https://www.inosr.

net/inosr-experimental-sciences/
Akech
INOSR Experimental Sciences 12(1):46-59, 2023.
©INOSR PUBLICATIONS
International Network Organization for Scientific Research ISSN: 2705-1692

Breast Self-Examination Knowledge, Attitudes, and Practices in Women of

Reproductive Age in Aburkot Ward, Amolatar District, Uganda

Akech Clare

Faculty of Clinical Medicine and Dentistry Kampala International University Western

Campus

ABSTRACT
This study aimed to assess the knowledge, attitude, and practice of Breast Self-Examination
(BSE) among women aged 15-49 in Aburkot ward, Amolatar Town council, Amolatar District,
northern Uganda. The majority of participants were young women aged 15-35 years, with
65% being Catholic, 16% Anglicans, 10% Pentecostals, 5% Seventh-day Adventists, and 4%
Muslim. The majority (67%) had never heard of BSE but knew it is a practice to detect breast
cancer early. Of the 100 participants, 10% stated that BSE is performed before
menstruation, 9% during menstruation, 23% after menstruation, 42% anytime, and 16% did
not know the right time to perform BSE. 78% of the participants pointed out that a mirror is
required to perform BSE, while only 22% disagreed. Most participants (90% disagreed)
disagreed with reporting any lump on their breasts to the doctor or nurse after waiting for
a while. Nearly 100% recognized the importance of BSE, with 64% agreeing that they
practice it to prevent breast cancer development. Factors influencing BSE practice include
family, peer, family history of breast cancer, advice from health workers, media, personal
history of breast cancer, and nothing in particular.
Keywords: Breast cancer, Breast self-examination, Breast lump, Malignancy.

INTRODUCTION
Cancer of the breast is a serious disease
and is the most common malignancy
affecting women worldwide [1]. There are
reports of increased incidence with
mortality rates of over 75% in developing
countries where, previously, low
incidences have been reported [2, 3]. Early
detection of breast cancer is crucial and
the most effective way of diagnosing
breast cancer to reduce its morbidity and
mortality [4]. The three screening
methods recommended by the American
Cancer Society are mammography, clinical
breast examination, and Breast self-
examination (BSE). Mammography is the
best method for early detection of breast
cancer; however, in most developing
countries, mammography is expensive
and inaccessible; thus, this makes BSE
comparatively cheaper and easy to
perform BSE allows women to become
aware of their breasts so as to detect
changes early [5, 6]. It is simple and cost-
effective in resource-limited settings and
in areas with limited access to health care
[7]. It is common knowledge that, in
Uganda, most women diagnosed with
breast cancer are usually in the advanced
stage of the disease [8, 9]. This has been
attributed to the low availability of
advanced equipment for mammography
for screening and diagnosis of breast
cancer, high cost, and delay in early
diagnosis[4]. Breast cancer is the third
most common cancer in women in Uganda
following Kaposi sarcoma and cervical
cancer [10–14]. A study conducted in
Uganda reported breast cancer incidence
at 22: 100,000 with a five-year survival
rate of 56% [15]. Breast cancer has also
been reported as being one of the most
frequent cancers of women in other areas

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[10, 11, 16]. It has been reported that by
the year 2020, almost 70% of new cancer
cases will occur among people from less
developed countries, with the majority of
these cancers likely to be breast cancers
[15] Literature has shown that this is
likely due to late presentation amongst
women especially from low-income
countries where there are no formal
breast cancer screening programmes,
hence having little survival probabilities.
The increased breast cancer rates in
developing countries could also be
attributable to the adoption of Western
lifestyles and diets. In addition, there is
limited knowledge and poor attitude in
relation to breast cancer issues.
Knowledge of breast cancer and attitude
have been reported to be important in
determining the stage at which women
present to health facilities [17]. It has also
been reported that factors relating to
women’s knowledge and beliefs about
breast cancer can perhaps contribute to
more positive health-seeking behaviours
[9, 18]. Early detection of breast cancer
through regular and routine screening
remains one of the most significant steps
in increasing survival rates [19]. This is
likely to result in prompt management
and treatment, and thus better patient
outcomes [20].
Knowledge, Attitudes and Practices (KAP)
are considered factors that influence early
detection of breast cancer[7]. Breast
cancer is one of the most common types
of cancer affecting women in Uganda.
Most women in Uganda tend to seek
medical advice when the disease (breast
cancer) is already in its advanced stages,
resulting in poor prognosis, because most
of the women seek medical attention and
present themselves to hospitals/ Doctors
at a late stage of cancer. An estimated 20 -
30% of women wait for at least 3 months
before seeking help when breast cancer
symptoms are evident and in advanced
levels when little time or no benefit is
derived from any form of therapy
resulting in poor survival and high
METHODOLOGY
Study Design
A descriptive cross-sectional study was
done.
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mortality rates [21]. Breast self-
examination is the most effective and
feasible means of detecting breast cancer
early in developing countries [22]. A
woman is more likely to discover any
changes that may have occurred in her
breast and the best time to perform BSE is
about a week after menstruation ends,
when her breast is not tender or swollen.
However, women in developing countries
do not perform breast self-examination
for various reasons and even those who
perform breast self-examination may
delay seeking medical attention because
of fear, economic factors, lack of
education, reluctance to act if no pain is
involved, psychological factors,
inadequate knowledge about sign and
symptoms of breast cancer, geographical
isolation and lack of information [12].
Studies and practice show that the earlier
breast cancer is detected, the better one
can have access to the available treatment
options and the greater the chances of
long-term survival. It is advised that early
detection and screening can save
women’s lives if adhered to. As a medical
student, and having worked both in
public and private hospitals, with 3 years
of experience, the principal investigator
observed that women with breast cancer
delay in seeking medical care. Breast
biopsies are often done at very late
stages. This leads to late detection of
breast cancer in the affected women who
consequently have to undergo surgical
procedures such as mastectomy since
treatment options become limited except
surgery and chemotherapy as a last
resort. This experience prompted the
principal investigator to conduct this
study. Despite efforts made to educate
women on the prevention and early
detection of breast cancer, statistics are
available that reveal that there still exists
a gap between the dissemination of
information and knowledge about
prevention and early detection of breast
cancer among women in Aburkot ward,
Amolatar District.
Area of Study
The study was conducted in the Aburkot
ward in Amolatar town council, Amolatar
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District Uganda. Amolatar District is
bordered by Apac District to the
north, Dokolo District to the
northeast, Kaberamaido District to the
east, Buyende District to the
southeast, Kayunga District to the south
and Nakasongola District to the west. The
administrative headquarters of the
district at Amolatar, is located 85
kilometres (53 mi), by road, south of Lira,
the largest city in the sub-region. This
location lies about 185 kilometres
(115 mi), by road, northeast of Kampala,
the capital of Uganda and the largest city
in that country. The coordinates of the
district are: 01 38N, 32 50E.
Study Population.
All women of reproductive age (15-49)
years in Aburkot ward, Amolatar town
council, Amolatar District were the study
population.
Inclusion criteria
All women in the childbearing age 15-49
years in Aburkot ward, Amolatar town
council, Amolatar District who consented
to participate in the study.
Exclusion Criteria
Women of non-reproductive age or less
than 15 years or above 49 years in
Aburkot ward, Amolatar town council,
Amolatar District and women
ofchildbearing age who declined to
participate in the study.
Sampling Size Determination
Using the Kish Leslie (1965) formula[23];
Where; n = sample size
Z, is the standard normal deviation at 95%
confidence interval (1.96)
p, proportion of a characteristic in a
sample, 7% [24]
q, population proportion = (1 – p)
e, marginal of error precision = 0.05
n = 1.962 × 0.07 (1 – 0.07)
0.052
n = 100
From the above formula an estimated
sample size of 100 respondents was
expected to be appropriate for the study.
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Sampling procedures
A simple random sampling technique was
used to select the study participants of
women aged 15-49 years.
Data collection methods and
management
Data for the study was obtained using a
questionnaire. The questionnaire shall be
pre-tested using a pilot study on a small
sample of the study participants before
actual data collection to detect any flaws
in its design. The respondents were
briefed about the aims of the study before
the administration of the questionnaire.
The questionnaire used consisted of four
parts: sociodemographic characteristics,
knowledge on BSE, and attitudes towards
BSE and practice of BSE. There were
questions on socio-demographics,
questions on knowledge, and questions
on attitudes and practice of BSE. The
questionnaires were distributed by the
researcher to participants in their places
of residence.
Data analysis
Statistical analysis was performed using
Statistical Package for Social Scientists
(SPSS) version 20.0. Chi-square statistical
test was done on categorical variables.
Results are presented as mean ±SD
(standard deviation) and percentage (%).
Quality control
Raw data was recorded in the raw data
collection tool (Appendix I). The raw data
forms were checked for mistakes and
completeness and kept under lock and
key. A data base was created from raw
data source(s) by double entering the raw
data, and verified using a suitable
computer program. The database was
edited, corrected and finalized. Data files
were then created from the databases.
These were analyzed using SPSS v. 20.0 by
a biostatistician. A pilot test of 20
questionnaires was conducted. It was
distributed to 20 mothers who were
randomly selected to avoid bias. Data
collected from the pilot test was not used
in the final analysis of this study. It
merely assisted in testing the
questionnaire to ascertain if respondents
understood each question and if the
questions were well formulated to solicit
the kind of responses required. Changes
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were made to two questions that
respondents experienced difficulty in
understanding.
Ethical Considerations
This research proposal was submitted for
approval to the Kampala International
University Research and Ethics Committee
(KIU-REC), the Uganda National Council
for Science and Technology (UNCST) and
the Research and Ethics Committee of the
Faculty of Clinical Medicine and Dentistry
RESULTS
Socio demographic characteristics of
study participants
The youngest participant was 15 years old
and the oldest was aged 48 years. The
mean age of participants was 28.58±9.68
years.From table 1 below the greatest
number 27(27%) of participants were aged
20-24 years, 18% of the participants were
aged 15-19 years, 17% were aged 25-29
years, 8% were aged 30-34 years, 10%
were aged 35-39 years, 11% were aged 40-
44 years and 9% were aged 45-49 years.
of Kampala International University.
Authorization letters to conduct the study
were obtained from the Faculty of Clinical
Medicine and Dentistry and KIU-REC.
Approval was also sought from the
district authorities of Amolatar District.
Finally, Informed consent was obtained
from all respondents before they could
participate in the study. All the
information obtained from the study
participants were kept confidential.
Regarding religion, majority (65%), of the
participants were catholic, 16% were
Anglicans, 10% were Pentecostals, 5% were
seventh day Adventists and 4% were
Muslim. When asked whether any of their
family members had ever had breast
cancer, 15% of the study participants
acknowledged that their family members
had ever had breast cancer while 85% of
the participants had no family history of
breast cancer.

Table 1: Socio demographic characteristics of study participants

Variables Frequency (n=100) Percentage (%)

Age (years)
15-19 18 18
20-24 27 27
25-29 17 17
30-34 8 8
35-39 10 10
40-44 11 11
45-49 9 9
Religion
Catholics 65 65
Anglican 16 16
Pentecostal 10 10
Seventh day Adventist 5 5
Muslims 4 4
History of breast cancer
Yes 15 15
No 85 85

Knowledge of Participants on Breast that it was necessary to perform Breast

Self-Examination Self-examination. Majority of the
Table 2 shows, majority (67%) of the participants 77% said Breast Self-
participants said they had never heard of Examination is a practice to detect breast
Breast Self-examination, though Eighty- cancer early and many 39% of participant
nine percent (89%) of the participants felt indicated that when performing breast

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self-examination, the breast is examined. pointed that a mirror is required to
Many (48%) of participants indicated that perform breast self-examination. Majority
breast self-examination should be done 78% of the participants said they use their
anytime and many (42%) stated that the fingertips to perform breast self-
right time for performing breast self- examination, with 42% of them saying the
examination is anytime. Regarding the hands should be moved randomly during
position from which breast self- breast self-examination. Lastly 59%
examination is done, many of the indicated that the hand should be placed
participants (42%) said it is done while firm and light.
sitting and 78% of the participants

Table 2: Knowledge of Participants on Breast Self-Examination

Statements Frequency Percentage (%)
(n=100)
Ever heard of Breast Self-examination
Yes 33 33
No 67 67
Is it necessary to perform Breast Self-Examination
Yes 89 89
No 11 11
Breast self-examination a practice to detect breast
cancer early
Yes 77 77
No 23 23
Which Parts of the body would you examine when
performing breast self-examination
Breast 39 39
Breast and Armpit 4 4
Breast and between breast and collarbone 23 23
Breast, Armpit and between breast and collarbone 34 34
How often should breast self-examination be
performed
Weekly 10 10
Monthly 19 19
Yearly 1 1
Anytime 48 48
Don’t know 22 22
When is the right time to perform breast self-
examination
Before Menstruation 10 10
During Menstruation 9 9
After Menstruation 23 23
Anytime 42 42
Don’t know 16 16
In which position is breast self-examination done
Standing 7 7
Lying down 10 10
Sitting 42 42
Standing and sitting 6 6

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Lying down and sitting 7 7
Standing, lying down and sitting 28 28
Is a mirror required for breast self-examination
Yes 78 78
No 22 22
Which part of your hand do you use for breast self-
examination
Fingertips 78 78
Middle Part of the fingers 10 10
Palm 6 6
Don’t know 6 6
In which direction is the hand moved during breast
self-examination
Random 42 42
Clockwise 29 29
Don’t know 29 29
How firm should the hand be placed on the breast
during breast self-examination
Very firm 13 13
Firm and Light 59 59
Not firm 23 23
Don’t know 5 5

Participants’ knowledge on symptoms of and 11% said otherwise. For the case of
breast cancer nipple discharge, 77% of participants said
To understand whether the communities a woman with breast cancer will have
of Aburkort ward know the symptoms of nipple discharge while 23% said
breast cancer, they were asked of the otherwise. For sore of the breast, 88% said
symptoms of breasts cancer as below: To that it is one of the symptoms and 12%
understand the symptoms, each symptom said otherwise. Change of breast
was treated as a dummy variable with a symmetry 97% said a woman with breast
yes and no responses table 15. Of the cancer will show s change in breast
100-participant interviewed, 91% said a symmetry while 3% said otherwise. And
woman with breast cancer has lumps in for the case of change in breast size, 97%
her breast, while 9% said otherwise. For said yes it is one of the symptoms while
discoloration of breast, 89% said a woman 3% denied.
with breast cancer has discolored breast

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Participant's knowledge on symptoms of breast cancer

120

100 97 97
91 89 88

80 77

60

40
23
20 12
9 11
3 3
0
lump Discoloration Nipple Sore of BreastChange breast Change in
of Breast Discharge Symmetry Breast Size
Know Don’t know
Figure 1: Graph showing participant’s knowledge on symptoms of breast cancer

Participants’ attitudes towards breast them agreed that breast self-examination

self-examination
Table 3 shows that of the 100
participants, 87 disagreed with breast
self-examination being time consuming.
Many (74%) disagree with no need to
practice breast self-examination if one
doesn’t have any family history of breast
cancer. Most of participants 90%
disagreed with the statement that they
should report any lump on their breasts
to the doctor or nurse after waiting for a
while. Of the people surveyed, 99% of
is a good practice and therefore all
women must be taught how to perform
breast self-examination and only 1% of the
participants were not sure whether or not
breast self-examination is a good practice
and all women must be taught. Majority
(64%) were not afraid of being diagnosed
with breast cancer and lastly 96%
disagreed with the statement “I don’t like
touching certain parts of my body for
such as the breast”.

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Table 3: Participants’ attitudes towards breast self-examination

Statements Agree Disagree Not sure

Breast self-examination is time consuming 10(10%) 87(87%) 3(3%)

Don’t have any family history of breast cancer so there 18 (18%) 74(74%) 8(8%)
is no need to practice breast self-examination

Report a lump on my breast to the doctor or nurse after 10 (10%) 90(90%) 0(0%)
waiting for a while

Immediately report a lump in my breasts to the doctor 90(90%) 10(10%) 0(0%)

or nurse.

Breast self-examination is a good practice and all 99(99%) 1(1%) 0(0%)

women must be taught

I am afraid of being diagnosed with breast cancer 33 (33%) 64(64%) 3(3%)

I don’t like touching certain parts of my body for 3(3%) 96(96%) 1(1%)
example the breast

Participants’ breast self-examination statement. Many 35% of the participants

practices
From table 4 majority of the participant
(64%) agreed to the statement that they
practice breast self-examination because
they do not want to develop breast
cancer. Fifty-seven percent (57%) of the
participants disagreed to the statement
indicating that they are fully aware of the
benefits of breast self-examination. Many
58% of the participants agreed that they
either have a family history of breast
cancer or know someone with breast
cancer, and 41% disagreed to the
agreed that they don’t know how breast
self-examination is done correctly, 25%
disagreed and 40% were not sure if they
knew or didn’t know to correctly do
breast self-examination. Thirty-three
percent (33%) of participants disagreed to
the statement “I know about breast self-
examination but I sometimes forget to
practice”, while 15% of the participants
agreed. Lastly, 52% disagreed with the
statement “I ’am not at risk of getting
breast cancer”.

Table 4: Participants’ breast self-examination practices

Statements Agree Disagree Not sure

I practice breast self-examination because I don’t want to develop 64(64%) 19(19%) 17(17%)
breast cancer

I am fully aware of benefits of breast self-examination 23(23%) 57(57%) 20(20%)

I have a family history of breast cancer/known someone who has it 58(58%) 41 41%) 1(1%)

I do not know how breast self-examination is done correctly 35 (35%) 25(25%) 40 (40%)

I know about breast self-examination but I sometimes forget to 15(15%) 33(33%) 52 (52%)
practice.

I’m not at risk of getting breast cancer 14 (14%) 52(52%) 34(34%)

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What influences participants to practice
breast self-examination
Figure 3 below shows what influences
participants to practice breast self-
examination. 4% said it is their family,5%
said it is peer that influences them 2%
said family history of breast cancer,32%
Nothing in particular
Personal History of breast cancer 2
2
The media
Advice by health workers
Family history of breast cancer 2
2
Peer
Family 4
4
0 5
Percentage (%)
Figure 2: What influences participants to practice breast self-examination
DISCUSSION
Socio-demographics of participants
Majority (70%) of the participants were
youth aged between 15-35 years. In this
study the greatest proportion (60%) of the
participants were Catholic whereas the
Muslim took the least percentage of
participants. This result agrees with
Majda et al. [25] which reports 53.4% of
study participants being Catholics,
followed by Anglicans (31.9%) with the
least being Muslims (1%) and Seventh-day
Adventists (0.5%). However, no
explanation was given for this trend.
said it is advice by health workers, 23%
said it is the media, 2% said personal
history of breast cancer influences them
and then 32% said nothing in particular
influences them practice breast self-
examination.
32
32
23
23
32
32
5
5
10 15 20 25 30 35
Frequency (n)
Knowledge of participants on BSE
In this study majority (67%) of the
participants said they had never heard of
Breast Self-examination and 33% they had
ever heard of breast self-examination. In
the study by Fondjo et al. [22], almost all
the study participants interviewed (90.9%)
were aware of BSE. The higher number of
participants in the later study could be
attributed to the fact that they were
students and therefore literate. The
finding is in agreement with that of
Fondjo et al. [22]. According to Fondjo et
al. [22], majority (91.6%) of participants
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were able to identify BSE as a tool for
early detection of breast cancer which is
similar 77% majority vs 33% who were
unable to identify BSE as a means for
early breast cancer detection. In the study
by Fondjo et al. [22], 63.1% knew that the
breasts, area between the breast and the
collarbone and armpit were to be
examined while in this study 34% of the
participants were aware of this fact. The
higher level of awareness reported by
Fondjo et al. [22] could be attributed to
the fact that the participants were
students and possibly had a higher
literacy compared to the participants in
this study who were community
members. In this study, 19% responded
that breast self-examination should be
done anytime, while in the study by Ossai
et al. [26] a much higher proportion
(45.5%) of the respondents were aware
that it was desirable to examine the
breasts monthly. In the study by Kayode
participants were secondary school
teachers who were probably much more
literate compared to the participants in
this study. Only 23% of the study
participants knew the right time to
perform breast self-examination which is
after menstruation whereas majority (77%)
did not know the right time to perform
BSE. This could be due to low level
awareness on BSE in the Aburkot. Seven
percent (7%) of the participants said
breast self-examination is done while
standing, 10% said it is done when lying
down, 42% said it is done while sitting, 6%
said it is done both when standing and
sitting, 7% said it is done both while lying
down and sitting and 28% said it can be
done in all the three positions i.e.,
standing, lying down and sitting. Majority
(78%) of the participants were aware that a
mirror is required to perform breast self-
examination whereas only 22% were not
aware that a mirror is not required to
perform breast self-examination. Only
10% of the participants interviewed knew
the right part of the hand used in BSE
whereas majority (90%) did not know the
right part of the hand used for BSE.
Twenty-nine 29% of the study participants
interviewed knew that the hand was to be
moved in a clockwise direction when
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performing a BSE which still disagrees
with the study done by Fondjo et al. [22]
which pointed that majority of the
participants knew that the hand was to be
moved in clockwise direction when
performing a BSE. Most of the participants
(59%) knew how firm the hand should be
placed on the breast during BSE and so
reported that the hand should be placed
firm and light, while the rest did not know
how firm the hand should be placed. Most
of the participants knew the symptoms of
breast cancer which include lump in the
breast (91%), discoloration (89), nipple
discharge (77%), sores (88%), change in
symmetry (97%) and change in size (97%)
and this is in agreement with the study
done by Fondjo et al. [22].
Participants’ attitudes towards breast
self-examination
Only 10% of the study participants agreed
that BSE is time consuming compared to
the majority (87%) who disagreed and this
agrees with the study done by Casmir, et
al, [27].Only 18% of the participants
interviewed agreed to the statement that
they had no family history of breast
cancer so there is no need to practice BSE
and this also agrees with the study done
by Fondjo et al. [22] which reported that
10.3% of the participants agreed to the
statement. Ten percent (10%) of the
participants agreed that they would report
a lump in the breast to the doctor or
nurse after waiting for a while and this
percentage was lower than the finding
from Fondjo et al. [22] study where up to
22.3% of the participants stated that they
would wait for some time to see if a lump
in their breast changes before seeking
medical attention. Ninety percent (90%) of
the participants agreed that they would
immediately report any lump in their
breasts to the doctor or nurse, while 10%
disagreed. This agrees with the study
done by Gabriel et al. [28] where by most
of the participants (82.1%) stated that
they would report a lump they detect in
their breasts to the doctor immediately.
Majority (99%) of the participants
recognized the importance of breast self-
examination. This finding agrees with a
cross -sectional study conducted by
Olayide et al. [29] whereby 98.5% of the
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participants thought breast self-
examination was necessary. Thirty-three
percent (33%) agreed to the statement “I
am afraid of being diagnosed with breast
cancer” whereas 64% disagreed with the
statement and 3% were not sure.
Participants’ breast self-examination
practices
Majority of the participants (64%) agreed
to the statement “I practice breast self-
examination because I do not want to
develop breast cancer”. This finding
agrees with the study done by Fondjo et
al. [22] whereby 63.9% thought they would
not like to be diagnosed of breast
cancer.Twenty-three percent (23%) of the
participants agreed to the statement
indicating that they are fully aware of the
benefits of breast self-examination which
disagrees with the finding in the study
done by Fondjo et al. [22] which stated
that majority (76.3%) of the participants
performed BSE because they were
completely aware of the benefits and this
could still be attributed to the fact that
the participants were students who are
literate and informed about BSE. Fifty-
eight percent (58%) of the participants
agreed that they either have a family
history of breast cancer or know someone
with breast cancer which disagrees with
the study students by Elsie et al, [30]
whereby only few participants in that
study (9.7%) indicated they would perform
BSE because of a family history of breast
cancer or because participants knew
CONCLUSION
The study found that 67% of participants
are unaware of breast self-examination
(BSE), but they believe it is necessary for
early detection of breast cancer. However,
many lack knowledge about BSE, including
its location, position, and frequency.
Many also don't understand its benefits.
Those who practice BSE do so to avoid
breast cancer. 52% of participants believe
they are at risk of getting breast cancer
and are not afraid to perform BSE without
fear. Overall, the majority of participants
believe BSE is a good practice for early
someone with breast cancer which could
be due to the fact that the study
participants were students who might
have not been exposed a lot to such
people in their communities. Thirty-five
percent (35%) of the participants agreed
that they don’t know how breast self-
examination is done correctly, 25%
disagreed and 40% were not sure if they
don’t know how to correctly do breast
self-examination.Of the 100 participants,
3% agreed that they don’t like touching
certain parts of their body for example
the breast, 96% disagreed with the
statement while 1% were not sure if they
don’t like touching certain parts of their
body. Fifteen percent (15%) of participants
agreed to the statement “I know about
breast self-examination but I sometimes
forget to practice”. From the study done
by Mekuria et al. [31] up to 23.5% of the
study participants stated forgetfulness
being one of the reasons for not doing
BSE. Of the 100 participants, 14% agreed
that they that they are not at risk of
getting breast cancer, 52% disagreed with
the statement and 34% were not sure.
Thirty-two percent (32%) stated that
advice by health workers was what
influenced them to practice BSE, 23% said
it was the media whereas in the study
done by Godfrey et al. [32] the majority
(56.9%) of the participants received
information about breast cancer via mass
media.
detection and prevention. The survey
shows that many women are unaware of
breast self-examination and its
importance in detecting early breast
cancer. It is recommended that all women
be taught about this practice, as it helps
detect breast cancer early. Regular
practice and reporting of breast changes
to a nurse or doctor are crucial. The
media and health workers should educate
women on best practices to reduce the
risk of breast cancer.
56
https://www.inosr.net/inosr-experimental-sciences/

REFERENCES

1. Obeagu, E. I., Ahmed, Y. A., Obeagu, G. secondary school teachers in Addis

U., Bunu, U. O., Ugwu, O. P. C. and Ababa, Ethiopia: using the health
Alum, E. U. (2023). Biomarkers of belief model. BMC Womens Health.
breast cancer: Overview. Int. J. Curr. 22, 317.
Res. Biol. Med., (1): 8-16. https://doi.org/10.1186/s12905-022-
DOI:10.22192/ijcrbm.2023.08.01.002 01904-w
2. Dias, A.R., Pereira, M.A., de Mello, E.S., 7. Erdem, Ö. and Toktaş, İ. (2016).
Nahas, S.C., Cecconello, I. and Ribeiro, Knowledge, Attitudes, and Behaviors
U. (2018). Lymph Node Yield After about Breast Self-Examination and
Neoadjuvant Chemoradiotherapy in Mammography among Female Primary
Rectal Cancer Specimens: A Healthcare Workers in Diyarbakır,
Randomized Trial Comparing Two Turkey. Biomed Res Int. 2016,
Fixatives. Dis Colon Rectum. 61, 888– 6490156.
896. https://doi.org/10.1155/2016/64901
https://doi.org/10.1097/DCR.000000 56
0000001097 8. Ginsburg, O., Rositch, A.F., Conteh, L.,
3. Aja, P.M., Agu, P.C., Ezeh, E.M., Mutebi, M., Paskett, E.D.,
Awoke, J.N., Ogwoni, H.A., Deusdedit, Subramanian, S.: Breast Cancer
T., Ekpono, E.U., Igwenyi, I.O., Alum, Disparities Among Women in Low-
E.U., Ugwuja, E.I., Ibiam, A.U., and Middle-Income Countries. Current
Afiukwa, C.A. and Adegboyega, A.E. Breast Cancer Reports. 10, 179–186
(2021). Prospect into therapeutic (2018).
potentials of Moringa oleifera https://doi.org/10.1007/s12609-018-
phytocompounds against cancer 0286-7
upsurge: de novo synthesis of test 9. Atuhairwe, C., Amongin, D., Agaba, E.,
compounds, molecular docking, and Mugarura, S. and Taremwa, I.M.
ADMET studies. Bulletin of the (2018). The effect of knowledge on
National Research Centre. 45, 99. uptake of breast cancer prevention
https://doi.org/10.1186/s42269-021- modalities among women in
00554-6 Kyadondo County, Uganda. BMC
4. Afaya, A., Japiong, M., Konlan, K.D. Public Health. 18, 279.
and Salia, S.M. (2023). Factors https://doi.org/10.1186/s12889-018-
associated with awareness of breast 5183-5
cancer among women of reproductive 10. Afodun, A.M., Quadri, K.K., Masud,
age in Lesotho: a national population- M.A. and Hammed, A.M. (2017).
based cross-sectional survey. BMC Superficial Galactocelic Progression,
Public Health. 23, 621. Size-Variation and Assessment in a
https://doi.org/10.1186/s12889-023- Patient. ABCR. 06, 100–106.
15443-y https://doi.org/10.4236/abcr.2017.64
5. Birhane, N., Mamo, A., Girma, E. and 009
Asfaw, S. (2015). Predictors of breast 11. Ali-Gombe, M., Mustapha, M.I.,
self - examination among female Folasire, A., Ntekim, A. and Campbell,
teachers in Ethiopia using health O.B. (2021). Pattern of survival of
belief model. Arch Public Health. 73, breast cancer patients in a tertiary
39. https://doi.org/10.1186/s13690- hospital in South West Nigeria.
015-0087-7 Ecancermedicalscience. 15, 1192.
6. Tewelde, B., Tamire, M. and Kaba, M. https://doi.org/10.3332/ecancer.202
(2022). Breast self-examination 1.1192
practice and predictors among female

57
https://www.inosr.net/inosr-experimental-sciences/
12. Karayurt, Ö., Özmen, D. and Implications for Evaluating Service
Çetinkaya, A.Ç. (2008). Awareness of Screening Programs. Breast J. 21, 13–
breast cancer risk factors and practice 20.
of breast self examination among https://doi.org/10.1111/tbj.12354
high school students in Turkey. BMC 19. Lee, M. S. (2019). Azmiyaty Amar Ma”
Public Health. 8, 359. Ruf, C., Nadhirah Izhar, D.P., Nafisah
https://doi.org/10.1186/1471-2458- Ishak, S., Wan Jamaluddin, W.S.,
8-359 Ya’acob, S.N.M., Kamaluddin, M.N.:
13. Ampofo, A.G., Adumatta, A.D., Owusu, Awareness on breast cancer screening
E. and Awuviry-Newton, K. (2020). A in Malaysia: a cross sectional study.
cross-sectional study of barriers to Biomedicine (Taipei). 9, 18.
cervical cancer screening uptake in https://doi.org/10.1051/bmdcn/2019
Ghana: An application of the health 090318
belief model. PLoS ONE. 15. 20. Ullah, Z., Khan, M.N., Din, Z.U. and
https://doi.org/10.1371/journal.pone Afaq, S. (2021). Breast Cancer
.0231459 Awareness and Associated Factors
14. Cadman, L., Waller, J., Ashdown-Barr, Amongst Women in Peshawar,
L. and Szarewski, A. (2012). Barriers Pakistan: A Cross-Sectional Study.
to cervical screening in women who Breast Cancer (Auckl). 15,
have experienced sexual abuse: an 11782234211025346.
exploratory study. J Fam Plann https://doi.org/10.1177/1178223421
Reprod Health Care. 38, 214–220. 1025346
https://doi.org/10.1136/jfprhc-2012- 21. Parkin, D.M., Nambooze, S., Wabwire-
100378 Mangen, F. and Wabinga, H.R. (2010).
15. Gakwaya, A., Galukande, M., Luwaga, Changing cancer incidence in
A., Jombwe, J., Fualal, J., Kiguli- Kampala, Uganda, 1991–2006.
Malwadde, E., Baguma, P., Kanyike, A. International Journal of Cancer. 126,
and Kigula-Mugamba, J. (2008). Breast 1187–1195.
cancer guidelines for Uganda (2nd https://doi.org/10.1002/ijc.24838
Edition 2008). Afr Health Sci. 8, 126– 22. Fondjo, L.A., Owusu-Afriyie, O., Sakyi,
132. S.A., Wiafe, A.A., Amankwaa, B.,
16. Li, X., Lewis, M.T., Huang, J., Acheampong, E., Ephraim, R.K.D. and
Gutierrez, C., Osborne, C.K., Wu, M.- Owiredu, W.K.B.A. (2018).
F., Hilsenbeck, S.G., Pavlick, A., Comparative Assessment of
Zhang, X., Chamness, G.C., Wong, H., Knowledge, Attitudes, and Practice of
Rosen, J. and Chang, J.C. (2008). Breast Self-Examination among
Intrinsic Resistance of Tumorigenic Female Secondary and Tertiary School
Breast Cancer Cells to Chemotherapy. Students in Ghana. Int J Breast
JNCI Journal of the National Cancer Cancer. 2018, 7502047.
Institute. 100, 672–679. https://doi.org/10.1155/2018/75020
https://doi.org/10.1093/jnci/djn123 47
17. Hs, C., Kj, V.Z (2015). Reexcision--The 23. Wiegand, H. and Kish, L. (1968).
Other Breast Cancer Epidemic. The Survey Sampling. John Wiley & Sons,
New England journal of medicine. Inc., New York, London 1965, IX + 643
373. S., 31 Abb., 56 Tab., Preis 83 s.
https://doi.org/10.1056/NEJMe15071 Biometrische Zeitschrift. 10, 88–89.
90 https://doi.org/10.1002/bimj.196801
18. Tabár, L., Yen, A.M.-F., Wu, W.Y.-Y., 00122
Chen, S.L.-S., Chiu, S.Y.-H., Fann, J.C.- 24. Batte, A., Siu, G.E., Tibingana, B.,
Y., Ku, M.M.-S., Smith, R.A., Duffy, Chimoyi, A., Paichadze, N., Otwombe,
S.W. and Chen, T.H. (2015). Insights K., Batte, A., Siu, G.E., Tibingana, B.
from the Breast Cancer Screening and Chimoyi, A. (2017). Incidence ,
Trials: How Screening Affects the patterns and risk factors for injuries
Natural History of Breast Cancer and among Ugandan children. 7300.

58
https://www.inosr.net/inosr-experimental-sciences/
https://doi.org/10.1080/17457300.20 in Africa. 7.
17.1416484 https://doi.org/10.4081/jphia.2016.5
25. Majda, A., Bodys-Cupak, I., Kamińska, 28
A., Suder, M. and Gródek-Szostak, Z. 29. Olayide, A.S., Halimat, A.J., Samuel,
(2022). Religiously Conditioned O.A., Ganiyu, R.A. and Soliu, O.A.
Health Behaviors within Selected (2017). Level of Awareness and
Religious Traditions. Int J Environ Res Knowledge of Breast Cancer in
Public Health. 19, 454. Nigeria. A Systematic Review. Ethiop J
https://doi.org/10.3390/ijerph19010 Health Sci. 27, 163–174.
454 30. Elsie, K.-M., Gonzaga, M.A., Francis,
26. Ossai, E.N., Azuogu, B.N., Ogaranya, B., Michael, K.G., Rebecca, N.,
I.O., Ogenyi, A.I., Enemor, D.O. and Rosemary, B.K. and Zeridah, M.
Nwafor, M.A. (2019). Predictors of (2010). Current knowledge, attitudes
practice of breast self-examination: A and practices of women on breast
study among female undergraduates cancer and mammography at Mulago
of Ebonyi State University, Abakaliki, Hospital. Pan Afr Med J. 5, 9.
Nigeria. Niger J Clin Pract. 22, 361– https://doi.org/10.4314/pamj.v5i1.56
369. 186
https://doi.org/10.4103/njcp.njcp_48 31. Mekuria, M., Nigusse, A. and Tadele,
2_18 A. (2020). Breast Self-Examination
27. Casmir, E.C.I., Anyalewechi, N.E., Practice and Associated Factors
Onyeka, I.S.N., Agwu, A.C.O. and Among Secondary School Female
Regina, N.C. (2015). Knowledge and Teachers in Gammo Gofa Zone,
Practice of Breast Self-Examination Southern, Ethiopia. Breast Cancer
among Female Undergraduates in (Dove Med Press). 12, 1–10.
South-Eastern Nigeria. Health. 07, https://doi.org/10.2147/BCTT.S2320
1134. 21
https://doi.org/10.4236/health.2015. 32. Godfrey, K., Agatha, T. and
79129 Nankumbi, J. (2016). Breast Cancer
28. Gabriel, O.E., Ajetunmobi, O.A., Shabi, Knowledge and Breast Self-
O.M., Elegbede, O.T., Okere, R.A., Examination Practices Among Female
Busari, O.A. and Dada, A.S. (2016). University Students in Kampala,
Awareness and practice of self breast Uganda: A Descriptive Study. Oman
examination among female nurses at Medical Journal. 31, 129.
the Federal Teaching Hospital Ido- https://doi.org/10.5001/omj.2016.25
Ekiti, Nigeria. Journal of Public Health

CITE AS: Akech Clare (2023). Breast Self-Examination Knowledge, Attitudes, and
Practices in Women of Reproductive Age in Aburkot Ward, Amolatar District, Uganda.
INOSR Experimental Sciences 12(1):46-59.

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