Breast Cancer Chapter 1-5

AWARENESS OF SELF BREAST EXAMINATION IN THE PREVENTION OF BREAST CANCER
AMONG STUDENTS IN LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY, OGBOMOSO, OYO

STATE.
BY:
ALEJOLOWO ABIBAT AYOMIDE
INDEX NUMBER - 2023/2922/142559/M
EXAMINATION NUMBER - M/23/01717
DEPARTMENT OF MATERNAL AND CHILD HEALTH NURSING, FACULTY OF NURSING SCIENCES,

COLLEGE OF HEALTH SCIENCES, LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY,
OGBOMOSO, OYO STATE.
AWARENESS OF SELF BREAST EXAMINATION IN THE PREVENTION OF BREAST CANCER
AMONG STUDENTS IN LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY, OGBOMOSO, OYO
STATE.
BY:
ALEJOLOWO ABIBAT AYOMIDE
INDEX NUMBER - 2023/2922/142559/M
EXAMINATION NUMBER - M/23/01717
A RESEARCH SUBMITTED TO THE DEPARTMENT OF MATERNAL AND CHILD HEALTH NURSING,

FACULTY OF NURSING SCIENCES, COLLEGE OF HEALTH SCIENCES, LADOKE AKINTOLA
UNIVERSITY OF TECHNOLOGY, OGBOMOSO, OYO STATE.
IN PARTIAL FULFILLMENT OF THE REQUIREMENT OF THE NURSING AND MIDWIFERY COUNCIL

OF NIGERIA FOR THE AWARD OF THE REGISTERED MIDWIFE CERTIFICATE.
MARCH, 2023.
DECLARATION
This is to declare that this research titled “AWARENESS OF SELF BREAST EXAMINATION IN THE
PREVENTION OF BREAST CANCER AMONG STUDENTS IN LADOKE AKINTOLA UNIVERSITY OF
TECHNOLOGY, OGBOMOSO, OYO STATE” was carried out by ALEJOLOWO ABIBAT AYOMIDE and it is
solely the result of my research work except where acknowledged as being derived from other person(s)
or resources.
EXAMINATION NUMBER: …………………………………………
In the DEPARTMENT OF MATERNAL AND CHILD HEALTH NURSING, FACULTY OF NURSING SCIENCES,
COLLEGE OF HEALTH SCIENCES, LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY, OGBOMOSO, OYO
STATE.
SIGNATURE: ……………………………………………
DATE: ……………………………………
CERTIFICATION
This is to certify that this research project by ALEJOLOWO, ABIBAT AYOMIDE with Examination number:
……………………………… has been examined and approved for the award of REGISTERED MIDWIFE.
Dr. O.Y MAKINDE _______________
(RNM.RPHN.RNE. BNSc.MSc.MEd.FWACN(MCH).PhD) SIGNATURE AND DATE
Supervisor
Dr. O.Y MAKINDE ________________
(RNM.RPHN.RNE. BNSc.MSc.MEd.FWACN(MCH).PhD) SIGNATURE AND DATE
Head of Department, Maternal and Child Health Dept,
____________________ _______________
CHIEF EXAMINER SIGNATURE AND DATE

ABSTRACT
In both industrialized and developing nations, breast cancer is the most common type of cancer
among women. If breast cancer can be found and treated early, many fatalities can be averted.
Breast self-examination (BSE) is a simple, free method that can be done frequently to find
breast cancer in its earliest stages. The study aimed to assess the awareness of self-breast
examination in the prevention of breast cancer among female undergraduate students
attending Ladoke Akintola University of Technology, Ogbomoso. A descriptive cross-sectional
approach was used in this study. A simple random technique was used to recruit 190
respondents. A predesigned self-structured questionnaire was used as an instrument of data
collection. The responses were analyzed with descriptive statistics (Frequency and table). The
majority of the respondents 182(95.8%) said they have heard of self-breast examination before.
Most of the respondents 102(53.7%) said breast cancer symptoms include breast lump, nipple
discharge, and pain in the breast region. There is no significant relationship between age and
the level of knowledge about self-breast examination among female undergraduate students
from LAUTECH Ogbomoso" (P=0.070, X2Cal=8.674a), no significant relationship was found
between ethnicity and the level of knowledge of breast cancer among female undergraduate in
LAUTECH Ogbomoso" (P=0.663, X2Cal=0.821a) and there is no significant relationship between
the level of knowledge and level of practice of self-breast examination in the prevention of
breast cancer among female undergraduate students attending LAUTECH, Ogbomoso"
(P=0.097, X2Cal=4.668a). In conclusion, the study showed that the majority of the respondents
have good knowledge about breast cancer and self-breast examination. Also, the majority of
the respondents have good practice towards the self-breast examination. Health education on
self-breast examination should be done frequently for women in the community and also, for
students in each school ranging from Primary to tertiary institutions.
Keywords: Awareness, Breast, Breast Self-Examination, Students, Breast Cancer, Prevention
Word Counts: 292 words

DEDICATION
The research work is dedicated to Almighty GOD, the beginning and the end and also to every
resource person who were there during the course of this work, especially my parents, siblings,
loved ones and all my respondents.
ACKNOWLEDGEMENT
I glorify God for making this research a successful one by giving me the grace and wisdom to
carry out this work and also for His provision and protection.
My in–depth appreciation goes to my supervisor Dr. Makinde for creating time to read through
my project, for supervision, advice, contribution and motherly encouragement towards the
success of this research. May God bless you abundantly ma.
I appreciate the Head of the department of Maternal and Child Health Nursing, Dr. O.Y
Makinde, Thanks for your support ma.
I also appreciate the Dean of the Faculty of Nursing Sciences, Prof. B. L. Ajibade for his fatherly
advice and encouragement. I do not take it for granted sir. Thank you sir. My appreciation goes
to the entire lecturers and staff of faculty of Nursing sciences, Ogbomosho.
In addition, my profound gratitude goes to my ever loving parents, for their love,
encouragement and support financially, throughout the course of this work, may you live long
and to reap the fruits of your labor. Also, my siblings, you are so supportive, God bless you.
Also, I want to appreciate my good friends who in one way or the other have contributed to this
research work, your contributions mean so much.
Lastly, I want to appreciate my respondents who took out their time to fill my questionnaire,
may you be honored and also to various authors whose journals or books were reviewed in this
research.
Thank you.
TABLE OF CONTENT
Cover page i
Title page ii
Declaration page iii
Certification iv
Abstract v
Dedication vi
Acknowledgement vii
Table of contents viii
List of tables ix
List of figures. x
CHAPTER ONE
1.0 Introduction
1.1 Background to the study
1.2 Statement of the problem
1.3 Objectives of the study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of Study
1.7 Scope/Delimitation of the study

1.8 Operational definition of Terms
CHAPTER TWO
2.0. Literature Review
2.1. Introduction
2.2. Conceptual Review
2.2.1 Overview of the Breast
2.2.2 Breast Cancer
2.2.3 Self Breast Examination
2.3. Empirical Review
2.4. Theoretical Review
2.4.1. Health Belief Model
2.5. Application of the model to the study
CHAPTER THREE
3.0 Research Methodology
3.1 Introduction
3.2 Research Design
3.3 Research Setting
3.4 Target Population
3.5 Sampling Size
3.6 Sampling Technique

3.7 Instrument for Data collection
3.8 Pilot study
3.9. Validity of the instrument
3.10. Reliability of the instrument
3.11 Method of Data Collection
3.12 Method of Data Analysis
3.13 Ethical Consideration
CHAPTER FOUR
4.0. Analysis and Presentation of data
4.1. Introduction
4.2 Demographic Characteristics of respondents
4.3 Answers to research questions
4.4 Hypothesis Testing
CHAPTER FIVE
5.1 Introduction
5.2 Discussion of findings
5.3 Implication for Nursing practice
5.4 Limitations of the study
5.5 Summary
5.6 Conclusion
5.7 Recommendations
5.8 Suggestion for further studies
REFERENCES
QUESTIONNAIRE
LETTER OF PERMISSION TO COLLECT DATA

CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND TO THE STUDY
Breast cancer is a disease in which malignant cells are formed in the tissues of the breast. It is a
malignant uncontrolled growth of breast cells. Breast cancer is the most common malignancy
among women worldwide with 55% of it occurring in developing countries. Globally, over 1.15
million cases of breast cancer are diagnosed every year, and 502,000; women die from diseases
each year (WHO 2021).
In both industrialized and developing nations, breast cancer is the most common type of cancer
among women. If breast cancer can be found and treated early, many fatalities can be averted.
Breast self-examination (BSE) is a simple, free method that can be done frequently to find
breast cancer in its earliest stages. (Dinegde et Al, 2020).
Non-communicable diseases (NCDs), such as breast cancer, are perceived by the public as being
unpreventable, even though they are a preventable cause of morbidity, disability, and mortality
Women over 50, dense breasts, a family history of breast cancer, early menstruation and late
menopause, late pregnancy, use of birth control pills, race, atypical hyperplasia of the breast,
and prior radiation therapy treatment are the most prevalent risk factors for breast cancer.
Obesity, a lack of exercise, alcohol use, and meals heavy in fat and low in fiber are examples of
lifestyle variables (Asmare et Al, 2022), revealed that engaging in regular physical activity,
maintaining a healthy weight, using alcohol in moderation, and refraining from using tobacco
products Breast cancer is currently the most common type of cancer worldwide, with 2.26
million cases recorded in 2020 (WHO, 2021). It is also the most common cancer among women
both in developed and developing countries, and a major cause of public health concern (WHO,
2021). According to WHO (2021), Breast cancer impacted 2.1 million women and it is estimated
that 627,000 women died from breast cancer, approximately 15% of all cancer deaths among
women.
Breast cancer accounts for roughly 25% and 15% of overall incidence and death, respectively,
according to global cancer statistics (Asmare et Al, 2022). According to statistics from the
United States, a woman's average lifetime risk of acquiring breast cancer was 13%, or one in
every eight women (Desantis, et al, 2019). It is a significant public health issue, not just in
affluent countries but also in underdeveloped ones (Asmare et Al, 2022). According to
estimates, 70% of all breast cancer cases reported worldwide occurred in low- and middle-
resource nations (Lera at Al, 2020). It is the leading cause of death for women. In Ethiopia, the
prevalence of breast cancer represents 22.6% of all cancer cases. (Asmare et al, 2021).
Women must be aware of breast cancer signs and symptoms, and risks, and ultimately seek
care for breast concerns if attempts to enhance early diagnosis in a situation without
population-based screening are to be successful. Fortunately, the majority of women said that
they would seek medical attention if they saw a change in their breasts, but the lack of
awareness of the signs and symptoms of cancer as well as prevalent risk factors highlights the
need for focused community education and awareness initiatives. (Chao et al, 2020).
The only practical strategy that is affordable and simple to implement across a large population
is BSE. The ultimate goal is prevention and early intervention. Despite its significance as a
technique for early detection, a significant barrier has been a lack of understanding of women.
Consequently, increasing women's awareness of, and behavior toward, BSE through the
development of breast cancer awareness campaigns will help in the prevention of breast cancer
(Asmare et Al, 2022).
Early BC detection aids in quick treatment coordination and a decrease in problems related to
BC. Breast self-examination (BSE) is effective for finding breast abnormalities, especially in areas
where access to clinical breast examination and mammography is limited. Of the 8.6 million
new occurrences of cancer worldwide in 2018, BC accounted for 24.2%, with 8.1% of those
instances occurring in SSA. Additionally, BC was responsible for 11.8% of the 4.2 million cancer-
related deaths worldwide, while SSA accounted for nearly 15%. According to estimates, 1 in 8
women will experience BC at some point in their lives. By 2020, 19.7 million new cases are
anticipated worldwide, with 10.6 million of those cases occurring in LMICs (low-and middle-
income countries). Similarly, it is anticipated that by the year 2020, 36.8% of women will die
globally from BC, with 43.1% of those deaths occurring in LMICs. Regional projections for
morbidity and mortality in British Columbia are worrisome. Immediate action is therefore
required for the prevention and early detection of CB through various screening methods, as
part of the mission to help achieve Sustainable Development Goal (SDG) 3.4 by 2030. To
facilitate early detection of CS, knowledge, attitude, and practice of screening methods are
essential. Although clinical breast exams and mammograms are ideal for diagnosing CS,
accessing health care in most countries in sub-Saharan Africa can be a major challenge.
Economic constraints in most SSA countries may prevent mammography in the majority of
healthcare settings. In addition, clinical breast examination and mammography require
expertise, specialized equipment, and visits to medical facilities. However, breast self-
examination (BSE) is a non-invasive procedure performed monthly by individuals to identify
normal breasts and recognize any breast changes to seek early medical attention. Evidence
suggests that nine out of ten breast tumors are detected by women themselves. To this end,
knowledge, attitudes, and practices about BSE in women are essential. Knowledge of BSE
involves having information about the signs of BC, the BSE procedure, and how to perform the
BSE. Evidence suggests that knowledge of BSE has a positive impact on the early detection of
CS. Knowledge of BSE can also influence BSE attitudes and practices. Attitude is an established
way of thinking about BSE that includes accepting that BSE is necessary, all women should
practice it, being willing to encourage others to take the information and practice it, and
seeking medical attention early if any unusual signs appear. The practice of BSE involves
monthly palpation of her breasts, immediately after menstruation, and the ability to detect
abnormalities. The practice of BSE allows the individual to become familiar with his or her
breast structure and take charge of his or her health as detecting any abnormalities will require
early medical treatment. (Udoh et Al 2020)
Therefore, BSE is unlikely to have any significant harmful side effects, the main strategy to
reduce breast cancer mortality is to increase the proportion of cases detected early through
breast self-examination. when it is convenient for the woman to perform the act herself. Other
methods such as clinical breast examination and mammography require hospital and
specialized equipment. This study aimed to assess the relative awareness of breast self-
examination in breast cancer prevention among university students.
1.2 Statement of the Problem
WHO (2020) classified breast cancer as the leading form of cancer among women from
developed, middle-income, and third-world economies. Rates of the disease in middle-income
and developing economies are on the rise due to urbanization. WHO asserts that
mammography screening serves as the only method that is effective but it is applied in a high-
resource method. . According to the American Cancer Society (2018), self breast examination
practice should be observed by women in their early 20s. In some countries, a self breast
examination is required to be conducted every month. Examples of these countries are
Jamaica, Singapore, Mauritius, South Africa, and Namibia.bin their study surveyed female
University students drawn from 20 European countries and the researchers revealed that 54%
of the study respondents never engaged in self breast examination while 8% practiced a
monthly basis. Some of the notable factors that serve as barriers to SBE are poor attitudes
toward the practice and lack of awareness. Sayi et al (2018) observed that South African
physicians have realized an alarming rate of breast cancer incidence among young black women
since 1998. What is even more worrying due to increased cases of the disease among young
black women is that they have the lowest survival rate due to seeking healthcare when it's
already too late. The reason for delays before seeking healthcare professionals' services
emanates from a tendency of the group to first weekly consultations with traditional healers
relating to lumps they experience in their breasts (Sayi et al, 2018). Late diagnosis of breast
cancer serves as the reason that subjects young women to lower survival rates as they have a
tendency of seeking medical care when the disease is at advanced stages than their older
counterparts.
Despite authorities recommending self breast examination to limit cases of breast cancer, Self
breast examination is still not widespread. Additionally, even with a quantifiable number of
women possessing knowledge about the practice, and the resulting health benefits.
Therefore, this study seeks to explore the awareness of self breast examination in the
prevention of breast cancer among female undergraduate students attending Ladoke Akintola
University of Technology, Ogbomoso.
1.3 Objectives of the study.
1.3.1 Broad Objective
The broad objective is to assess the awareness of self breast examination in the prevention of
breast cancer among female undergraduate students attending Ladoke Akintola University of
Technology, Ogbomoso.
1.3.2 Specific Objectives
 To assess the awareness of self breast examination among female undergraduate

students attending Ladoke Akintola University of Technology, Ogbomoso.
 To determine the knowledge of breast cancer among female undergraduate students
attending Ladoke Akintola University of Technology, Ogbomoso.
 To determine the practices of self breast examination in the prevention of breast cancer
among female undergraduate students attending Ladoke Akintola University of
1.4 Research Questions
 What is the knowledge of self breast examination among female undergraduate

students attending Ladoke Akintola University of Technology, Ogbomoso?
 What is the knowledge of breast cancer among female undergraduate students
attending Ladoke Akintola University of Technology, Ogbomoso?
 What is the level of practice of self breast examination in the prevention of breast
cancer among female undergraduate students attending Ladoke Akintola University of
Technology, Ogbomoso?
1.5 Research Hypotheses
H1: There is no significant relationship between age and the level of knowledge about self
breast examination among female undergraduate students attending Ladoke Akintola
University of Technology, Ogbomoso.
H2: There is no significant relationship between ethnicity and the level of knowledge of breast
H3: There is no significant relationship between the level of knowledge and level of practice of
self breast examination in the prevention of breast cancer among female undergraduate
1.6 Significance of Study
This study was conducted at Ladoke Akintola University of Technology. This research project
will examine the awareness of self breast examination in the prevention of breast cancer
among female undergraduate students in the school and enlighten females on how to perform
self breast examination without visiting the hospital or any help rendered. With this study,
female students are allowed to examine their breasts and discover any changes felt in the
breast and reduce the risk of breast cancer. The study will help to identify ways to instill
knowledge to improve breast self-examination among female undergraduate students.
The results of this study are of great importance as they may assist health professionals in
planning Health education for students to create awareness about the importance of breast
self-examination and its relation to breast cancer.
1.7 Scope/Delimitation of Study.
This study will assess the awareness of self breast examination in the prevention of breast
Technology, Ogbomoso, Oyo State.
1.8 Operational Definition of Terms
Awareness: The understanding of breast self-examination.
Breast: Female organ located at the anterior chest wall.
Breast self-examination: A practice carried out by women in whom one's breast is palpated at a
particular period each month to assess for abnormal tissue in the breast.
Student: A female student attending Ladoke Akintola University of Technology.
Breast cancer: An abnormal malignant cellular growth in the breast.
Prevention: Any measure intended to limit health-related risk

CHAPTER TWO
2.1 Introduction
This chapter gives an insight into various studies conducted by outstanding researchers.
2.2 Conceptual Review
2.2.1 Overview of the Breast
The breast is located on the anterior thoracic wall. It extends horizontally from the lateral
border of the sternum to the mid-axillary line. Vertically, it spans between the 2nd and 6th
costal cartilages. It lies superficially to the pectoralis major and serratus anterior muscles.
The breast can be considered to be composed of two regions:
Circular body – the largest and most prominent part of the breast.
Axillary tail – a smaller part, that runs along the inferior lateral edge of the pectoralis major
towards the axillary fossa.
At the center of the breast is the nipple, composed mostly of smooth muscle fibers.
Surrounding the nipple is a pigmented area of skin termed the areolae. There are numerous
sebaceous glands within the areolae – these enlarge during pregnancy, secreting an oily
substance that acts as a protective lubricant for the nipple
2.2.2 BREAST CANCER
Breast cancer is a pathological entity that begins with a genetic change in a cell and can take
several years to become tangible. The most common histological type of breast cancer is
invasive ductal carcinoma (80% of cases), whereby tumors arise from the ductal system and
invade surrounding tissues. Invasive lobular carcinoma represents 10% to 15% of cases. These
tumors arise from the lobules epithelium and usually appear as an indistinct thickened area
inside the breast. Infiltrative ductal and lobular carcinoma usually spreads to bones, lungs, liver,
adrenal glands, pleura, skin, or brain. Some less common invasive cancers, such as medullary
carcinoma (5% of cases), mucinous carcinoma (3% of cases) cases) and ductal carcinoma (2% of
cases) with a prognosis that is very favorable. Inflammatory Carcinoma and Paget are less
common forms of breast cancer. Ductal carcinoma in situ is a non-invasive (also known as )
cancer ductal carcinoma), but if left untreated, there is an increase in the likelihood that it will
progress to invasive cancer. There is no specific cause of breast cancer; rather a combination of
genetic, hormonal, and possibly environmental factors events can contribute to its
development. If the lymph nodes are unaffected, the prognosis is better. The key to a better
healing rate is early diagnosis, before metastasis.
Risk factors
• Gender (female) and age increase gradually.
• History of breast cancer: risk of developing breast cancer The same or opposite breast is
significantly increased.
• Family history: Having a first-degree relative with breast cancer (mother, sister, daughter)
doubles the risk; having two first-degree relatives increases the risk fivefold.
• Genetic mutations (BRCA1 or BRCA2) account for the majority of hereditary breast cancers.
• Hormonal factors: early menstruation (before 12 years old), infertility, first childbirth after
age 30, late menopause (after age 55), and hormone therapy (formerly called hormone
replacement therapy).
• Other factors may include exposure to ionizing radiation in adolescence and early adulthood
obesity, alcohol consumption (beer, wine, or spirits), and a high-fat diet (controversial, need
further study). Protective factors may include regular high-intensity exercise (reduced body fat),
pregnancy before age 30, and breastfeeding.
Prevention strategy
 Patients at high risk for breast cancer can consult a specialist about possible or
appropriate prevention strategies. such as the following:
 Long-term follow-up including clinical examination every six months breast exam from
age 25, annual mammogram, and possibly magnetic resonance imaging (in BRCA1 and
BRCA2 carriers)
 Chemical prophylaxis to prevent disease before it occurs, use tamoxifen (Nolvadex) and
possibly raloxifene (Evista)
 Prophylactic mastectomy (“reduced risk”) for patients with a family history of breast
cancer, diagnosis of lobular carcinoma in situ (DCIS) or atypical hyperplasia, BRCA gene
mutation, extreme fear cancer (“cancer obsession”), or previous cancer in one Breast
clinical manifestations.
 Lesions are usually painless, fixed, and hard, with irregular margins; most occur in the
upper outer quadrant.
 Some women have no symptoms and no palpable lump but have an abnormal
mammogram.
 Signs of progression may include sunken skin, inverted nipples, or skin ulcers.
 Methods of assessment and diagnosis
 Biopsy (eg, percutaneous, surgical) and histological examination of cancer cells.
 Tumor staging and analysis of additional prognostic factors were used to determine the
optimal prognosis and treatment diet.
 Chest X-ray, CT scan, magnetic resonance imaging, PET scan, bone and blood scan work
(full blood cell count, complete metabolism panel, tumor markers [i.e. carcinoembryonic
antigen (CEA), CA15-3]). Breast cancer stage Classifying tumors into stages 0, I, or IV is
fairly straightforward. Stage II and III tumors represent a broad spectrum of cancer and
are divided into stages IIA, IIB, IIIA, IIIB, and IIIC. Factors determining the stage include
the number and characteristics of axillary lymph nodes and the status of other regional
nodes. lymph nodes and underlying skin or muscle involvement. Look at “Stage” in
“Cancer”. medical management Various management options are available. The patient
and the doctor may decide to have surgery, radiation, chemotherapy, hormone therapy,
or a combination of therapeutic therapy.
 Modified radical mastectomy involves the removal of all breast tissue, including the
nipple-areola complex and part of the axillary lymph nodes.
 Total mastectomy including mastectomy and nipple removal– auroral complex but does
not include axillary lymph nodes dissection (ALND).
 Breast-conserving surgery: lumpectomy, broad excision, partial or partial mastectomy,
then a quarter excision. removal of lymph nodes for invasive breast cancer.
 Lymph node biopsy: considered standard of care for the treatment of early-stage breast
cancer.
 External beam radiation therapy: usually radiation therapy to the entire breast, but
radiation therapy to part of the breast (radiotherapy only at the site of tumor removal)
is currently being evaluated in some institutions. in carefully selected patients.
 Chemotherapy to eliminate the micrometastatic spread of disease: regimens of
cyclophosphamide (Cytoxan), methotrexate, fluorouracil, anthracycline (eg, doxorubicin
[Adriamycin], epirubicin [Elence]), taxane (paclitaxel [Taxol], docetaxel [Taxotere]).
 Hormone therapy based on estrogen and progesterone receptors: tamoxifen
(Soltamox) is a key Hormonal agent used to prevent hormonal dependence tumors;
others are anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin)
inhibitors.
 •Target therapy: trastuzumab (Herceptin), bevacizumab (Avastin).
 Breast reconstruction. (Brunner and Suddarth 2017).
2.2.3 Self Breast Examination
Breast self-examination (BSE) is a routine examination that should be carried out at the same
time each month to physically check for any lumps or other changes. It entails two important
components, i.e. looking and feeling. With this method, women should learn what is normal for
them, so that they can recognize any changes immediately.
Though scientists have concluded that breast self-examination is not an effective method of
reducing mortality from breast cancer and the vast majority of changes found during breast
self-examination are not cancerous, in many countries, it may be the only alternative and
women should be encouraged to be aware of what is normal breast and recognize changes in
their breast, size, shape, skin, and nipples as soon as possible by self-examination once in a
month or two bases. Most breast lumps are detected when women take baths.
W.H.O. says that National Cancer Control programs should not recommend mass screening by
breast self-examination and physical examinations of the breast. Rather, programs should
encourage breast awareness and early diagnosis of breast cancer, especially for women aged
40-69 years attending primary health care centers or hospitals for other reasons, by offering
them clinical breast examinations.
The best time to do a monthly breast self-exam is about 3 to 5 days after menstruation starts at
the same time every month because the breasts are not as tender or lumpy at this time of the
monthly cycle. One important component during breast examination is the position. Depending
on whether looking at or feeling their breast, women should select different options. The use of
a mirror and a proper light system facilitate the detection of abnormalities. Breast self-
examination can be done either in the sitting or lying down position (dusting the hand with
powder or using cream).
Steps in conducting Breast Examination
Step 1
Stand in front of a mirror.
Check both breasts for anything unusual.
Look for discharges from the nipple, puckering, dimpling, or scaling of the skin.
Step 2
Watch closely in the mirror as you clasp your hands behind your head and press your hands
forward.
any change in the contour of your breast
Step 3
Press your hands firmly on your hips and now slightly toward the mirror as you pull your
shoulders and elbows forward.
Note any change in the contour of your breast
Step 4
Raise your left arm
Use three or four fingers of your right hand to feel your left breast firmly, carefully, and
thoroughly.
Beginning at the outer edge, press the flat part of your fingers in small circles, moving the
circles slowly around the breast.
Gradually work toward the nipple.
Be sure to cover the whole breast.
Pay special attention to the area between the breast and the underarm, including the underarm
itself.
Feel for any unusual lumps or masses under the skin.
If you have any spontaneous discharge during the month, whether it is during breast self-
examination or not, see your doctor. Repeat the examination on your right breast.
Step 5
Lying down procedure

Lie flat on your back with your left arm over your head and a pillow or folded towel under your
left shoulder.
The same circular motion described above should be used.
Repeat on your right breast.
2.3 Empirical Review
A study on the knowledge, attitude, and practice towards breast self-examination and
associated factors among women in Gondar town, Northwest Ethiopia with a total of 571
women, about 541 participants were involved in the study with a response rate of 94.7%. Of
these, 56%, 46%, and 45.8% of women had adequate knowledge, and favorable attitudes, and
performed breast self-examination (BSE) respectively. Women College and above AOR: 3.8
(95% CI: 1.43–10.14) and spouses College and above AOR: 3.03 (95% CI: 1.04–8.84), Women
College and above AOR: 4.18 (95% CI: 1.59–10.92) and history of breast cancer AOR: 6.06 (95%
CI: 2.19–16.74) and knowledge level AOR: 2.67 (95% CI: 1.18–6.04) were significantly associated
with knowledge, attitudes, and practices towards breast self-examination respectively. (Asmare
et al 2022).
In a study conducted by Israel et al (2023) on the determinants of breast self-examination

practice among women attending pastoralist health facilities, in Southern Ethiopia. The mean
age of the women was 25.43 ± 6.66 years. Fifty-four percent (n = 173) of the women had heard
of BSE from health professionals. Eighty-nine (21.1%) women had undergone BSE. Women who
resided in the urban areas (AOR = 6.79, CI: 3.40, 13.56), attained at least primary education and
above (AOR = 8.96, CI: 4.14, 19.35), heard about BSE (AOR = 4.07, CI: 2.07, 7.98), and had a
family history of breast cancer (AOR = 7.46, CI = 3.27, 17.00) were significantly associated with
BSE practice.
Another study on the knowledge and Practice of Breast Self-Examination Among Young Women
in Tertiary Education in Addis Ababa, Ethiopia showed that a few females implemented regular
BSE. Almost half of 188 (52.5%) respondents had heard about breast cancer self-examination,
while the media were the main source of information. The study revealed that only as few as 47
(13.1%) respondents did appropriate BSE. While confounding factors were controlled for, the
linear multivariate regression analysis indicated that the healthcare providers as information
sources about BSE (β = 1.9; CI= 0.62, 2.9; p < 0.01) make the greatest unique contribution to
explaining the BSE knowledge level. Moreover, the study indicated that the more age (β = 1.4;
CI=1.1, 1.8; p < 0.01) and knowledge (β = 1.34; CI=1.1, 1.64; p < 0.01) the females have, the
more likely it is that they will report practicing BSE. (Dinegde et al, 2020).
Elemile et al 2020 conducted research on the level of awareness and practice of BSE among
senior secondary school girls in Ado-Ekiti. A cross-sectional descriptive study design with 240
female adolescents in selected secondary schools in Ado-Ekiti was adopted. Data was obtained
by the administration of structured questionnaires. SPSS was utilized for the analysis of data
while descriptive statistics and Chi-Square were used to present data at α0.05 level of
significance. Results: Respondents' mean age was 15.6 +1.17 while about 43% of respondents
had a moderate level of awareness of BSE. The level of awareness was significantly associated
with the practice of BSE as both levels of awareness and practice were low as the calculated
value of 10.0 is greater than the tabulated value of 3.84. The study revealed poor awareness of
breast cancer and poor practice of BSE.
Another study revealed that there was limited knowledge about breast self-examination
among women in Mbale Regional Referral Hospital and this corresponds with the low practice
of the same after a cross-sectional study employing qualitative and quantitative methods was
carried out among 386 women selected by simple random sampling. Data was analyzed using
SPSS v 16.0 and presented in tables. Univariate and bivariate analysis was done and a P-value <
0.05 was considered statistically significant while the results with a P-value ≤ 0.2 were
considered for multivariate analysis. Results Both the knowledge and practice of breast self-
examination among the participants in this study were low. Less than 50% of the participants
had ever heard about breast self-examination. Only 24% of those who had ever heard about
breast self-examination correctly reported that it should be done monthly. Both knowledge and
practice of breast self-examination were associated with living in an urban setting, a high level
of education, occupation, and religion. ( Joyce et al, 2020).
A cross-sectional descriptive study was performed about women's knowledge, attitude, and
practice of breast cancer screening and breast self-examination. The mean age of the
participants was 34 years with extremes ranging from 18 to 64 years. 47% of women surveyed
have already performed breast self-examination at least once during the last year. 14% of
participants practiced breast cancer screening less than once a year. The first source of learning
for breast cancer screening was health professionals in 27% of cases. The score of the practice
of women surveyed was average; mostly, women have intermediate results for the technique
of self-examination breast. No woman had a score of 15/15. (Bannour et al 2020).
Prakash et Al, 2020 conducted a cross-sectional study using self-structured questionnaires

among female adolescents of Model Multiple College, Dhanusha. Out of 120 participants,
67.5% participants had knowledge about breast cancer and 40% had knowledge of breast self-
examination (BSE). Most of them (94.2%) had a poor knowledge of BSE followed by 5.8% of
participants with a moderate level of knowledge of BSE. The mean knowledge score was 18.7 ±
3.5. The majority (66.7%) of participants were from science faculties. More than half (51.7%) of
participants stated source of information on BSE was health personnel. Only 25% of the
respondents had a family history of breast cancer. The study revealed that most (94.2%) of the
participants had poor knowledge of breast self-examination.
A descriptive cross-sectional design that used a purposive sampling technique to select 204
consenting women from all specialties working in the State Secretariat, Agodi, Ibadan, to assess
their views on breast cancer prevention actions (BSE and mammogram). Findings from this
study demonstrate that although the majority of the respondents had adequate knowledge of
BSE and mammogram, the level of utilization of these methods was still low. More so, a
significant association was found between knowledge, level of education, and use of BSE and
mammogram. Identified barriers to wider utilization of the screening methods were time, fears
of the result of the screening, and other sociocultural factors, and these should be taken into
account when designing interventions. This may reduce the barriers, facilitate wider utilization
and ultimately lead to a decrease in the morbidity and mortality rate of breast cancer. (Ohaeri
et al 2019).
2.3 Theoretical Review
2.3.1 Health Belief Model (HBM).
The health belief model (HBM) is a social psychological health behavior change model
developed to explain and predict health-related behaviors, particularly about the uptake of
health services. (Siddiqui et al, 2016). The HBM theoretical constructs originate from theories
in Cognitive Psychology. In terms of health-related behaviors, the value is avoiding sickness. The
expectation is that a certain health action could prevent the condition for which people
consider they might be at risk (Glanz and Karen, 2015). In the 1950s, US public health
researchers began developing psychological models designed to enhance the effectiveness of
health education programs (Hochbaum 1958; Rosenstock 1966). Demographic characteristics
such as socio-economic status, gender, ethnicity, and age were known to be associated with
preventive health-related behavior patterns (i.e. patterns of behavior predictive of differences
in morbidity and mortality) as well as differential use of health services (Rosenstock 1974). Even
when services were publicly financed, socio-economic status was associated with health-related
behavior patterns. Demographic and socio-economic characteristics could not be modified
through health education but it was hypothesized that other potentially modifiable individual
characteristics associated with health-related behavior patterns could be changed through
educational interventions, and thus shift health behavior patterns at population levels. Beliefs
provide a crucial link between socialization and behavior. Beliefs are enduring individual
characteristics that shape behavior and can be acquired through primary socialization. Beliefs
are also modifiable and can differentiate between individuals from the same background. If
persuasive techniques can be used to change behavior-related beliefs and such interventions
result in behavior change, this provides a theoretical and practical basis for evidence-based
health education.
The relationship between health beliefs and behaviors was conceptualized primarily in terms of
Lewin’s (1951) idea of ‘valence’. Particular beliefs were thought to make behaviors more or less
attractive. This resulted in an expectancy-value model of belief–behavior relationships in which
events believed to be more or less likely were positively or negatively evaluated by individuals.
In particular, the likelihood of experiencing a health problem, the severity of the consequences
of that problem, and the perceived benefits of a preventive behavior, in combination with its
potential costs, were seen as key beliefs that shaped health-related behavior patterns.
(Abraham et al, 2018).
Early research found that these health beliefs were indeed correlated with differences in
health-related behavior patterns (referred to below as ‘health behaviors’ or ‘health behavior
patterns’) and so could be used to differentiate between those who did and did not undertake
such behaviors. The model was initially applied to preventive behaviors but later successfully
extended to identify the correlates of health service usage and adherence to medical advice
(Becker et al. 1977b).
Rosenstock (1974) attributed the first health belief model (HBM) research to Hochbaum's
(1958) studies of the uptake of tuberculosis X-ray screening. Hochbaum found that perceived
susceptibility to tuberculosis and the belief that people with the disease could be asymptomatic
(making screening beneficial) distinguished between those who had and had not attended for
chest X-rays. Similarly, a prospective study by Kegeles (1963) showed that perceived
susceptibility to the worst imaginable dental problems and awareness that visits the dentist
might prevent these problems were useful predictors of the frequency of dental visits over the
next three years. Haefner and Kirscht (1970) took this research further by demonstrating that
an HMM-based health education intervention designed to increase participants’ perceived
susceptibility, perceived severity, and anticipated benefits resulted in a greater number of
check-up visits to the doctor compared with no intervention over an eight-month follow-up.
Thus, by the early 1970s, a series of studies suggested that the HBM specified a series of key
health beliefs that provided a useful framework for understanding individual differences in
health behavior patterns and for designing behavior. The HBM had the advantage of specifying
a discrete set of common-sense beliefs that appear to explain, or mediate, the effects of
demographic variables on health behavior patterns and are amenable to change through
educational intervention. The model could be applied to a range of health behaviors and so
provided a framework for shaping behavior patterns relevant to public health as well as training
healthcare professionals to work from their patients’ subjective perceptions of illness and
treatment. Consensus regarding the utility of the HBM was important for public health research
and, simultaneously, placed cognition modeling at the center of health service research.
The HBM was consolidated when Becker et al. (1977b) published a consensus statement from
the Carnegie Grant
Subcommittee
on Modification of
Patient Behavior for
Health Maintenance
and Disease Control. This
paper considered a
range of alternative
approaches to understanding the social psychological determinants of health and illness
behavior and endorsed the HBM framework. The components of the model were defined and
further research on the relationships between individual beliefs and health behaviors was
called for.
The HBM focused on two aspects of individuals’ representations of health and health behavior:
threat perception and behavioral evaluation. Threat perception was construed as two key
beliefs: perceived susceptibility to illness or health problems, and anticipated severity of the
consequences of illnesses. The behavioral evaluation also consisted of two distinct sets of
beliefs: those concerning the benefits or efficacy of a recommended health behavior, and those
concerning the costs of, or barriers to, enacting the behavior. In addition, the model proposed
that cues to action can activate health behavior when appropriate beliefs are held. These ‘cues’
included a diverse range of triggers, including individual perceptions of symptoms, social
influence, and health education campaigns. Finally, an individual’s general health motivation, or
‘readiness to be concerned about health matters’, was included in later versions of the model
(e.g. Becker et al. 1977). There were therefore six distinct constructs specified by the HBM.
Figure 2.1 The Health Belief Model
As Figure 2.1 indicates, there were no clear guidelines on how to operationalize the links
between perceived susceptibility, severity, and overall threat perception. Similarly, although it
was suggested that perceived benefits were ‘weighted against’ perceived barriers (Becker et al.
1977), no formula for creating an overall behavioral evaluation measure was developed.
Consequently, the model has usually been operationalized as a series of up to six separate
independent variables that potentially account for variance in health behaviors. Even the
definition of these six constructs was left open to debate. Rosenstock (1974) and Becker and
Maiman (1975) illustrated how various researchers used somewhat different
operationalizations of these constructs and, in a meta-analysis of predictive applications of the
HBM, Harrison et al. (1992) concluded that this lack of operational homogeneity weakens the
HBM’s status as a coherent psychological model of the prerequisites of health behavior.
Nevertheless, a series of studies have shown that these various operationalizations allowed the
identification of beliefs correlated with health behaviors (Abraham et al, 2018).
2.3.2 Application of the Theory to the Study.
Perceived susceptibility
Perceived susceptibility refers to the subjective assessment of the attitude of female students
towards breast self-examination and risk of having breast cancer among female undergraduate
students attending Ladoke Akintola University of Technology, Ogbomoso. The HBM predicts
that female students who perceive that they are susceptible to developing cancer will engage in
behaviors such as reduction in alcohol intake, Intake of postmenopausal hormone therapy, and
oral contraceptives to reduce their risk of developing cancer. Female students with low
perceived susceptibility may deny that they are at risk for developing cancer due to a lack of
knowledge on breast self-examination. Others acknowledge the possibility that they could
develop cancer but believe it is highly unlikely. Women who believe they are at low risk of
developing cancer are more likely to engage in unhealthy, or risky behaviors such as excessive
alcohol intake, Intake of post-menopausal hormone therapy, and oral contraceptives. Female
students who perceive a high risk that they will be personally affected are more likely to engage
in behaviors to decrease their risk of developing cancer (Rosenstock et al, 2018).
Perceived Severity.
Perceived Severity refers to the subjective assessment of the attitude of female students
towards breast self-examination and risk of having breast cancer among female undergraduate
students attending Ladoke Akintola University of Technology, Ogbomoso. The HBM proposes
that female students who perceive attitudes and practices of breast self-examination as serious
are more likely to engage in behaviors to prevent cancer from occurring or reduce its severity.
Perceived seriousness encompasses beliefs about cancer as well as broader impacts on
functioning in work and practicing self breast examination. (Rosenstock et al, 3
2019).
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Introduction
This chapter will discuss the research design, the setting of the study and the study area, the
target population and size, the sampling technique that was used to select respondents, the
method and approach used for data collection, the methods that were adopted for the analyses
of the data collected, the validity and the reliability of the data obtained for the research and
the ethical consideration required by the university management to proceed on the research.
3.2 Research Design
A descriptive cross-sectional study design was adopted because the research will enable the
researcher to assess the awareness of self breast examination on the prevention of breast
cancer among undergraduates in a selected department of Ladoke Akintola University of
Technology Ogbomoso Oyo state, Nigeria. The design also enabled the researcher to draw
inferences from the sample following an in-depth investigative survey and thus derive relevant
information which could be generalized within the population.
3.3 Research Setting
The setting of this study is Ladoke Akintola University of Technology Ogbomoso Oyo State,
Nigeria.
Ladoke Akintola University of Technology was established in 1990, which was previously owned
by the old Oyo state which comprised the present Oyo and Osun states, it was then known as
Oyo State University. With the creation of Osun state in 1991, and the sharing of assets
between the two states, it was resolved that the university should be jointly owned and funded
by both states since the people of the two states are related; the name was then changed to
LAUTECH and the university edict was so amended but is now presently owned by only Oyo
state. The main campus is in Oyo state North Local Government, Ogbomoso, Oyo State, Nigeria
with geographical coordinates 8° 8' 0' ' North, 4° 16' 0" East. This is where most of the
University's teaching and research is carried out. This campus is the site of the university's
administration, as well as home to six faculties as well as the postgraduate school. Fields of
study include pure and applied science, medicine, Nursing, agriculture, engineering and
technology, and environmental science.
3.4 Target Population

The subjects used for this study are undergraduate students of selected departments studying
at Ladoke Akintola University of Technology Ogbomoso Oyo State, Nigeria.
3.5 Sampling Size
The entire population of students in selected departments in Ladoke Akintola University of

Technology is 2000. (Departmental register, 2020)
The formula to calculate the sample size will be Taro Yamane.
The formula for Taro Yamane:
n=N/(1+N)e^2
n= expected sample size
N= Total population
e= Level of significant
1= Constant
Calculation:
e=0.05 according to Taro Yamane
n=300/1+300(0.05^2)
n=300/1+0.75
n= 300/1.75
n= 171
The attrition rate of 10% was added to calculate this:
AR= (PS × PA)/ (PA-1)
AR= attrition rate

PS= Previous Sample size
1= Constant
AR= (171×10)/(10-1)
AR= 1710/9
AR= 190
AR=190 - 171
AR=19
Therefore, the sample size will be 190
The researcher therefore will be distributing 190 questionnaires to give room for the attrition
rate.
3.5 Sampling Technique
This is carried out primarily with one hundred and ninety students from selected departments
in LAUTECH. The respondents were selected using a simple random technique, which means
that all the respondents were chosen randomly by chance and randomly in such a way that
each student had an equal chance of being chosen and the structured questionnaire was
administered to the respondents to adequately evaluate the awareness of self breast
examination on the prevention of breast cancer among undergraduate students in Ladoke
Akintola University of Technology, Ogbomoso, Oyo State.
3.6 Instrument for data collection
The instrument for data collection was a structured self-administered questionnaire tagged "
Awareness of self breast examination in the prevention of breast cancer among female
undergraduate students attending Ladoke Akintola University of Technology, Ogbomoso, Oyo
State". The questionnaire was self-administered and it was divided into three sections that
consist of close-ended questions.
Section A: consists of demographic data ( Age, Gender, Religion, Ethnic group, marital status,
accommodation type) of respondents.
SECTION B: Knowledge of Self Breast Examination.
SECTION C: Practice of Self Breast Examination
3.7 Pilot Study
In determining the consistency and reliability of the self-designed instrument, the questionnaire
was administered to 19 undergraduate students at Bowen University Ogbomoso to ascertain
the reliability of the study instruments.
3.8 Validity of the instrument
The content of this questionnaire corresponds with the research objectives and questions of
this research. Each section represents each research objective and answers each research
question. The grammatical words used are appropriate for the respondents. This is to ensure a
proper understanding of the question by the respondents. To ensure the face, content and
construct validity of the questionnaire, it will be submitted to my research supervisor who will
read through it and make necessary corrections before it will be sent for typing.
3.9 Reliability of the instrument
The reliability of the questionnaire was ascertained by the pilot study. Ten percent of the
questionnaire, 19 was administered to a sample population in another University. The
tresponses of students with the same inclusion criteria stated for this research were analyzed
to see how reliable the questionnaire is. This is the pilot study. The value yielded 0.75 which is
equivalent to 75% reliability. Hence, the instrument was a reliable one.
3.10 Method of Data collection:
The self-designed e-questionnaire was administered to the respondents in Ladoke Akintola

University of Technology Ogbomoso, Oyo State Nigeria with permission and appreciation of
consent. Researchers explained the purpose of the research and how to answer the
questionnaire given to the respondents when required. The instrument was administered and
collected by the researcher on the same day.
3.11 Method of Data analysis
The data collected were analyzed by two methods of data analysis. These are descriptive and
inferential statistical methods. The descriptive statistics presented the response in simple
percentages using tables and graphs while the inferential statistical method was used to test
the hypotheses of the study.
3.12 Ethical Consideration
A letter of permission was collected from the Faculty of Nursing, College of Health Sciences,
Ladoke Akintola the University of Technology, Ogbomoso to administer the questionnaire
among the respondents. This letter was submitted to the Dean of student affairs, LAUTECH,
Ogbomoso who permitted to use of the students for the research. The selected respondents
were fully informed about the questionnaire, verbal consent was taken from each respondent
before administering the questionnaire and they were assured of confidentiality and the
questionnaire was self-administered by the researcher and collected on the appointed day.
CHAPTER FOUR
4.0 ANALYSIS AND PRESENTATION OF DATA.
4.1 Introduction.
This chapter deals with the analysis of collected data and presentation of results with the use of
percentages, frequencies and are displayed using frequency tables. Relationships between
variables were determined using Pearson’s chi square with level of significance set at 0.05 (p<
0.05) to determine level of statistical significance. This section also answers all the research
questions.
Data were computer-analyzed using statistical package for social sciences (SPSS) 21.0 version.
A total of 190 respondents were recruited and all the respondents completed the questionnaires
and had adequate data for analysis. This translates to a response rate of 100%.
4.2 Demographic characteristics of respondents
Table 4.1 showing the socio-demographic characteristics of respondents
Variables Categories Frequency Percent
Age 18-25 years 119 62.6
26-30 years 56 29.5
31-36 years 15 7.9
Religion Christianity 176 92.6
Islam 14 7.4
Ethnic group Yoruba 182 95.8
Igbo 8 4.2
Faculty Basic Medical Sciences 37 19.5
Agriculture 16 8.4
Management 21 11.1
Engineering 36 18.9
Nursing science 80 42.1

Accommodation type Flat 152 80.0
Self contain 18 9.5
School hostel 15 7.9
Scouting with a friend 5 2.6
Marital status Single 55 28.9
In a relationship 81 42.6
Engaged 40 21.1
Married 14 7.4
Total 190 100.0
Table 4.1 showed that majority of the respondents 119(62.6%) were aged between 18-25 years,
56(29.5%) were between the ages of 26-30 years while 15(7.9%) were between the ages of 31-36
years. 176(92.6%) were Christians while 14(7.4%) were Muslims. Majority of the respondents
182(95.8%) were Yoruba while 8(4.2%) were Igbo. Most of the respondents 37(19.5%) were
from Basic Medical Sciences. 152(80.0%) were living in Flat. Majority of the respondents
81(42.6%).
4.3 Answering of Research questions
Research question one: What is the knowledge of self-breast examination among female
undergraduate students attending Ladoke Akintola University of Technology, Ogbomoso.
Table 4.2 showing the knowledge of self-breast examination among female undergraduate
students attending Ladoke Akintola University of Technology, Ogbomoso

Have you heard of self-breast Yes 182 95.8

examination before?
No 8 4.2
If yes, How did you hear Friends 47 24.7

about it?
Mass media 54 28.4
Health worker 67 35.3
Family 22 11.6
What do you understand by It is a way of looking at the shape of the 14 7.4

self-breast examination? breast
it is a way of determining how beautiful 3 1.6

one's breast looks like
It is a way of examining the breast 173 91.1

monthly by oneself to detect any change
or abnormality
At what time should breast Daily 37 19.5

examination be performed?
Weekly 24 12.6
Monthly 126 66.3
Every 3-6 months 3 1.6
Breast self-examination can Lying down and sitting down only 8 4.2
be performed while?
In the shower, standing and looking at 42 22.1
the mirror
Lying down, sitting down, in the 140 73.7

shower, standing and looking at the
mirror
Total 190 100.0
Table 4.2 showed that majority of the respondents 182(95.8%) said they have heard of self-breast
examination before while 8(4.2%) said they haven’t heard of self-breast examination before.
67(35.3%) heard it from health workers, 47(24.7%) said they heard it from their friends,
54(28.4%) said they heard it from mass media. Majority of the respondents 173(91.1%) said
breast self-examination is a way of examining the breast monthly by oneself to detect any change
or abnormality. Most of the respondents 126(66.3%) said breast self-examination should be
performed monthly while a few 3(1.6%) said it should be performed every 3-6 months.
140(73.7%) said said breast self examination should be performed while lying down, sitting
down, in the shower, standing and looking at the mirror while 8(4.2%) said breast self-
examination shod be performed while lying down and sitting down only.
Research question two: What is the knowledge of breast cancer among female
undergraduate students attending Ladoke Akintola University of Technology, Ogbomoso?
Table 4.3 showing the knowledge of breast cancer among female undergraduate students
attending Ladoke Akintola University of Technology, Ogbomoso
Can the chances of survival from breast cancer be Yes 184 96.8
improved by carrying out self-breast examination?
No 6 3.2
Only females are affected by breast cancer True 100 52.6

False 90 47.4
Breast cancer can be transmitted from one person True 21 11.1

to another
False 129 67.9
Maybe 40 21.1
Breast cancer is the most common cancer among True 176 92.6
females
False 14 7.4
Breast cancer symptoms are breast lump 42 22.1
Nipple discharge 13 6.8
Pain in the breast 33 17.4

region
All of the above 102 53.7
Total 190 100.0
The table above showed that majority of the respondents 184(96.8%) said that the chances of
survival from breast cancer can be improved by carrying out breast self-examination whe
6(3.2%) of the respondents said no. 100(52.6%) said only females are affected by breast cancer
while 90(47.4%) said only females are affected by breast cancer. Most of the respondents
129(67.9%) said breast cancer cannot be transmitted from one person to another while
21(11.1%) said it can be transmitted from one person to another. 176(92.6%) said breast cancer
is the most common cancer among females while 14(7.4%) said breast cancer isn't the most
common cancer among Females. Most of the respondents 102(53.7%) said breast cancer
symptoms include breast lump, nipple discharge and pain in the breast region.
Research question three: What is the level of practices of self-breast examination in the
prevention of breast cancer among female undergraduate students attending Ladoke
Akintola University of Technology, Ogbomoso.
Table 4.4 showing the level of practices of self-breast examination in the prevention of
breast cancer among female undergraduate students attending Ladoke Akintola University
of Technology, Ogbomoso
Do you practice self-breast examination Yes 152 80.0
No 38 20.0
If yes, when do you practice self-breast Weekly 14 7.4

examination?
Monthly 22 11.6
Occasionally 154 81.1
If no, what is your reason for not performing I am healthy 80 42.1

self-breast examination?
I am afraid it may reveal 7 3.7
breast cancer
it's obscene 8 4.2
Nil 95 50.0
At what age did you start practicing self- At puberty 23 12.1

breast examination
15-20 years 109 57.4
20-25 years 35 18.4

25 years above 23 12.1
When was the last time you performed a self- Less than a month ago 126 66.3
breast examination
Less than 6 months ago 27 14.2
More than a year ago 37 19.5
What time do you normally perform self- During menstrual flow 31 16.3
breast examination?
During pregnancy 4 2.1
A week after period 85 44.7
No idea 70 36.8
Self-breast examination should be done by Doctor 22 11.6
Trained Nurse 13 6.8
The individual 150 78.9
Others 5 2.6
Do you know what to check for during self- Yes 147 77.4
breast examination?
No 43 22.6
Do you encourage your friends and relatives Yes 176 92.6

to do self-breast examination?
No 14 7.4
Total 190 100.0

Table 4.4 revealed that majority of the respondents 152(80.0%) said they practice breast self
examination while 38(20.0%) said they do not practice breast self-examination. 154(81.1%) they
practiced it occasionally. Most of the respondents 95(50.0%) said they didn't have reason of not
practicing. Most of the respondents 109(57.4%) said they started practicing breast at the of 15-20
years while a few 23(12.1) said they started at puberty. 126(66.3%) said they performed self
breast examination Less than one month ago. 85(44.7%) said they do perform self breast
examination a week after period while a few 4(2.1%) said they perform it during pregnancy.
150(78.9%) said self-breast examination should be done by individual. 147(77.4%) said they
know what to check for during self breast examination. Most of the respondents 176(92.6%) said
they do encourage their friends and relatives to do self-breast examination.
4.4 Hypothesis testing
Decision rule: If the P-value is less than 0.05 the null hypothesis (HO) will be rejected and the
alternative hypothesis (HI) will be accepted otherwise null hypothesis be accepted and the
alternative will be rejected.
Hypothesis one
Ho - There is no significant relationship between age and the level of knowledge about self-breast
examination among female undergraduate students attending Ladoke Akintola University of
H1 - There is significant relationship between age and the level of knowledge about self-breast
examination among female undergraduate students attending Ladoke Akintola University of
Table 4.5 showing the association between age and the level of knowledge about self-breast
examination among female undergraduate students attending Ladoke Akintola University
of Technology, Ogbomoso
What do you understand by self-breast examination? Tot X d P

2
al f valu
e
It is a way of it is a way of It is a way of 8. 4 .070

looking at the determining examining the 67
shape of the how beautiful breast monthly by 4a
breast one's breast oneself to detect
looks like any change or
abnormality
Age 18-25 10 0 109 119

years
26-30 4 3 49 56
years
31-36 0 0 15 15
years
Total 14 3 173 190
Inference: Since the P-Value (0.070) is greater than 0.05 level of significance, we accept the null
hypothesis and reject the alternative hypothesis. Therefore, there is no significant relationship
between age and the level of knowledge about self-breast examination among female
undergraduate students attending Ladoke Akintola University of Technology, Ogbomoso
Hypothesis two
Ho - There is no significant relationship between ethnicity and the level of knowledge of breast
H1 - There is significant relationship between ethnicity and the level of knowledge of breast
Table 4.6 showing the association between ethnicity and the level of knowledge of breast
What do you understand by self-breast examination? Tot X2 d P

al f valu
e
It is a way of it is a way of It is a way of .82 2 .663

looking at the determining how examining 1a
shape of the beautiful one's the breast
breast breast looks like monthly by
oneself to
detect any
change or
abnormality
Ethnic Yoruba 14 3 165 182

group
Igbo 0 0 8 8
Total 14 3 173 190
between ethnicity and the level of knowledge of breast cancer among female undergraduate
Hypothesis three
Ho - There is no significant relationship between level of knowledge and level of practice of self-
breast examination in the prevention of breast cancer among female undergraduate students
H1 - There is no significant relationship between level of knowledge and level of practice of self-
breast examination in the prevention of breast cancer among female undergraduate students
Table 4.6 showing the association between level of knowledge and level of practice of self-
breast examination in the prevention of breast cancer among female undergraduate
students attending Ladoke Akintola University of Technology, Ogbomoso
Do you practice self- Total X2 d P

breast examination f Value
Yes No 4.668 2 .097

a
What do you It is a way of looking at the 14 0 14

understand by shape of the breast
self-breast
examination it is a way of determining 3 0 3
how beautiful one's breast
looks like
It is a way of examining 135 38 173

the breast monthly by
oneself to detect any
change or abnormality
Total 152 38 190

Do you practice self- Total X2 d P
breast examination f Value
between level of knowledge and level of practice of self-breast examination in the prevention of
Technology, Ogbomoso
CHAPTER FIVE
DISCUSSION OF FINDINGS
5.1 Introduction
This aspect of study deals with the discussion of findings, summary, conclusion, implication for
Nursing practice, Limitation of study, conclusion, recommendations and suggestions for further
study.
5.2 Discussion of Findings
This study was aimed to assess the awareness of self-breast examination in the prevention of
Discussion on Socio-demographic characteristics
Table 4.1 showed that majority of the respondents 119(62.6%) were aged between 18-25 years,
56(29.5%) were between the ages of 26-30 years while 15(7.9%) were between the ages of 31-36
years. 176(92.6%) were Christians while 14(7.4%) were Muslims. Majority of the respondents
182(95.8%) were Yoruba while 8(4.2%) were Igbo. Most of the respondents 37(19.5%) were
from Basic Medical Sciences. 152(80.0%) were living in Flat. Majority of the respondents
81(42.6%).
Discussion on the knowledge of self-breast examination among female undergraduate

Table 4.2 showed that majority of the respondents 182(95.8%) said they have heard of self-breast
examination before while 8(4.2%) said they haven’t heard of self-breast examination before.
67(35.3%) heard it from health workers, 47(24.7%) said they heard it from their friends,
54(28.4%) said they heard it from mass media. Majority of the respondents 173(91.1%) said
breast self-examination is a way of examining the breast monthly by oneself to detect any change
or abnormality. Most of the respondents 126(66.3%) said breast self-examination should be
performed monthly while a few 3(1.6%) said it should be performed every 3-6 months.
140(73.7%) said said breast self examination should be performed while lying down, sitting
down, in the shower, standing and looking at the mirror while 8(4.2%) said breast self-
examination shod be performed while lying down and sitting down only.
Discussion on the knowledge of breast cancer among female undergraduate students
The table above showed that majority of the respondents 184(96.8%) said that the chances of
survival from breast cancer can be improved by carrying out breast self-examination whe
6(3.2%) of the respondents said no. 100(52.6%) said only females are affected by breast cancer
while 90(47.4%) said only females are affected by breast cancer. Most of the respondents
129(67.9%) said breast cancer cannot be transmitted from one person to another while
21(11.1%) said it can be transmitted from one person to another. 176(92.6%) said breast cancer
is the most common cancer among females while 14(7.4%) said breast cancer isn't the most
common cancer among Females. Most of the respondents 102(53.7%) said breast cancer
symptoms include breast lump, nipple discharge and pain in the breast region.
Discussion on the level of practices of self-breast examination in the prevention of breast
Table 4.4 revealed that majority of the respondents 152(80.0%) said they practice breast self
examination while 38(20.0%) said they do not practice breast self-examination. 154(81.1%) they
practiced it occasionally. Most of the respondents 95(50.0%) said they didn't have reason of not
practicing. Most of the respondents 109(57.4%) said they started practicing breast at the of 15-20
years while a few 23(12.1) said they started at puberty. 126(66.3%) said they performed self
breast examination Less than one month ago. 85(44.7%) said they do perform self breast
examination a week after period while a few 4(2.1%) said they perform it during pregnancy.
150(78.9%) said self-breast examination should be done by individual. 147(77.4%) said they
know what to check for during self breast examination. Most of the respondents 176(92.6%) said
they do encourage their friends and relatives to do self-breast examination.
5.2.1 Findings from Hypotheses
Table 4.5 revealed the Hypothesis one which stated that " there is no significant relationship
between age and the level of knowledge about self-breast examination among female
undergraduate students attending Ladoke Akintola University of Technology, Ogbomoso"
(P=0.070, X2Cal=8.674a). Since the P-Value (0.070) is greater than 0.05 level of significance, we
accept the null hypothesis and reject the alternative hypothesis.

Table 4.6 revealed the Hypothesis two which stated that "there is no significant relationship
between ethnicity and the level of knowledge of breast cancer among female undergraduate
students attending Ladoke Akintola University of Technology, Ogbomos" (P=0.663,
X2Cal=0.821a). Since the P-Value (0.663) is greater than 0.05 level of significance, we accept
the null hypothesis and reject the alternative hypothesis.
Table 4.7 revealed the Hypothesis three "there is no significant relationship between level of
knowledge and level of practice of self-breast examination in the prevention of breast cancer
among female undergraduate students attending Ladoke Akintola University of Technology,
Ogbomoso" (P=0.097, X2Cal=4.668a).Since the P-Value (0.097) is greater than 0.05 level of
significance, we accept the null hypothesis and reject the alternative hypothesis.
5.3 Implications for Nursing practice
WHO (2020) classified breast cancer as the leading form of cancer among women from
developed, middle - income, and third world economies. Therfore, Nurses and Midwives must
initiate the practice of self-breast examination by educating women to perform it especially
during antenatal clinic. Moreover, students should also be taught self-breast examination
during their sex education.
5.4 Limitation for the Study
This study is subjected to the following limitations.
Time factor: The researcher had limited time to combine the study with other academic
activities.
One-site setting: The study is limited by the use of one study settings which could affect the
generalizability of the study.
5.5 Summary
The broad objective is to assess the awareness of self breast examination in the prevention of
Technology, Ogbomoso. Research questions were asked and answered, three hypothesis were
tested in the study. The study used a descriptive cross-sectional approach and data was gathered
using self-structured questionnaire distributed to the female undergraduates who participated in
the study. The collected data was analyzed using statistical Package for Social Sciences (SPSS)
and the results were presented in tables.
5.6 Conclusion
The findings from the study showed that majority of the respondents have good knowledge about
breast cancer and self breast examination. Also, majority of the respondents have good practice
towards self breast examination.
5.7 Recommendations
The following recommendations were made based on the findings:
1. Students should be taught on to carryout self breast examination in schools
2. Health education on self breast examination should be done frequently for women in the
community
3. Awareness on breast cancer should be organised in the community

5.8 Suggestions for Further Studies
Further studies could be carried out on this same subject matter using a large number of subjects
and a different location. Studies could also be carried:
1. Social cultural factors contributing to the development of breast cancer
2. The contribution of health care workers in the prevention of breast cancer
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FACULTY OF NURSING SCIENCE
COLLEGE OF HEALTH SCIENCES
LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY, OGBOMOSO
QUESTIONNAIRE ON AWARENESS OF SELF BREAST EXAMINATION IN THE
PREVENTION OF BREAST CANCER AMONG UNDERGRADUATE STUDENTS IN

LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY IN OGBOMOSO, OYO
STATE.
I am a 500 level Nursing student of Ladoke Akintola University of Technology, Ogbomoso
conducting a research on the above topic.The questionnaire is meant for data collection.Your
honest and sincere response to this question will be highly appreciated.Be assured that all
information provided is absolutely confidential,your name is not required and it is basically for
academic purpose.
Thanks for your willingness to participate.
ALEJOLOWO, ABIBAT AYOMIDE.
Instruction: Kindly tick the appropriate option in front of each section.
SECTION A: Demographic characteristics of respondents
1. Age: (a) 18-25 years (b) 26-30 years (c) 31-36 years (d) 36 and above
2. Religion: (a) Christianity (b) Islam (c) Traditional (d) Others
3. Ethnic group: (a) Yoruba (b) Igbo (c) Hausa (d) Others(specify)
4. Faculty: (a) Basic Medical Sciences (b) Agriculture (c) Management (d) Engineering
5. Accomodation type: (a) flat (b) Self contain (c) School hostel (d) scouting with a friend
6. Marital status: (a) Single (b) In a relationship (c) Engaged (d) Married
SECTION B: Knowledge of Self Breast Examination
7. Have you heard of self breast examination before? (a) Yes (b) No
8. If yes, How did you hear about it? (a) Home (b) Friends (c) mass media (d) Health worker (e)
others (specify_______________)
9. What do you understand by self breast examination? (a) It is a way of looking at the shape of
the breast (b) it is a way of determining how beautiful one's breast looks like (c) It is a way of
examining the breast monthly by oneself to detect any change or abnormality
10. At what time should breast examination be performed? (a) Daily (b) Weekly (c)Monthly (d)
Every 3-6 months
11. Breast self examination can be performed while? (a) Lying down and sitting down only (b)
In the shower, standing and looking at the mirror (c) Lying down, sitting down, in the shower,
standing and looking at the mirror
12. Can the chances of survival from breast cancer be improved by carrying out self breast
examination? (a) Yes (b) No
13. Only females are affected by breast cancer (a) True (b) False
14. Breast cancer can be transmitted from one person to another (a) True (b) False
15. Breast cancer is the most common cancer among females (a) True (b) False
16. Breast cancer symptoms are (a) breast pump (b) Nipple discharge (c) Pain in the breast
region (d) Dimpling of breast (e) Change in the shape of breast (f) All of the above (g) None of
the above
SECTION C: Practice of Self Breast Examination
17. Do you practice self breast examination? (a) Yes (b) No

18. If yes, when do you practice self breast examination? (a) Weekly (b) Monthly (c)
Occasionally
19. If no, what is your reason for not performing self breast examination? (a) I am healthy (b) I
am afraid it may reveal breast cancer (c) it's obscene (d) I feel shy (e) Others (specify_______)
20. At what age did you start practicing self breast examination (a) At puberty (b) 15-20 years
(c)20-25 years (d) 30 years above
21. When was the last time you performed a self breast examination? (a) Less than a month ago
(b) Less than 6 months ago (c) More than a year ago
22. What time do you normally perform self breast examination? (a) During menstrual flow (b)
During pregnancy (c) A week after period (d) During breastfeeding (e) No idea
23. Self breast examination should be done by (a) Doctor (b) Trained Nurse (c) The individual
(d) Others(Specify______)
24. Do you know what to check for during self breast examination? (a) Yes (b) No
25. Do you encourage your friends and relatives to do self breast examination? (a) Yes (b) No

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AWARENESS OF SELF BREAST EXAMINATION IN THE PREVENTION OF BREAST CANCER

AMONG STUDENTS IN LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY, OGBOMOSO, OYO

ALEJOLOWO ABIBAT AYOMIDE

INDEX NUMBER - 2023/2922/142559/M

EXAMINATION NUMBER - M/23/01717

DEPARTMENT OF MATERNAL AND CHILD HEALTH NURSING, FACULTY OF NURSING SCIENCES,

ALEJOLOWO ABIBAT AYOMIDE

INDEX NUMBER - 2023/2922/142559/M

EXAMINATION NUMBER - M/23/01717

A RESEARCH SUBMITTED TO THE DEPARTMENT OF MATERNAL AND CHILD HEALTH NURSING,

IN PARTIAL FULFILLMENT OF THE REQUIREMENT OF THE NURSING AND MIDWIFERY COUNCIL

EXAMINATION NUMBER: …………………………………………

Dr. O.Y MAKINDE _______________

(RNM.RPHN.RNE. BNSc.MSc.MEd.FWACN(MCH).PhD) SIGNATURE AND DATE

Dr. O.Y MAKINDE ________________

(RNM.RPHN.RNE. BNSc.MSc.MEd.FWACN(MCH).PhD) SIGNATURE AND DATE

Head of Department, Maternal and Child Health Dept,

CHIEF EXAMINER SIGNATURE AND DATE

Keywords: Awareness, Breast, Breast Self-Examination, Students, Breast Cancer, Prevention

Word Counts: 292 words

Declaration page iii

Table of contents viii

1.1 Background to the study

1.2 Statement of the problem

1.3 Objectives of the study

1.4 Research Questions

1.5 Research Hypothesis

1.6 Significance of Study

1.7 Scope/Delimitation of the study

2.0. Literature Review

2.2. Conceptual Review

2.2.1 Overview of the Breast

2.2.2 Breast Cancer

2.2.3 Self Breast Examination

2.3. Empirical Review

2.4. Theoretical Review

2.4.1. Health Belief Model

2.5. Application of the model to the study

3.0 Research Methodology

3.2 Research Design

3.3 Research Setting

3.4 Target Population

3.5 Sampling Size

3.6 Sampling Technique

3.8 Pilot study

3.9. Validity of the instrument

3.10. Reliability of the instrument

3.11 Method of Data Collection

3.12 Method of Data Analysis

3.13 Ethical Consideration

4.0. Analysis and Presentation of data

4.2 Demographic Characteristics of respondents

4.3 Answers to research questions

4.4 Hypothesis Testing

5.2 Discussion of findings

5.3 Implication for Nursing practice

5.4 Limitations of the study

5.8 Suggestion for further studies

LETTER OF PERMISSION TO COLLECT DATA

1.1 BACKGROUND TO THE STUDY

1.2 Statement of the Problem

1.3 Objectives of the study.

1.3.1 Broad Objective

1.3.2 Specific Objectives