Knowledge and Attitudes about Breast Cancer among Women: A Wake-Up Call in Nigeria

Management of BRCA-associated breast cancer patients in low and middle-income countries: a review

Breast cancer poses a significant global health challenge, with higher incidence rates in developed countries. However, low- and middle-income countries (LMICs) suffer from higher mortality rates due to various factors, including limited screening programs, delayed diagnosis and inadequate access to healthcare and advanced treatments. Approximately 5%-10% of breast cancer cases stem from germline mutations in BRCA-1/2 genes. A positive BRCA1/2 status obtained through genetic testing significantly influences surgical and medical treatment decisions. Therefore, genetic counseling, proper surveillance and customized interventions for BRCA1/2 carriers are essential to maximizing the benefits of monitoring, chemoprevention and risk-reducing surgeries for breast and ovarian cancers. Identification of BRCA mutations also impacts treatment strategies, leading to the integration of chemotherapeutic agents like platinum-based chemotherapy and PARP inhibitors. However, implementing these advanced treatment guidelines in LMICs with complex, fragmented and underfunded healthcare systems presents numerous challenges. In this review, we explore the current status and obstacles associated with managing BRCA1/2-associated breast cancer in LMICs.

Age-Stratified Assessment of the Impact of Breast Cancer Knowledge on the Lifestyle and Dietary Patterns Among Nigerian Females

PURPOSE

Breast cancer (BC) is a major cause of cancer-related mortality in Nigeria, which is exacerbated by a lack of understanding of how knowledge of BC risk factors influences the lifestyle and dietary patterns of Nigerians across age groups. This study evaluated the influence of knowledge of BC risks on lifestyle and dietary patterns across age groups, aiming to inform early management, prevention, and survival rates.

METHODS

A cross-sectional survey was conducted in Ota, Ado-odo, Ogun State, Nigeria, involving participants from six educational institutions. The study assessed knowledge of BC risks factors and lifestyle/dietary habits using questionnaires. Results were analyzed using Epi Info software and SPSS version 20.

RESULTS

The participants' age ranged from 13 to 60 years, with a mean of 21 years. The age categories of the participants were 75.24% adolescents (13-19), 18.68% young adults (20-40), and 6.08% middle-aged (41-60). Middle-aged individuals had the least knowledge about smoking (7.58%), alcohol (26.09%), antibiotics (7.25%), and red meat/smoked foods (20.09%), which translated into their poor dietary/lifestyle patterns. Young adults showed profound physical inactivity (71.00%), while adolescents consumed more carbonated drinks (71.53%), which corresponded to lack of knowledge about the effects of physical inactivity (10.85%) and consumption of carbonated drinks (13.70%) on BC risk.

CONCLUSION

The study found that understanding BC risk factors directly affects lifestyle and dietary patterns. Age groups with higher knowledge had better lifestyle/dietary patterns. This highlights the need for a tailored intervention on lifestyle and dietary education across all age groups, especially the middle-aged, so as to inform a deliberate adjustment in lifestyle and dietary habits, which play crucial roles in BC incidence, survival, and prevention.

Measurement properties of the Iranian version of the breast cancer perception scale (BCPS) according to the COSMIN checklist

BACKGROUND

Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran.

METHODS

The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed.

RESULTS

The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response.

CONCLUSIONS

The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors.

Assessing nutrition-related knowledge, attitudes, and practices towards breast cancer prevention among female students at the Federal University of Oye-Ekiti, Nigeria

BACKGROUND

Breast cancer remains a complex disease and leading cause of cancer-related death in Nigerian women. Recently, the role of nutrition has been highlighted in the etiology of breast cancer.

METHODS

The aim of this research was to evaluate the nutrition-related knowledge, attitude, and practices of female university students. We also investigated the correlation between their demographic characteristics and their knowledge and attitudes of the survey participants. A descriptive cross-sectional study was carried out among female students at the Federal University of Oye (FUOYE), Nigeria. Participants completed self-administered questionnaires designed to assess their knowledge, attitude, and practices concerning cancer prevention. Statistical analysis was performed using SPSS 20, and significance was set at p < 0.05.

RESULTS

Out of the 402 students who received the questionnaire, 300 completed it. The average age of the participants was 21.26 years with a standard deviation of 2.68. There was generally limited knowledge regarding breast cancer risk factors, with 45% of participants citing family history as the most recognized risk factor. Overall, knowledge level was influenced by the participants' permanent place of residence and course of study. Attitudes towards the impact of maternal and paternal nutrition on breast cancer prevention were notably low. Additionally, less than half of the participants demonstrated good dietary practices.

CONCLUSION

This study revealed low levels of nutrition-related knowledge concerning cancer prevention, accompanied by poor dietary habits among the participants. These results suggest a possible link between inadequate knowledge about breast cancer prevention and the observed poor dietary practices among the participants. The frequent consumption of unhealthy foods among the participants may be a pointer to higher risk of breast cancer in the future, emphasizing a need for health education targeted at this group.

Student nurses' practices and willingness to teach relatives breast self-examination in Nigeria

Background

Breast cancer is the most common cancer and the leading cause of cancer-related death for women worldwide. Breast self-examination (BSE) is an essential, low-cost, and simple tool for detecting breast cancer early. Employing the idea of 'charity begins at home' by involving student nurses in teaching BSE to relatives will improve early detection.

Aim

To assess nursing students' practice and willingness to teach BSE to their relatives.

Setting

A college of nursing and midwifery in one state under North-Central Nigeria.

Methods

A cross-sectional descriptive design was employed. Through incidental sampling technique 197 respondents were selected from the first to the third year. Data were collected using a structured questionnaire. Descriptive and inferential analyses, with a p-value of 0.05 were conducted.

Results

Respondents indicated where they learned about BSE. There were 98.5% respondents who had heard about BSE, and 89.8% of them had good practice of BSE. However, a quarter did not teach BSE to relatives. There were no statistically significant associations noted.

Conclusion

Most of the nursing students were aware of BSE and knew how to perform it, although a quarter did not teach BSE to their relatives. Therefore, it may be necessary to sensitise nurses to cultivate the habit of teaching BSE to relatives and women in the community.

Contribution

It is crucial to provide nurses with the skills and knowledge required to carry out BSE effectively, as well as teach women how to perform it on themselves, to improve breast cancer detection rates in Nigeria.

Awareness and practice of breast self-examination among female staff at Babcock University, Nigeria

Background

Despite the ever-growing breast cancer awareness campaigns in Nigeria, the practice of breast self-examination (BSE) continues to vary widely among women. We aimed to assess breast cancer awareness and practice of BSE among female staff at Babcock University, Ogun State, Nigeria.

Methods

The cross-sectional descriptive design was adopted for this study. Data were collected using a structured questionnaire administered to 160 respondents. Data analysis was done using Statistical Package for Social Sciences version 23.

Results

Although the majority of the respondents were highly aware of breast cancer (78.12%) and had good knowledge about BSE (96.9%), their practice of BSE was low. Only 11.3% always examine their breasts in the mirror by raising their hands over their head, looking at their breasts and examining it in a circular motion; 56% rarely looked for puckering, colour changes and dimpling of the skin when examining their breasts in the mirror, although 53.8% sometimes squeezed their nipples and looked for discharge when they examined their breasts.

Conclusion

Knowledge and positive opinions toward preventive strategies for breast cancer should not be interpreted as readiness for practice. Educational intervention programs emphasising the importance of early detection in managing breast cancer should be reinforced to birth the desirable change.

Assessment of breast cancer risk perception, knowledge, and breast self-examination practices among market women in Owo, Ondo State, Nigeria

BACKGROUND

Breast cancer (BC) is the leading cause of cancer death among women worldwide, and its incidence is increasing, particularly in low-medium-income countries (LMICs). Evidence shows that breast self-examination (BSE) is culturally acceptable, religiously friendly and inexpensive. This study assessed BC risk perception, knowledge and breast self-examination practices among market women in Ondo State, Nigeria.

METHODS

A descriptive cross-sectional survey was conducted among market women in 3 selected markets in Owo. A semi-structured interview-based questionnaire was used to collect data. The instrument consisted of five sections based on the objective of the study. Selection of the study participants was done using a multistage sampling technique. The test-retest method was used to determine the reliability of the instrument. Participants knowledge and practices were categorised into good (≥ 50% total score) and poor (< 50% total score) while risk perception was grouped into high (≥ 50% total score) and low (< 50% total score).Data were analysed using descriptive and inferential statistics at a p value < 0.05 for determining statistical significance.

RESULTS

A total of 335 respondents completed the study and the mean age ± S.D. was 37.19 ± 9.19 years (range: 18-65 years). 47.5% of respondents were Christian while 60.0% of the respondents were married. 15.5% had tertiary education, and more than two-thirds were from the Yoruba tribe. More than two-thirds (78.5%) of the participants stated that they practiced breast self-examination, while 58.5% reported to have been taught how to perform BSE. 75.8% agreed that the use of injectable contraception or oral pills can result in BC, while 75.8% also agreed that women of reproductive age are at risk of BC. Less than 50% mentioned that they were uncomfortable taking off clothes in front of health professionals during the examination. The perceived risk of BC showed that 221 (65.97%), and 114 (34.03%) of respondents had high, and low levels of perceived risk of BC, respectively. However, 184 (54.93%) and 151 (45.07%) of the respondents had good and poor knowledge. The majority (139, 41.49%) of the respondents had poor BSE practice. Age (p = 0.023), educational qualifications (p < 0.001), average income per month (p < 0.001) and ethnicity (p =  < 0.001) were statistically associated with knowledge of breast self-examination while religion (p = 0.02), marital status (p = 0.01), educational qualification (p = 0.001) and distance from facility (p = 0.009) were statistically associated with perceived risk of BC. Participants' educational qualification (p = 0.006) and ethnicity (p = 0.013) were statistically associated with practice of BSE. Good knowledge was also identified as a significant predictor of good practice of participants among the women (95%CI: 4.574 (2.841-7.365), p < 0.001).

CONCLUSION

This study identified high level of perception, good knowledge and good practice of BSE among majority of the market women in Owo Town. Interventions and extensive health education on BSE with the aim of creating positive awareness and understanding of BSE among the population should be encouraged.

The relationship between the fear of breast cancer, risk factors, and early diagnosis behaviors of women by age groups

PURPOSE

This study investigates the relationship between fear of breast cancer, risk factors, and early diagnosis behavior of women aged 20 or above.

METHOD

It is a descriptive cross-sectional study.

FINDINGS

It was found that 17.3% of the women conducted breast self-examination, 14.0% underwent clinical breast examination, and that 9.3% of them underwent mammography. The predictors regularly affecting early diagnosis behaviors were identified through logistic regression. Different predictors for breast cancer diagnostic behaviors were found in each age group.

PRACTICE IMPLICATIONS

This study is important in terms of taking into account the age factor in the practices aiming to increase the diagnostic behavior of healthcare personnel, especially nurses.

CONCLUSION

It was concluded that there were different predictors of breast cancer diagnostic behaviors in both age groups of the women in the study.

Breast Cancer Perception Scale: Psychometric Development Study

Objective

The Breast Cancer Perception Scale was developed using a well-supported theory, thought to be associated with breast cancer prevention behaviors. The aim of this study is to develop the Breast Cancer Perception Scale based on the Health Belief Model and conduct psychometric analysis.

Materials and Methods

The study was conducted with women aged 20 or above with a methodological design. The scale study was conducted with 572 women who were not diagnosed with breast cancer and willing to participate in the study.

Results

The results of the exploratory factor analysis revealed that the scale is made up of six sub-dimensions (perceived knowledge, perceived treatment belief, the perceived need for a health check, perceived stigma, perceived fear, perceived risk) and 24 items, which explain the 74.36% of the total variance. The model obtained from the confirmatory factor analysis was within the limits of the acceptable fit index and factor loads between 0.655 and 0.998. Cronbach's alpha reliability coefficient of the scale sub-dimensions was determined as 0.815-0.950.

Conclusion

The overall psychometric evaluation results of the Breast Cancer Perception Scale found it to be a valid and reliable instrument that can be associated with multi-dimensional cases, such as healthy life behaviors in women, breast cancer diagnostic behaviors, family history, traumatic experiences regarding breast cancer, and the level of breast cancer knowledge.

Moderating Role of Demographic Characteristics in Breast Cancer Awareness and the Behavioural Disposition of Women in Ogun State, Nigeria

BACKGROUND

Breast cancer incidence is fast increasing, posing a significant threat to the health of women of all races globally. In Nigeria, breast cancer causes the most cancer-related deaths among women each year as a result of inadequate awareness.

AIM

This study is aimed at examining the moderating role of demographic characteristics in facilitating breast cancer awareness among women, and how it relates to their behavioural disposition to the disease.

METHODS

The study adopted the descriptive (survey) and cross-sectional research designs to elicit information from women of adult age selected across five Local Government Areas in Ogun state. The data, collected through questionnaire were analysed through the use of a variance-based SEM Partial Least Square (PLS).

RESULTS

The result shows that demographic characteristics (age and education) has a significant positive effect and jointly explain 74.9% of the variance in the breast cancer awareness and behavioural disposition among women in the study area. The findings revealed that a significant number of women with breast cancer had not acquired useful knowledge that could potentially be used to diagnose, prevent, and manage the disease. Unfortunately, the practice of Breast Self-Examination is grossly low among Nigerian women, as a consequence, only 20-30% of the women in study areas, including professionals, are aware of the benefits of BSE and only a smaller percentage practice BSE.

CONCLUSION

There is, therefore, a need to educate women on the benefits of this simple life-saving procedure through the consistent use of media platforms.