• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.678-695
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• 1994

The purpose of this study was to investigate knowledge, attitudes and practices of women toward breast self-examination and to identify factors that may influence compliance with breast examination. The subjects for this study were 282 women in three hospitals located in In-Chun. Data were collected during the period from October 15 to 30, 1993 by means of a structured questionnaire. The data were analyzed using the SAS program and include descriptive statistics, 1-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression. The results of study are as follows : 1. The mean knowledge score for the total sample was 13.58. Factors affecting the women's knowledge of breast cancer and BSE were : age, level of education, experience with breast cancer patients, experience in learning BSE, information about BSE, self-practice of BSE, level of intention to perform BSE, and participation in a BSE class. 2. Elements related to attitude included : (a) perceived feeling of susceptibility to breast cancer, and (b) belief about the effectiveness of BSE. The mean perceived susceptibility score was 1.62 and the mean effectiveness score was 4.22. Factors affecting the women's perceived susceptibility to breast cancer were exercise for health, level of intention to perform BSE , intention to recommend to others and self-practice of BSE. The relation between the womens' belief about effectiveness of BSE and level of intention to perform BSE and intention to recommend to others were statistically significant. 3. The mean self-practice score for the total sample was 4.01. Factors affecting the women's practice were experience with breast cancer patients, information about BSE, experience in learning BSE, enlisting the help of significant peers, and level of intention to perform BSE. Results indicated 35.8% of the total sample practiced BSE. The most frequent reason women gave for not performing BSE was “Didn’t knew about BSE technique”, “Didn’t think do it”. 4. No relation was found between knowledge and attitudes and practices. 5. When all the variables were examined for their contribution to the variance in the practice of BSE, it was found that confidence in ability to detect a mass by BSE, knowledge about breast cancer and BSE, and experience with breast cancer patients were significant variables and explained 35.8% of the variance. From the results of this study it can be said that women need to be taught proper BSE technique so they can become more proficient in detecting breast abnormalities.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4829-4834
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• 2013

Background: Breast self examination (BSE), performed regularly every month, is one of the most important methods in the early diagnosis of breast cancer. This study was performed with the aim of establishing the knowledge, attitudes, and behavior of women working in government hospitals within the province of Samsun regarding BSE. Materials and Methods: This cross-sectional study was conducted between January-March 2012, on a total of 550 women (500 health personnel, and 50 general administration services (GAS) workers) from 7 government hospitals and the Cancer Early Diagnosis, Screening, and Education Centre (CEDSEC). Percentages were used for the descriptive statistics, and the chi-square test for the evaluation of statistical importance. Values of p<0.05 were accepted as significant. Results: The mean age of the participants was $36.2{\pm}15.3$, and 42.5% were in the 30-39 year old age group, 78.0% being married. Seventy-eight point four percent (78.4%) of the health personnel and 76.0% of the GAS workers performed BSE. However, the rates of performing BSE regularly every month were only 25.6% and 5.0%. Within the health personnel, 1.4% stated that they did not perform BSE because they found it unnecessary as they had no history of breast cancer in their family, 3.6% did not do so due to fear and stress, 13.2% because they forgot, and 14.6% because they had no complaints. Some 22.2% of the health personnel and 52.0% of the GAS workers had undergone mammographic evaluation, the difference being significant (p<0.05), 84.1% of the health personnel and 61.9% of the GAS workers knowing symptoms of breast cancer. Conclusions: Women in society should be brought to a certain level of awareness and knowledge regarding BSE. It is of the utmost importance that health personnel, who carry the responsibility for counseling and enlightening society, should interiorize the necessary knowledge, attitudes and behavior.

• Women's Health Nursing
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• v.16 no.2
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• pp.126-136
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• 2010

Purpose: This study was done to evaluate factors affecting active early detection behaviors of breast cancer and performance rate of breast self examination (BSE), physical examination and mammography. Methods: The participants were 264 women from an outpatient breast clinic of a university hospital and materials were collected from March 2007 to February 2008 using a structured questionnaire. The data were analyzed using $x^2$ test, logistic analysis. Results: The rate for BSE was 58.3%, for physical examination, 55.3% and for mammography experience, 63.4%. Women with all of these active early detection behaviors accounted for 31.8% of the participants. Various factors such as age, income, marital status, and menopause showed increased significant performance rate. The explanation power of logistic model was 48.5%, and was significant for age, income and health belief. Factors related to high performance rate were being over 40 years of age, high income and high health belief score. Conclusion: Active early detection behaviors were not high in spite of marked increases in breast cancer incidence. Encouragement for women practicing early detection behavior is important, but there is also a need to develop interest and support for the low performance group. More sustained education and public relations are needed to further improve active early detection behavior.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6697-6704
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• 2015

Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

• Journal of Home Health Care Nursing
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• v.28 no.2
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• pp.186-196
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• 2021

Purpose: Breast cancer is becoming increasingly prevalent among young Korean women. During pregnancy, women's concern regarding their breasts heightens. Thus, pregnancy provides a window of opportunity for breast cancer prevention and management along with antenatal care. This study developed and evaluated an integrated breast health program for pregnant women. Methods: This study employed a non-equivalent control group and non-synchronized design (22 experimental, 29 control). Women pregnant for over 28 weeks participated. The two-session integrated breast health program focused on breast management during breastfeeding and education about breast cancer prevention and early screening. Results: During the early postpartum period (within three months after the program), there were statistically significant differences in knowledge and attitude about breast cancer and breast self-examination before and after the program. There were also statistically significant differences in BSE at 6 and 12 months after the program and mammography at 12 months after the program. However, there were no statistically significant differences in clinical breast examination and breast ultrasonography at 6 and 12 months after the program. Conclusion: The integrated breast health management program was effective in increasing knowledge and improving attitudes regarding breast cancer, BSE, and early screening practices among pregnant women. Further studies should consider providing breast health programs differently for each phase of pregnancy and continuing the same after delivery.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.295-300
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• 2012

Breast self-examination (BSE) is important for early diagnosis of breast cancer (BC). However, the majority of Turkish women do not perform regular BSE. We aimed to evaluate the effects of education level on the attitudes and behaviors of women towards BSE. A descriptive cross-sectional study was conducted on 413 women (20-59 years), divided into university graduates (Group I, n = 224) and high school or lower graduates (Group II, n = 189). They completed a 22-item scale assessing the knowledge level, attitudes and behaviors regarding BSE, and the Turkish version of the Champion's Revised Health Belief Model. A significantly higher number of women in Group II did not believe in early diagnosis of BC. A significantly higher number of Group I had conducted BSE at least once, and their BSE frequency was also significantly high. Moreover, a significantly lower number of Group I women considered themselves to not be at risk for BC and the scores for "perceived susceptibility" and "perceived barriers" were significantly higher. Logistic regression analysis identified the university graduate group to have a higher likelihood of performing BSE, by 1.8 times. Higher educational levels were positively associated with BSE performance. Overall, the results suggest that Turkish women, regardless of their education level, need better education on BSE. Consideration of the education level in women will help clinicians develop more effective educational programs, resulting in more regular practice and better use of BSE.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8163-8171
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• 2016

Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10943-10947
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• 2015

Background: This study aimed to understand the relationship between knowledge level and behavior on breast care in Chinese students, so as to provide strategies for improving the health education of breast care and subsequently for aiding in breast cancer prevention. Materials and Methods: A self-designed questionnaire was used to evaluate breast care knowledge level and characterize related behavior. Correlation analysis was conducted for the knowledge level and behavior. The study was carried out using 597 female undergraduate students in medical and non-medical colleges in Wuhu, China. Results: The average score of breast care knowledge was $5.32{\pm}1.68$ ($5.62{\pm}1.68$ and $5.00{\pm}1.68$ for medical and non-medical students, respectively), with a greater score value for sophomores ($5.59{\pm}1.72$) than freshmen ($5.18{\pm}1.65$). The average score of breast care behavior was $2.21{\pm}1.13$, again with a greater value in sophomores ($2.37{\pm}1.15$) than freshmen ($2.21{\pm}1.13$). A significant positive correlation (r=0.231, p<0.01) between knowledge scores and behavior scores was observed. In addition, various factors, including paying attention to breast care information, receiving breast self-examination guidance, TV program and Internet, were found to influence breast care knowledge. Conclusions: In general, female undergraduate students lack of self-awareness of breast care with a low rate of breast self-examination. It is necessary to carry out health education to improve early detection of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6863-6870
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• 2015

Background: Breast cancer accounted for almost 25% of all cancers in women globally in 2012. Although breast cancer is the most prevalent cancer in India, there is no organised national breast cancer screening programme. Local studies on the burden of breast cancer are essential to develop effective context-specific strategies for an early detection breast cancer programme, considering the cultural and ethnic heterogeneity in India. This study examined the knowledge, attitudes, and practices about breast cancer in rural women in Central India. Materials and Methods: This community-based cross sectional study was conducted in Wardha district, located in Maharashtra state in Central India in 2013. The sample included 1000 women (609 rural, 391 urban) aged 13-50 years, selected as representative from each of the eight development blocks in the district, using stratified cluster sampling. Trained social workers interviewed women and collected demographic and socio-economic data. The instrument also assessed respondents' knowledge about breast cancer and its symptoms, risks, methods of screening, diagnosis and treatment, as well as their attitudes towards breast cancer and selfreported practices of breast cancer screening. Chi-square and t-test were applied to assess differences in the levels of knowledge, attitude, and practice (the outcome variables) between urban and rural respondents. Multivariable linear regression was conducted to analyse the relationship between socio-demographic factors and the outcome variables. Results: While about two-thirds of rural and urban women were aware of breast cancer, less than 7% in rural and urban areas had heard about breast self-examination. Knowledge about breast cancer, its symptoms, risk factors, diagnostic modalities, and treatment was similarly poor in both rural and urban women. Urban women demonstrated more positive attitudes towards breast cancer screening practices than their rural counterparts. Better knowledge of breast cancer symptoms, risk factors, diagnosis, and treatment correlated significantly with older age, higher levels of education, and being office workers or in business. Conclusions: Women in rural Central India have poor knowledge about breast cancer, its symptoms and risk factors. Breast self-examination is hardly practiced, though the willingness to learn is high. Positive attitudes towards screening provide an opportunity to promote breast self-examination.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1193-1196
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• 2012

Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but they are largely preventable. There are limited data on knowledge and practices on screening methods of breast and cervical cancers among female health care workers in Sri Lanka, in spite of having an organized screening programme islandwide. A cross-sectional survey was conducted among 219 female health care workers including public health midwives (68.9%) selected from 6 districts in Sri Lanka using convenient sampling methods. A self-administered questionnaire was used as a pre-test in a capacity building training programme to collect the data. The mean (SD) duration of work experience of the respondents was 12 years and 52.5% were aged over 35 years. Most (76.7%) were married, and afamily history of cancer was reported by 24.2%. Over 98% knew about self breast examination. Even though 84.1% practiced it, only 47.9% practiced it on a monthly basis. Clinical breast examination and mammography were known by 94.1% and 64.3% respectively. Only 19.2% had undergone a clinical braest examination within one year and 3.6% had ever undergone a mamography. Only 76.3% knew that a Pap smear detects precancerous stage of cervical cancer. Among 169 married workers, 73.4% had never had a Pap smear and only 17.2% had got it done within the preceding 5 years. Among the reasons for not doing a pap smear within 5 years, 47.0% belived it as not nescessary, 17.3% due to fear/dislike, 23.2% as not having symptoms, 3% had not known about it and 3% not known about availability of services. The study findings suggest that the knowledge and practices on breast and cervical cancer screening methods among female health care workers need to be improved. Considering the role that health care workers play in communicating health behaviors to the general public, strengthening health education interventions for this group of females is essential.