessary information in the practice of it is lacking.
        The gaps in knowledge on breast self examination culminated in poor attitudes of respondents
to breast self examination. Less than one-fifth (18.3%) of respondents cared to seek for knowledge on
breast self examination. This showed that many respondents still believed that breast cancer is a rare
disease and that they can never be affected by it. It is imperative to know that only 29.8% of
respondents claimed they know how to perform breast self examination. It will not be surprise if during
practical demonstration many respondents who claimed to know how breast self examination is done
will later realized that they did not know how breast self examination is performed. Less than half
(42.8%) of respondents believed that it is necessary to perform breast self examination. This showed
that the level of concern about screening for breast cancer is still low among the respondents. Only
one-quarter (25.7%) of respondents thought there is need to find time for breast self examination; this
demonstrated that limited attention is given by the young adults in this study to check their breast for
early onset of lump and other symptoms of breast cancer.
        Most respondents had heard of breast cancer as a disease entity but the knowledge and
understanding of the disease was very low. Few respondents were willing to undergo mastectomy for
possible breast cancer as they considered it non-feminine to have one breast or lose both and some
considered it unacceptable in the society while others emphasized on the psychological effect after
surgery. Very few respondents cared to seek information on breast self examination. There is need for
further study to address the knowledge gaps on breast cancer and breast self examination so that
positive attitudes can be developed by the young adults to breast self examination.




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[1]    Haris JS, Lippman ME, Veronesi U, Willett W. Breast Cancer N.Engl J. Med 1992; 327: 319 –
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[2]    Adebamowo CA, Adekunle OO. Case controlled study of the epidemiology risk factors for
       breast cancer in Nigeria. British Journal of Surgery 1999; 86: 665 – 668.
[3]    Parkin DM, Muir CS, Whelan SL, Gao Y, Ferlay J, Powell J. Cancer incidence in five
       continents. IARC Scientific Publication 1992;6:120-124
[4]    Donegan WL, Redlich PN, Lang PJ. Carcinoma of the breast in males: a multi-institutional
       study. Cancer 1998; 83:498-509.
[5]    Mathew J. The pattern of Breast diseases among Nigerians-The Lagos University Teaching
       Hospital Experience . A Histopathological Survey,1978-1987. Fellowship Thesis, National
       Postgraduate Medical College of Nigeria, Faculty of Pathology, 1988.
[6]    Khwaja MS, Nirodi NS, Lawrie J. Malignant tumours of the breast in Northern Savannah of
       Nigeria. East Afr. Med.J 1980; 57:555-561
[7]    Anyanwu SNC. Breast cancer in Eastern Nigeria: A ten year review. West African Journal of
       Medicine 2000;19:120-125.
[8]    Solanke TF. An overview of cancer in Nigeria. Report of the Workshop on state of the Art of
       Oncology in Ibadan and Ife. Ibadan, National headquarters of cancer Registries in Nigeria.
       1996: 7-12.
[9]    Baines CJ. Breast self examination. Cancer 1992;69:1942
[10]   Nwagbo DF, Akpala CO. Awareness of breast cancer and breast self examination among
       women in Enugu urban, Eastern Nigeria. J. Coll. Med. 1996; 1: 34-36.
[11]   Ekanem IA, Etukudo MH. Cancer information survey among students in Calabar University
       and School of Nursing, UCTH, Calabar, Nigeria. Nig. Med. J. 1990;20: 32-34.
[12]   Oyeka ICA, Ezeama MM. Breast cancer: Information gap among female school teachers in
       Nigeria. Orient Journal of Medicine 1997; 9: 18-22.
[13]   Musa OI, Akande TM, Salaudeen AG, Soladoye OM. Family communication on HIV/AIDS
       among secondary school students in a Northern State of Nigeria. Afr. J. Infect. Diseases 2008;
       2(1):1-5.
[14]   Van Parijs LG, Public education in cancer prevention. Bulletin of the World Health
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[15]   Adelusola KA, Fadiran OA, Adesunkanmi ARK, Odesanmi WO. Breast Cancer in Nigeria
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[16]   Uche EEO. Awareness of Breast cancer. Nigerian Journal of Surgical Sciences 1998;8:27-28.




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Table 1:        Respondents’ first source of information about breast cancer and BSE

                                            Breast Cancer                                   BSE
 Sources of information
                                            Frequency (%)                              Frequency (%)
 Television                                   221 (31.6)                                 165 (23.6)
 Print media                                  166 (23.7)                                 105 (15.0)
 Health worker                                102 (14.6)                                 130 (18.6)
 Radio                                         90 (12.8)                                 128 (18.2)
 Friends                                       75 (10.7)                                  30 (4.3)
 Relation                                      28 (4.0)                                    15 (2.2
 None response                                 18 (2.6)                                  127 (18.1)
 Total                                        700 (100)                                  700 (100)

Table 2:        Knowledge about breast cancer

                                                      Freq (%)
 Knowledge/scores                         Poor                       Fair                          Good
 Cause of breast cancer                200 (28.6)                  243 (34.7)                    257 (36.7)
 Age of occurrence                     289 (41.3)                  145 (20.7)                    266 (38.0)
 Symptoms                               59 (8.4)                   323 (46.1)                    318 (45.5)
 Treatment options                      95 (13.6)                  147 (21.0)                    458 (65.4)

Table 3:        Respondents’ knowledge of what to look for during BSE* N=572

 what to look for in Breast self examination                                    Frequency (%)
 Lump                                                                             447 (78.0)
 Changes in the nipple                                                            272 (47.5)
 Size of the breast                                                               262 (45.7)
 Discolouration                                                                   267 (46.6)
 Others                                                                            35 (6.1)
*multiple response


Table 4:        Attitude to Breast Cancer

 Variable                                                                       Frequency (%)
 Necessity of BSE (N=700)
 Yes                                                                              402 (57.4)
 No                                                                               298 (42.6)
 Who to consult if breast lump is detected (N=700)
 Health worker/doctor                                                             649 (92.7)
 Traditional healer                                                                32 (4.6)
 Spiritual (prayer)                                                                19 (2.7)
 Willingness to have mastectomy (N=700)
 Yes                                                                              212 (30.3)
 No                                                                               285 (40.7)
 Undecided                                                                        203 (29.0)




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