Breast Cancer Screening Awareness, Practice and Knowledge among Women Attending Out Patient in Tertiary Care Centre

Background: The second most common cancer in the world among women is breast cancer. The survival rate can be increased by early detection and treatment. Objectives: To assess the knowledge about breast cancer screening methods among women attending outpatient setup. Materials and Methods: A semi structured pretested questionnaire was distributed to 200 women attending outpatient setup. The questionnaire contained information of their demographic details, questions about knowledge on symptoms, risk factors, screening methods and management outcomes of breast cancer. Results: The most marked result is that 71.5% women were aware of the fact that mammography detects breast cancer in early stages. A fair percentage of 68.3% women agreed that breast cancer is the second most common cancer among women. Conclusion: Awareness about breast cancer screening methods and treatment would enhance early detection and reduces the mortality rate. Original Research Article Lathishna and Kamal; JPRI, 33(54A): 146-150, 2021; Article no.JPRI.75485 147


INTRODUCTION
The most frequent and second most common cancer in the world among women is breast cancer with a newer diagnosed cases of 1.67 million which constitutes 25% of all cancers [1]. In both developed and undeveloped regions breast cancer stands as the most common disease [1]. Symptomatic breast cancer with delayed presentation, have lower survival rates whereas a population of 20-30% women would wait for a period of three months before visiting a clinic [2,3]. Earlier diagnosis, breast screening and improved treatment methods have caused a decline in deaths due to breast cancer [4]. The most effective screening tool for breast cancer is mammography. Mammography reduces the mortality due to breast cancer in women of age group 50 -74 years nonetheless of number of mammography done per year and the screening interval stated by results from clinical trials and case control studies [ 5]. Other screening methods include breast self-examination and clinical examination [6]. Number of studies have been conducted worldwide to assess the knowledge of women about breast cancer screening methods [7]. The aim of the study is to evaluate the knowledge about breast cancer screening methods and conduct educational health programmes in order to improve their understanding and knowledge about breast cancer.

Study Design
Cross sectional study.

Sampling Method
Random sampling.

Sample Size
A number of 200 women attending outpatient department.

Study Setting and Population
the study was conducted among women attending outpatient setup in Saveetha Medical College, Kancheepuram, Tamil Nadu, India. during the period of 15 th February to 15 th march, 2021. A total of 200 women were selected and study was conducted by getting informed consent from them.

Inclusion Criteria
All women attending outpatient setup in the age group of 30-80 years.

Exclusion Crietria
Women who are not willing to participate in the study.

Study Tool
semi structured pretested questionnaire.
The questionnaire was distributed to women attending outpatient setup and collected immediately. The questionnaire contained information of their demographic details, questions about knowledge on symptoms, risk factors, screening methods and management outcomes of breast cancer.

RESULTS
The responses were obtained from 200 women who belong to age between 30-80 years. Majority of participants fall in 4 th decade followed by 5 th , 6 th , 3 rd and 7 th decades. Of 200 women surveyed, 63.1% were unemployed and 36.9% were employed. About 40.7% women surveyed have completed primary school at least. A larger number of women (60.1%) under study were from rural area and 39.9% were from urban areas.
A percentage of 68.3% women have agreed that breast cancer is the second most common cancer among women and a majority of 61.3 % have said that there is increase in incidence of death in breast cancer. 84.1% of women were conscious about bloody nipple discharge as an abnormal symptom and 72% of women were aware of presence of lump has an association with breast cancer. Knowledge about risk factors of breast cancer were summarised and tabulated in Table 1.  Table 3 shows their source of knowledge about breast cancer screening methods.

DISCUSSION
Breast cancer awareness would create early detection, diagnosis and reducing the stage potentially improves the chances for survival and also makes the treatment more sensible. Among the three breast cancer screening methods such as BSE, CBE and mammography, the last one is found to be the most effectual one [8][9][10][11].
On considering the knowledge about risk factors of breast cancer, 41.5%, 11%, 32% and 15.5% of study population have given correct response on positive correlation with age, obesity, family history of breast cancer and previous history of contralateral breast cancer respectively. These values are comparatively lower than the results from a study conducted by Aylin YUCEL et al. [12].

CONCLUSION
The desire to learn, discuss and spread knowledge about breast cancer among family and friends can be encouraged by educational programmes which in order increases the screening practice and also results in early detection and reduction in mortality rate from breast cancer. Awareness can be created not only through educational programmes but also through media such as radio, television, newspaper, pamphlets and plays. With increased prevalence of screening methods, most of the breast cancer cases can be diagnosed in early stages and can be treated effectively.

CONSENT
Informed consent was obtained from the participants before initiating the study.

ETHICAL APPROVAL
The proposal for the study submitted to the institution ethics committee and approval was obtained.