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A Study on Knowledge, Attitude and Practices on Breast Self-Examinations among Women

of Reproductive Age in Purok 14, Canaway, Iligan City 

BACKGROUND / SIGNIFICANCE OF THE STUDY:

Philippines has the highest incidence of breast cancer in the continent and an estimated 3 out of

100 Filipino women will contract the disease before age 75; 1 out of 100 will die before age 75, according

to the Philippine Society of Medical Oncology in 2013. This complements the Department of Health and

Philippine Cancer Society, Inc. report, which states that breast cancer is the most common cancer in the

country, comprising 16 percent of the 80,000 new cancer cases in 2010. Breast cancer has overtaken lung

cancer as the most prevalent form of cancer in the country.

With these distressing statistics, PSMO emphasized the importance of women checking their breasts for lumps every month and to have them checked by their physicians annually. Early detection isstill considered the best weapon in combating the disease. Routine self-breast examinations,

mammograms and vigilance in observing changes in the physical form of the breasts and nipples are keysto preventing the disease from advancing. Other factors in lowering one’s risk are limiting alcohol intake,

no smoking, controlling one’s weight, exercising, limiting the dose and duration of hormone therapy, andthe avoidance of exposure to pollution and radioactive substances. Also among the many advantages of

 breastfeeding is that it lowers incidence of breast cancer. The earlier the cancer is detected, diagnosed,and treated by the team of medical oncologists the better the success rates. Treatment for early breast

cancer, stages 0-3, is very important in terms of survival (PSMO, 2013).

Though the risk of breast cancer for younger women is lower, it is an apparent risk throughoutevery woman’s lifetime.  Health prevention habits should be encouraged throughout every woman’slifespan, in particular breast self-examinations (BSE) and clinical breast examinations (CBE). Habits tend

to be easier to establish and maintain earlier in life; practicing breast cancer screening behaviors in a

woman’s 20’s may carry through her lifetime. The American Cancer Society has developed breast cancerscreening guidelines for every stage of a woman’s life (American Cancer Society, 2007).

A national campaign of breast cancer awareness month in October, publicizing statistics,

education, and treatment, has increasingly become the focus of media attention each year. As breastcancer becomes part of the public consciousness, there seems to be a lack of perceived susceptibility,one’s belief of the chance of getting breast cancer,  especially for young women. This is in part becausethe risk of getting breast cancer in young women is relatively low compared to postmenopausal women

(Murphy, 2003).Young women’s perceived susceptibility to breast cancer and the seriousness of breast  cancer is low.

The purpose of this study is to report the breast cancer screening knowledge  and behaviors of

women of their reproductive age. Descriptions of breast cancer, extent of the problem, risk factors, population specific factors, and prevention and early detection will also be discussed.

REVIEW OF RELATED LITERATURE:

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The American Cancer Society recommends that women under 40 years of age have a clinical breast examination (CBE) every three years and have breast self-awareness or optional monthly breast

self-examination (BSE). Furthermore, according to the Centers for Disease Control and Prevention(CDC), breast cancer screening behaviors can be and need to be improved upon (Behavioral Risk FactorsSurveillance Survey, 2001a; & 2001b). Among women 40 years of age and older, 9 percent have neverhad a clinical breast examination (CBE; Behavioral Risk Factors Surveillance Survey, 2001). Upon

further examination, 18 percent of the previously stated population had not had a mammogram within the previous two years. (Behavioral Risk Factors Surveillance Survey, 2001). Bottom et al. (2006) examinedtrends for breast cancer risk of females 15-29 years of age. It was found that general breast cancer riskfactors included age, reproductive history, personal or family history, and environmental exposure tocarcinogens. It was noted, however, that caution should be taken when associating family history of breastcancer with breast cancer risk; only five percent of breast cancer is hereditary.

STATEMENT OF THE PROBLEM:

1. To what extent is reproductive-aged women routinely conducting breast self-examinations (BSE)?

2. How do demographic factors (i.e., personal and/or family history, knowledge level, age, etc.) affect the breast self-examinations knowledge, attitude and practices among women of reproductive age?

OBJECTIVES OF THE STUDY:

To determine reproductive-aged women breast self-examinations knowledge, attitude and practices.

Specifically, this study aims to:

Determine if there is a relationship between socio-demographic profile and breast self-

examinations knowledge, attitude and practices.

METHODOLOGY

Design: Descriptive type

Sampling Method:

The population of interest for this research study is women of their reproductive age and are

 presently residing in Purok 14, Canaway, Iligan City.

Inclusion Criteria: Participant eligibility criteria include being female, of her reproductive age,

 being able to read, speak and write English or Tagalog, and being physically and mentally willing andable to complete a questionnaire.

Operational Definition of Terms:

1.  Breast Self-Examination (BSE) - Used to detect changes in breast tissue. Self-awareness is animportant aspect in BSE with appearance and feel of the tissue to detect changes.

2.  Women of Reproductive Age –  women aged 15 to 44 years.

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Statistical Analysis:

For the purpose of the study, descriptive statistics (frequency distribution and percentages) and

multivariate analysis will be employed. In order to carry out the latter, logistic regression will be used to

determine socio demographic variables that are associated with respondent’s breast cancer screening

 beliefs and practices. Correlations will be determined through Safrit and Wood (1995) correlation scales. 

BIBLIOGRAPHY:

American Cancer Society (2007a). Breast Cancer Facts and Figures 2007-2008. Atlanta: American Cancer Society. [ElectronicVersion]. p. 1-26.

American Cancer Society (2007b). Cancer Prevention and Early Detection Facts and Figures 2007. Atlanta: American Cancer

Society. [Electronic Version]. p. 1-2, 30-50. 

Behavioral Risk Factor Surveillance Survey (BRFSS). (2001a). Chronic disease indicators: Indicator definition for clinical

breast examination among women >=40 years. Centers for Disease Control and Prevention. [Electronic Version]. 

Bottom, K., O’Leary, M., Sheaffer, J., Phillips, M., Shu, X., & Arun, B. (2006).  Cancer epidemiology in older adolescents and young adults 15-29 years of age, including SEER incidence and survival: 1975-2000 (pp. 111-121). National Cancer Institute,

 NIH Pub. No 06-5767. Bethesda, MD 2006.

Champion, V. L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 73-87.

Champion, V. L. (1990). Breast self-examination in women 35 and older: A prospective study.  Journal of Behavioral Medicine,13(6), 523-539.

Champion, V. L. (2003). Breast self-examination: What now? [Electronic Version]. Oncology Nursing Forum, 30(5), 723-724.

Frankenfield, K. M. (2009). Health Belief Model of Breast Cancer Screening. Master’s Theses and Doctoral Dissertations, 7 -35.

Foxall, M. J., Barron, C. R., & Houfek, J. (1998). Ethnic differences in breast selfexamination practice and health beliefs.[Electronic Version]. Journal of Advanced   Nursing, 27 , 419-428.

Janz, N. K., Champion, V. L., & Strecher, V. J. (2002). The Health Belief Model. Health Behavior and Health Education:Theory, Research, and Practice 3rd Edition (pp.45-66). Jossey-Bass. San Francisco, CA 2002.

Murphy, E. (2003).  Fighting for our Future: How Young Women Find Strength, Hope, and Courage While Taking Control of Breast Cancer . New York: McGraw-Hill. 

Philippine Society of Medical Oncology, 2013. Retrieved from www.psmo.org.ph/cancer awareness (September, 2014).

QUESTIONNAIRE

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Name: 

Age:

Marital Status:

Religion:

Educational Attainment:

Occupation:

Part II. Place a check ( ) on the box provided.

Knowledge on Breast Self-Examinations:

No. Question YES NO

1 Have you heard of cancer of the breast?2 Can it be detected early?

3 Can early detection increase the chances of survival?

4 Who should perform BSE?

-Male and Female Individual-Female Only

5 At what age should BSE begin?

-Less than 19 yrs-19 yrs and above

6 How often should BSE be performed?-Weekly

-Monthly-Yearly

7 When should a woman perform BSE?-Anytime of the month

-Within 5 days after each menstruation

Attitude on Breast Self-Examinations:

No. Question YES NO

1 Do you think BSE is necessary?

2 Have you done BSE before?

If YES, why?I might have breast cancer in the future.

To examine my breast regularly.Check progression of any lump.

Doctor’s advice Breast pain

 Nipple discharge

Feeling of a massBreast cancer in the family

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  If NO, why?I don’t know to do it. I don’t think it is important. I don’t believe in the efficiency of the test. 

I don’t have any symptom. I am scared of being diagnosed of breast cancer.

3 What do you think of BSE?-embarrassing-painful

-time-consuming

Breast Self-Examinations Level of Practice:

1. 

At what age did you start doing BSE?

a.  Less than 19 years old b.  Above 19 years

2.  What time do you usually do BSE?

a. 

Any regular day of each month b.  Within 5 days of each month

3.  When was the last time you performed BSE?a.  A week ago

 b.  A month agoc.  A year ago

4. 

Where was the examination done?a.  At home

 b.  Health center

c.  Hospital