INTRODUCTION: Breastcancer affects approximately 1 in 3000 pregnant women and is the second mostcommon malignancy affecting pregnancy1. Presently 75,000 new cases occur in India every year.
The first noticeablesymptom of breast cancer is typically a lump that feels different from the restof the breast tissue 2.Pregnancy Associated Breast CancerPABC is defined as breast cancer diagnosed during pregnancy or in the firstpostpartum year. It is one the most common tumour of reproductive agegroup. Previous studies have suggested that approximately 10% of breastcancers diagnosed in patient’s aged ?40 years were diagnosed during thepregnancy. It is a dangerous myth that women who are pregnant or breastfeedingcannot get breast cancer. So, it is still vitally important to check the breasteven during pregnancy. More than 80% of breast cancer cases are discovered whenthe woman feels a lump 3. Lack of awareness, no clinical breast examinationor mammography, no access to proper healthcare are risk factors for developingbreast lesions.
Breast Self Examinations BSE orregularly examining your breasts on your own, can be an important step forearly detection of breast lesions and making them more likely to be treatedsuccessfully and it has been positively linked to a decrease in mortality andmorbidity. Though debates have been going on about how valuable Breast SelfExamination is in detecting breast lesions, the procedure can be verybeneficial to women of the rural population who lack the means to properhealthcare or general mammography. Multiple socio-demographic factors, myths,cultural beliefs, lack of accessibility to the health care services have beenidentified as the reasons for the poor uptake of BSE 4. BSEshave been seen to be very useful and essential screening strategy, especiallyin combination with regular physical examination by a doctor and mammography.
OBJECTIVESOF THE STUDY:1. To assess the awareness and practice of Breast Self Examinationamong pregnant women residing in an urban and rural areas of Bangalore. 2. To determine the sociodemographic factors affecting the awareness and practice towards Breast SelfExaminations in pregnant women. METHODOLOGY:STUDYAREA:1. Pregnant women attending the OBG OPDs at M.S Ramaiah hospitals2. Rural Field practice area ofRamaiah Medical College.
INCLUSIONCRITERIA:1.All pregnantwomen attending the OBG OPDs at Ramaiah hospitals and the rural centres attachedto the Community Medicine department of Ramaiah Medical College who giveconsent to participate. EXCLUSIONCRITERIA:1. Pregnant women who have alreadybeen diagnosed with breast cancer. STUDYDURATION: 2 monthsSTUDYDESIGN: Cross sectionalstudySAMPLESIZE- 97 in each group (194)RATIONALEFOR SAMPLE SIZE:Based on the literature review, in aprevious study conducted by Anantha Lakshmi Satyavathi Devi Kommula,Surendranath Borra and Vani Madhavi Kommula; it was found that 16.5% of thewomen were aware of BSE 5. In the present study expecting a difference of 20%in the knowledge level regarding Breast Self Examination between rural andurban pregnant women; considering power of 80% and confidence level of 95%, thesample size worked out to be minimum of 97 pregnant women in each group.
STATISTICALANALYSIS:Qualitative variables like socio-demographiccharacteristics of the participants and practice regarding BSE will be presentedusing frequency and percentages. Quantitative variables like awareness scoreswill be analysed and presented using descriptive statistics like mean and SD.The knowledge scores of urban and rural women will be computed and tested forstatistical significance difference using Mann Whitney U test. Chi Square testwill be used to find the association between knowledge level and select sociodemographic factors. SPSS version 17 will be used for statistical analysis. STUDYDURATION: 2 monthsSTUDYDESIGN: Cross sectional PROCEDURE:The study subjects will be recruitedfrom the OBG OPDs at Ramaiah hospitals and its attached rural centres. Thestudy questionnaire is translated into the local language and the subject isrequested to fill it. If the subject is not literate, the investigator will askthe questions orally and fill the questionnaire for the subject.
Subjects arerequested to assemble individually or in groups at a convenient common pointwhere health education about Breast Self Examination BSE, its advantages willbe explained by the investigator through pictorial references. This will befollowed by an interactive session where their doubts on BSE will be clarified.If they are already aware of BSE, a demonstration is asked of the subject, wherethey are corrected if needed, while those unaware are taught the completeprocess.
The sessions are expected to last for a period of approximately 15-20 minutes. IMPLICATIONOF THE STUDY:Literature review suggests that pregnantwomen in whom diagnosis was delayed or treatment deferred have a lower survivalrate. BSE involves visualization and palpation of the breast by oneselffor lumps, shape, texture, size and contour.
The purpose of this is for a womanto learn the topography of her breasts, know how her normal breasts feel and beable to identify changes in them should they occur in the future 6. It iscost effective and more readily available than any other method of earlydetection of breast cancer in our environment. This study emphasizes on theimportance of creating awareness and accurate knowledge about Breast SelfExamination to pregnant women and thus help in early detection of breastlesions 7.
