ABSTRACT

Breast cancer is cancer that  forms in the cells of the breast. It’s is disease in which cells of the breast grow out of control. It’s the most frequent cancer among women, affecting 2.1million women each year and also causes most of the greatest number of cancer related deaths amongst women. Apart from African women especially in Cameroon been predisposed to the more aggressive form of breast cancer , the disproportionately greater mortality rate compared to high resource countries can be attributed to lack of public knowledge of the disease and little knowledge on the practice of breast self-examination. The aim of this research was to assess women’s knowledge on the causes of breast cancer, signs and symptoms and importance of breast self-examination at Bakweri town  Buea. A descriptive cross –sectional survey was used in the study and a convenient sampling method used to select 50 respondents .The data  obtained from the study was analyzed manually by the investigator  with the use of  a calculator and Microsoft Excel  . The results reveal that  the most cited cause of breast cancer was hereditary (62%) followed by history of breast cancer(44%) and increased age (30%) while just a few cited alcohol consumption(16%) , hormone based medications(14%) and menstruation/menopause(16%) and known for increased body weight. The study also reveals  lumps inside the breast  or under arm(90%) and sore or rash on the nipple(30%) as most the cited  early signs and symptoms of breast cancer with headache (48%) and shortness of breath (42%) as the most cited late symptoms. Concerning the importance of breast self-examination,( 44% )of the women cited that  it helps in early identification of breast cancer, (18%) for early detection of breast abnormalities , and (38%) for better and early management of the disease . It was therefore concluded that the women had inadequate knowledge on the causes, signs and symptoms of breast cancer and importance of breast self – examination. Thus, it’s suggested that women be educated more on the disease and most importantly, the practice of breast self-examination.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND 

  Breast cancer is cancer that forms in the cells of the breast. It is a disease in  which the cells of the breast grow out of control.  Breast cancer can start in different parts of the breast. The most common type of breast cancer starts in the ducts. The ducts are tubes in the breast that carry breast milk to the nipple. Sometimes cancer can start in the lobules. The lobules are glands that produce milk for breastfeeding(1).

            According to the World Health Organization statistics,  breast cancer is the most frequent cancer among women affecting 2.1million women each year and also causes most of the greatest number of cancer-related deaths among women(2) . It also accounts for ‘23%(1.38million) of the total new cancer cases and 14%(458,400) of the total cancer deaths in 2008 thus ranking second most common cancer over   all (10.9% of all cancers) but ranks fifth as the cause of death (3). GLOBACON( 4), also reveals the striking  patterns of cancer in women and highlights that priority should be given to cancer prevention and control measures for breast and cervical cancers globally (5) . Studies shows that in Africa, breast cancer caused  74072 deaths, and 16890 cases were estimated to have occurred in 2018 .The age standardized incidence rate stood at 37.9/100000 in Africa, varying from 6.9/100000 in Gambia to 69.6/100000 in Mauritius .Also, the mortality rates stood at 17.2/100000 in 2018, ranging from 4/100000 in Gambia to 29.1/100000 in Somalia in 2019, with Nigeria been the leading country in terms of absolute burden with 26310 cases and 11564 deaths ,followed by Egypt with 23081 new cases and 9254 deaths ,and Cameroon with 2625/100000 new cases  32.5% deaths (6). Equally, the incidence of breast cancer has been   increasing in most regions of the world, but there is a huge difference in breast cancer survival rates worldwide, with an estimated 5years survival of 80% in developed countries to below 40% for developing countries. (7). Reason being that developing countries face resource and infrastructure constraints that challenge the objective of improving breast cancer outcomes by timely recognition, diagnosis and management and as for the developed countries, there is a significant decline in mortality due to  constant enhancement in both screening, mammography and management. (8).

Studies have showed that  70-90% of African women  especially in Cameroon present with stage 3 and 4  breast cancer as a result of delayed  presentation  for medical evaluation which according to (9), can be as high as 11 years from the time of self -detected breast cancer. While in western countries breast cancer detection or screening is done using the following methods that is clinical breast examination and mammography which helps in early detection and management of breast cancer, this is not the case for developing countries, which goes a long way to reduce mortality rates (10) .Early detection of breast cancer leads to better prognosis.(11)

     Prevention remains the cornerstone to fight against breast cancer worldwide. Although some prevention methods have been proposed, many remain inaccessible to women in developing countries who ironically, given the limited diagnostic and curative facilities available to them, need prevention the most. Breast self-examination (BSE) although not having been shown to be effective in reducing mortality (12), is recommend as a general approach to increasing breast health awareness and thus potentially allow for early detection of any abnormalities (13). With greater awareness of breast cancer and proper training in BSE, in combination with regular clinical breast examination, it will be possible to diagnose breast cancer earlier which will go a long way to reduce the incidence of it reaching at advance stage and help in early treatment

1.2 RATIONALE

      Breast cancer is cancer that forms in the cells of  the breast. It is a disease in which cells of the breast grow out of control. According to WHO statistics  for 2018 ,breast cancer is on a rise and is the most frequent cancer  affecting 2.1millon women each year. Breast cancer is the leading cause of cancer related deaths amongst women mostly in developing countries and especially in Cameroon with a statistic of  2625 deaths from 2016-2018  and the disease is still on a rise. This increasing number of cases can  be as a result of  inadequate knowledge of the disease and the low  practice of breast self-examination which is one of the reasons why they present to the hospital late, that is when it is already at an advanced stage making it difficult to manage therefore leading to situations such as breast amputation  which mostly leads to low self-esteem  and  death. Thus the need to carry out this study. 

1.3 GOAL OF THE STUDY

     The goal of this study is to assess knowledge on breast cancer and the importance of breast self-examination   amongst women in Bakweri town so as to create awareness of the disease and the need for early detection of breast cancer through the practice breast self-examination leading to better management.

1.4 OBJECTIVES

  1.4.1 GENERAL OBJECTIVE

  The general objective was  to assess women’s knowledge on the causes of breast cancer, signs and symptoms  and the importance of breast self-examination amongst women 20-55 years at  Bakweri town Buea