Screening for early detection and diagnosis of diseases and health conditions is an important public health principle. Breast cancer examination is whereby a woman will examine the breast by Breast Self Examination (BSE), Clinical Breast Examination (CBE), and Mammogram. The aim of the study was to assess the knowledge, attitudes and practices of breast cancer examination. An interviewer administered questionnaire was administered to 375 women attending a health facility in Gaborone, Botswana. Results indicate low knowledge of breast cancer examination, e.g. only 34.1% knew about the commonest presentation of breast cancer (painless breast lump). Although participants had a positive attitude towards breast cancer examination, only few (23.5%) of those who practiced breast self examination (63.5%) (BSE), practiced monthly as required. Similarly, only 22.7% had visited a doctor for clinical breast examination (CBE) in the past year, and 1.6% of the respondents had done mammogram in the past 2 years. There was no association between socio-demographic characteristics with the knowledge attitude and practice of breast cancer examination. The results of this study reflect an urgent need for increasing breast cancer education for these women.
Key words: Knowledge; Attitudes; Practice; Breast cancer examination, Health facility attendees; Botswana
Breast cancer is the second most common type of cancer affecting women after cervical cancer in Botswana (Botswana Cancer Registry 2008). The earliest presentation of breast cancer, which is a painless breast lump sometimes, is being taken for granted by women, thus making treatment limited once they are presented to the health centre. Besides that they can also present with other breast symptoms such as changes in nipple or areola, breast size and nipple discharge, but not pain (Humphrey. 2002). Breast cancer has received a great deal of publicity and has been the focus of intensive study relative to its origins, diagnostic methods and treatment. With the goal of formulating recommendations for early detection of breast cancer in developing countries, the 2002 Global Summit Consensus Conference on International Breast Health Care focused on several key issues, including educating and empowering women to adhere to guidelines for breast screening, developing infrastructure for diagnosing and treating breast cancer, and educating primary health care professionals (National Cancer Control Programme, 2002).
The three screening methods for breast cancer include breast self-examination (BSE), physical examination of the breasts by a physician or qualified health workers or clinical breast examination (CBE) and mammography. Unlike CBE and mammography which require hospital visit availability of equipment and expertise, BSE is inexpensive and is carried out by women themselves. The World Health Organisation (WHO, 2002) recommends BSE as an alternative cost-effective screening method of women above age of 20years. This is because mammography, though effective in screening breast cancer, is not available for many women in developing countries. Breast cancer is amenable to almost complete cure in its early stages but to seek medical help early in the course of disease, women need to be "breast aware": they must be able to recognize symptoms of breast cancer through routine performance of practicable screening (Okobia, Bunker, Okonafua & Osime, 2006).
It has been reported that in Botswana most women only seek medical help in the late stage of the disease (Botswana Cancer Registry, 2006). This could be attributed to inadequate knowledge of breast cancer examination. Since the common presentation of breast cancer is the painless lump, knowledge of breast cancer examination is very important. Most studies found low knowledge of breast cancer among women (e.g., in Zambia; Mukupo, & Mubita-Ngoma, 2007) and low knowledge on cancer screening methods (e. …