CHAPTER ONE

INTRODUCTION

Background of the Study

The term cancer was derived from the observation by Hippocrates in 400 B.C. that the veins radiating from a breast cancer resembled the legs of crab, hence referred to as “karkinoma” in Greek and cancer in Latin.

Cancer is not a single disease, but is many different diseases that all share common biological and pathological characteristics. In most Western societies, cancer is a leading cause of death. The disease may develop in any body tissue or organ and over hundred different types of cancer can occur in adults. Cancer also occurs in children and may even be present at birth Wilson (2007).

Breast cancer can’t be prevented but early detection of it can reduce its spread. Breast cancer is an abnormal growth of cells which tend to proliferate in an uncontrollable way and in some cases spread around the breast region of a woman. In other words, breast cells. Breast cancer is the most common cause of cancer related death among women worldwide, breast cancer account for 31% of cancer among women and 19% of death among women are due to cancer (Dermirkiran, 2012). Breast self examination is a step by step approach that a woman can use to look and feel her breast for any abnormal growth or lump. (Ertem, 2011).

According to Aburoma (2010), breast cancer is a major public health problem and one of the common types of cancer, affecting women today and accounting for one in every three cancer cases. Cancer is rising rapidly among the fast growing demographic group of Sub-Sahara African especially Nigeria breast cancer has witnessed a marked diminution in developed nations suggesting that the combination of early detection and improved treatment modalities would lead to overall survival of the patient.

The World Health Organization (2012) recommended breast self examination as an alternative, cost-effective screening method of women above 20 years of age. Breast self examination is a screening techniques that can be done at home to check for breast lumps. Breast self examination can help screen for tumors, cysts and other abnormalities in the breasts.

According to International Agency for Research on Cancer (2012), breast self examination is a routine examination that should be carried out at the same time each month to physically check for lumps and other changes.

Bundler (2009) stressed that the uterus, the breast under goes cyclic changes in response to hormonal stimulation each month, in rhythm  breast becomes engorged with fluid in anticipation of pregnancy and the woman may experience sensation of tenderness, lumpiness or pain. Monthly breast self-examination is the best method for dictating breast masses early.

Breast cancer is a global health issue and a leading cause of death among women internationally in India. It accounts for the second most common cancer in women around 80,000 cases are estimated to occurs annually.

The age standardized incidence rate of breast cancer among Indian women is 22.9 and the mortality rate 11.19 the present scenario roughly 1 in 26 women are expected to be diagnosed with breast cancer in their life time. PGOTZSCH (2003)

Breast cancer is distinguished from other types of cancer be the fact that it occurs in a visible organ and can be detected and treated at an early stage, the five (5) year survival rate reached 85% with early detection whereas later detection decreased the survival rate to 58% the low survival rates in less developed countries can be attributed to the lack of early detection as well as inadequate diagnosis and treatment facilities.

Recommended preventive techniques to reduce breast cancer mortality and morbidity include breast. Self examination (BSE), clinical breast examination (CBE), and mammography. Mammography require hospital visit and specialized equipment and expertise whereas breast self examination is an inexpensive tool that can be carried out by women themselves breast self examination benefits women in two ways: women become familiar with both the appearance and the feel of their breast and detect any changes in their breast as early as possible. In the literature, it is stated that 90% of the times breast cancer is first noticed by the person herself. Also several studies have shown that barriers to diagnosis and treatment can be addressed by increasing women’s awareness of breast cancer. Even though breast self examination is a simple, quick and cost free procedure, the practice of breast self examination is low and varies in different countries, like in England a study by Philip et al reported that only 54% of the study population practiced breast self examination, furthermore, in Nigeria, the practice of breast self examination ranged from 19% to 43.2% and in India, it varied from 0 to 52% Nelson, Tynek, Nalk et al (2009).

Several reasons like lack of time, lack of self-confidence in their ability to perform the technique correctly, fear of possible discovery of a lump, and embarrassment associated with manipulation of the breast have been cited as reason for not practicing breast self examination with this background, the present study was designed to determine the knowledge, attitude and practice regarding breast self examination in a school of Government Girls Secondary School Damaturu Female Students.

With the incidence of breast cancer rising and also absence of any established national breast screening in Damaturu it becomes important to assess the knowledge and practice of breast self examination in various age groups. The present study will involve groups. The present study involve female students (aged 15-24 years) as it can motivate them and instill in them preventive health behavior of practicing breast self examination regularly.

The etiology of breast cancer is multifactorial and studies have revealed significant interaction between endogenous (hormonal genetic) and exogenous (drugs/radiation) factors other factors like women’s age: parity, practice of late initiation of breast feeding oral contraceptives and hormone replacement therapy, high dietary fat, excessive alcohol consumption, positive family history, age at menarche, menopausal status age at first live birth, genetics mutations and benign breast diseases have also been cited. With regards to symptoms of breast cancer, bloody discharge from the nipple and presence of lump in breast are well known. Early diagnosis of breast cancer is of extreme significance in improving the survival rates and quality of life especially in low-income countries although awareness about breast cancer has been long advocated across the world unfortunately studies have revealed that a major proportion of women are still not aware of breast cancer. As discussed earlier, techniques such as breast self examination (BSE), clinical breast examination (CBE), and mammography have been advocated for bringing about a marked reduction in breast cancer associated morbidity and mortality. As compared to clinical breast examination and mammography which require hospital visit and specialized equipment/technical expertise, breast self examination is helpful in the regard that it is cost free, simple, and non-involve intervention carried out by women themselves.

Statement of the Problem

The incidence of breast cancer has been observed to be rising at an alarming rate, among the fast growing group of sub – Sahara African including Nigeria. Research has shown that breast cancer is the most common cause of cancer related death among women in underdeveloped, developing and developed countries. Studies like Dermirkiran et al (2007), Waugh (2010) has shown that the percentage of women who know how to perform breast self – examination is very low and that pose a point of concern in the health sector. Yet breast self – examination is cost effective and an alternative for early detection of breast cancer. In Yobe state Government Girls Secondary Schools Damaturu, most of the female students are above the age of 20 and therefore may be prone to breast cancer. Hence, the needs to carry out the research on the knowledge and practice of breast self examination in detection of breast cancer among female students with particular reference to Government Girls Secondary Schools Damaturu has necessitated the researcher for the choice of above definitions.

Purpose of the Study

The purpose of the study is to determine the knowledge and practice of breast self examination in detection of breast cancer among female students with particular reference to Government Girls Secondary Schools Damaturu. Specifically, the purpose seeks to:

i.                   To determine the level of knowledge towards breast self examination among female students in Government Girls Secondary Schools Damaturu.

ii.                 To find out the practice of breast self examination female students in Government Girls Secondary Schools Damaturu.

iii.              To ascertain the strategies that could be adopted to improve the practice of breast self examination among female students in the study area.

Significance of the Study

The finding from this research study will be of immense benefit to the students of the community and the society. The result shall serve as reference point for both local government area, state, for the purpose of formulating policies that will address the low level of awareness of breast self examination in detection of breast cancer in the local government area, state and the entire society at large. The findings would provide the scientific basis for health and breast self examination in detection of breast cancer among females generally.

The study would serve as a programme support and answer to the call for more research for measure to prevent breast cancer among female students, community health practitioners and the nation at large. The finding from this research study will be of immense benefit to the student of the community and society. The result shall serve as reference point for both local government area, state, for the purpose of formulating policies that will address the low level of awareness of breast self examination in detection of breast self examination in detection of breast cancer in the Local Government Area, state and the entire society at large.

The finding would provide the scientific basis for health and breast self examination in detection of breast cancer among females generally. The knowledge and practice of breast self examination help in early detection of any abnormalities may be cancer or not and may likely be cured at early stage (onset) and lead to attainment of good health and happy living among the student. Parent health practioners. Therefore the parent also need to acquire significance knowledge about breast self examination through awareness in order to monitor and control their girls to decrease the rate of morbidity and mortality of breast cancer for these the parent benefit touched their economic stability as far as the girls live healthy. The health care provider took advantages of having less over load work in the health facilities (three tiers). Breast cancer is the major public health challenges so government spend much on prevention and treasures about breast cancer. With these knowledge and practice awareness among the student, parent, community and the society at large assist the Government to have less budget in health sectors since awareness and information explored to know the health important which generate an adequate knowledge toward practices good hygienic practices.

Research Questions

i.                   What is the level of knowledge of female students toward breast self examination in Government Girls Secondary Schools Damaturu?

ii.                 To what extent is breast self examination being practiced among the female students in Government Girls Secondary Schools Damaturu?

iii.              What strategies could be adopted to curb the practice of breast self examination among female students in Government Girls Secondary Schools Damaturu?

Scope of the Study

This study is centered on the knowledge and practice of breast self examination in detection of breast cancer among female students. A case study of Government Girls Secondary Schools Damaturu, Yobe State.  

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