Awareness and practice of breast self-examination among

women in reproductive age in Poblacion 1 & 2, Sagay City

 CHAPTER I

INTRODUCTION

BACKGROUND OF THE STUDY

Breast cancer is the most frequently diagnosed cancer worldwide in women, with nearly two
million new cases diagnosed in 2018. In the Philippines, breast cancer is the most common cancer among
women. Remains a worldwide public health dilemma and is currently the most common tumor in the globe.
Breast cancer is becoming more common, accounting for one-third of all female malignancies, according
to recent reports. The biggest issue is late-stage breast cancer, which should have been clearly
detectable in most cases. Early diagnosis is an essential alternative to explore for breast cancer
control. Breast self-examination has been considered as a safe and easy to perform screening
procedure to detect breast lumps and swelling. This study was conducted to determine knowledge on
breast cancer and breast self-examination among woman reproductive age.

Awareness surrounding breast cancer is incredibly important as early detection, often through

public attentiveness, and advancement in breast imaging has made a positive impact on recognition and

screening of breast cancer can catch the disease when it is most treatable.
 If breast cancer is diagnosed and treated early, many fatalities can be averted. Breast
self-examination (BSE) is a simple, low-cost instrument that may be used on a regular basis to detect
breast cancer in its early stages. As a result, the goal of this study was to analyze adolescent
females' awareness and practice of breast self-examination.

Since the breast cancer is one of the public health dilemmas in the Philippines. The
researcher triggers to determine the awareness and practice among women reproductive age towards
Breast Self-Examination (BSE) and also to explore their level of awareness and frequency. Also, to
develop necessary plans according the results of this study.

According to Dinegde NG, Demie et al. (2020). Breast cancer is the top cancer among women
both in the developed and the developing world. Many deaths can be avoided if breast cancer can be
detected and treated early. The practice of breast self-examination (BSE) is convenient, no-cost that
can be used regularly for detecting breast cancer at early stage. The knowledge and practice of BSE
could be considerably lower in communities having a more diversified female population and living in
remote areas in the country. Implementations are needed in addressing young females, making awareness
and advocacy campaigns about BSE to increase early diagnosis of breast cancer, which raises the
chances for successful treatment in Ethiopia
 STATEMENT OF THE PROBLEM

The main purpose of this study is to determine the knowledge of breast cancer and
practice of breast self-examination in Poblacion 1 & 2, Sagay City

SPECIFICALLY, THIS STUDY WILL SEEK TO ANSWER THE FOLLOWING QUESTIONS:

1. What is the profile of respondents in terms of:

1.1; Age

1.2; Educational Attainment

1.3; Financial Income

1.4; Practice of Breast Self-examination

2. Is there any significant difference on the respondent’s level of breast cancer awareness when group according

to:

2.1; Age

2.2; Educational Attainment

2.3; Financial Income

2.4; Practice of Breast Self-examination

3. Is the level of awareness (knowledge) of women on breast cancer and how frequently the woman perform breast

self-examination when group according to:

2.1; Age

2.2; Educational Attainment

2.3; Financial Income

2.4; Practice of Breast Self-examination

4. Based on the results of the study, what specific program should be developed?
CONCEPTUAL FRAMEWORK OF THE STUDY

Input
Level of Knowledge of
breast cancer &
practice of breast Output
self-examination among Recommendation
Process
women in reproductive Create a necessary
Researcher-made
age plan according to
•Age questionnaire
the results of the
•Educational Attainment study
•Family Income
•Practice of Breast
Self-examination
THEORETICAL FRAMEWORK OF THE STUDY

The framework used in our study is Health Belief Model. Using the five stages of this

theory can help us to promote the health and disease prevention program for all women under

reproductive age in the community of Baranggay Poblacion 1&2. This framework will help all

reproductive women to be more aware with regards of breast cancer and will know how to conduct

self-breast examination. Motivating women to be mindful of what breast cancer is and thus,

healthy lifestyle is a need to be practice. In this theory it can help to promote awareness of

a breast cancer and disease prevention for all women in reproductive age in the community of

Poblacion 1&2.
SIGNIFICANCE OF THE STUDY

This study will be conducted to raise awareness to women in reproductive age on Breast Cancer and

practice of breast self-examination in Poblacion 1&2, Sagay City.

Benefiting are the various sectors as follows:

The Respondents

This study will be beneficial to the respondent of Poblacion 1 & 2, Sagay City since this can help

them gain awareness with regards to breast cancer and breast self-examination. With this study they will be

able to know the importance of breast self-examination.

Midwives/BHWs:

The result of the study benefits the midwives/BHWs by providing the respondents with evidence-based

information about the awareness in breast self-examination. They can also create advocacy that can help

encourage the respondents to practice the breast self-examination.

Nursing Students

The result will help them realize whether the knowledge and skills developed in the

research would be useful to them in their future careers. It can also be the basis for their

future research study.

Future Researchers

The findings of the study will serve as a reference material and a guide for future

researchers who wish to conduct the same experimental or any study related to breast cancer and

breast self-examination.
SCOPE AND LIMITATION OF THE STUDY

This study aims to raise awareness and practice of breast self-examination among women

in reproductive age. The scope of the study limits to the women ages 20 - 24 of Poblacion 1

and 2, Sagay City. The researchers will prepare a self-made questionnaire as main source of

data analysis. Researchers will observe strict confidentiality measures and preventive

measures against COVID-19 during the investigation. The research is limited to whether the

interviewee is willing to participate in the research, so the possibility of rejection is

accommodated.
DEFINITION OF TERMS

Cancer - a disease in which some of the body’s cells grow uncontrollably and spread to other
parts of the body. Operationally breaks down, and abnormal or damaged cells grow and multiply
when they shouldn’t. These cells may form tumors, which are lumps of tissue.

Breast cancer – a type of cancer that most common in women in which cells in the breast grow out
of control. There are different kinds of breast cancer when breast cancer spreads to other parts
of the body, it is said to have metastasized. Operationally, breast cancer most commonly
presents as a painless lump or thickening in the breast non-painful lumps or masses, lumps or
swelling under the arms, nipple skin changes or discharge, noticeable flattening or indentation
of the breast.

Practice- to do (something) regularly or constantly as an ordinary part of your life.

Operationally this can help to enhance the lifetyle and their knowledge about breastcancer
awareness by practicing breast-self examination

Practice of breast self-examination - is the practice procedure wherein a woman examines the
parts of the breast to detect the normal and abnormal findings. Operationally, women do some
procedure to check their breast to check the entire breast and armpit area pressing down with
light, medium, and firm pressure. Check both breasts each month feeling for any lump,
thickening, hardened knot, or any other breast changes.

Reproductive age - in women, those years of life between menarche and menopause, roughly from
ages 12 to 49. Operationally, since some women can become pregnant and bear children at younger
or older ages.
 CHAPTER II
REVIEW OF RELATED LITERATURE
This chapter involves a review of related literature about a relevant ideas and concepts associated to the
existing research study.
The mean age of the study group was 36.9±8.8 years. Eighty percent were literates. Most of the women
178 (89%) were aware of breast cancer. Only 26% of the women were aware of BSE. Only 18% of the females had ever
checked their breast and 5% practiced it regularly. Awareness of BSE was found to be significantly associated
with age and educational attainment. Journal of mid-life health 8 (2), 84, 2017
According to Journal of family medicine and primary care, (2017). Breast cancer cases is about 115,000
per year and this is expected to rise to 250,000 new cases per year by 2015. It needs to be noted that breast
cancer is leading in the age groups of 15–34 years which is a cause of concern as this denotes the need for
educative and awareness programs targeting younger members of the society, to implement early practices of
breast examination. This study was carried out with the intention of assessing the level of knowledge and
awareness of carcinoma breast and breast self-examination (BSE) in female college students.
The current study shows that there was a high statistically significant relationship between
sociodemographic variables and women’s knowledge on BSE, as the highly knowledgeable women immediately after the
program were found to be the following: women aged between 20 and 30 years, not married, employed, and
university educated. In the same line, a study by Ayed et al. (2015) on BSE
Breast cancer has overtaken lung cancer as the most prevalent form of cancer in the Philippines. It
has been also noted that the Philippines has the lowest survival rate of people with breast cancer among 15
countries in Asia. 3 out of 100 Filipino women get breast cancer before 75 years old and 1 out of 100 will die
before reaching 75 years old. 15 % of cancer cases in the Philippines come from breast cancer for not just women
but also for men. 8 % of the Filipino cases die. With the distressing statistics presented, breast self-
examination is being advised to be done every month (Tubeza, 2012).
According to Henderson JA, Duffee D, Ferguson T, (2019). The National Comprehensive Cancer Network
screening guidelines suggest that women between 25 and 40 years old who are asymptomatic and have no special
risk factors for breast cancer undergo a clinical breast exam every 1 to 3 years.
 There are some obstacles that prevent female individuals from practicing BSE, as
reported by El-lassy and Abd Elaziz (2015), which include not having time and being too busy,
forgetting, not believing that it is beneficial, thinking it is wrong to touch the breast,
anxiety about the possibility of recognizing a breast mass, and embarrassing procedures.
As for most young adult women whose aware of BSE but fails performing BSE on regular
basis, they consider their fear of finding a lump that could indicate cancer (Takeda, 2012).
Breast screening is an essential health maintenance activity, is very important in
reducing mortality, and helps to detect BC at an earlier stage. Women who are familiar with
their own normal breast characteristics can easily discover any abnormalities early and can be
effectively treated. Each woman and girl should be aware of her own risk factors for BC
(Aghamolaei et al., 2011).
Health education on BSE practice is lacking and the knowledge deficit can contribute
negatively to early detection of breast cancer and compound late detection. Interventions should
go beyond just campaigns on awareness creation but to ensure young females know the procedures
involved BSE. (GRACE SELASIE Fiador University of Ghana, 2018)
The results of the current study showed that during the preprogram, three-quarters of
the study participants have correct knowledge about the importance of BSE, and most of the
participants know that it helps early detection of BC, and know the appropriate time and
frequency of performing BSE immediately after the program implementation. The highest percentage
of the respondents obtained their source of information throughout the program phases from the
social media. In the same line, a study by Ahmed et al. (2017)
 Approximately one million new cases of BC are diagnosed each year worldwide. It is the
commonest malignancy in women and comprises 18% of all female cancers; it accounts for nearly
one in four cases of cancer among all women (Moodi et al., 2011; Loh and Chew, 2011). It is the
most common cause of cancer morbidity and mortality among women in low-income and middle-income
countries, as most women who have BC are diagnosed in late stages due to lack of awareness on
early detection and BSE. Therefore, WHO (2016) recommended the use of BSE as an early screening
method to detect BC in low-income and middle-income countries. Early diagnosis affords a better
chance of survival and better prognosis in the absence of an etiological agent for BC; the most
appropriate way of controlling it will be early detection and treatment. Regular BSE can
identify any abnormal changes in the breast to establish good prognosis. The baseline data
provided in this study will be used to develop strategies to increase the efficacy of BSE among
women, and hence help in early screening of cancer with effective treatment, which in turn is
useful to the nursing profession and the community. Reduced cost of cancer treatment will be a
significant effect of the current study to the community and will give an opportunity to nursing
staff to develop educational programs to teach female individuals about BSE. For research
purpose, the results of the current study give indicators about female individual’s awareness,
and thus can help in investigating barriers to implement the procedure, and make an improvement
plan for nursing staff and female individuals to maximize the effect of BSE.
Breast cancer (BC) is one of the most prevalent and aggressive women’s cancer in both
low- and middle-income countries and its incidence in these countries is on increase due to
adoption of Western lifestyles (Pengpid & Peltzer, 2014).
According to Arch Public Health 78, (2020) Breast cancer (BC) is a non-communicable
disease with increased morbidity and mortality. Early detection of BC contributes to prompt
linkage to care and reduction of complications associated with BC. Breast self-examination (BSE)
is useful for detecting breast abnormalities particularly in settings with poor access to
healthcare for clinical breast examination and mammography. Therefore, we mapped evidence on
women’s knowledge, attitude, and practice of BSE in sub-Sahara Africa (SSA).
 Breast cancer typically produces no symptoms when the tumor is small and most treatable.
Therefore, it is very important for women to follow recommended screening guidelines for detecting
breast cancer at an early stage, before symptoms develop. The only way to control this disease is
early detection, that it can be treated in about 90% of women with breast cancer. The best way for
early detection of breast cancer is screening, and the best accessible way is breast self-examination
(BSE) (Reisi et al., 2013)
Early detection plays a crucial role for BC. Breast self-examination (BSE), mammography, and clinical
breast examination are screening methods, which are used to detect BC early. In addition, special
attention should be paid to BSE to enhance the possibility of early detection of any changes in
breast tissue. Although BSE alone is not sufficient for early detection of BC, it allows women to be
responsible for their own health, to recognize breast tissus well as to adopt the preventive health
behavior (Fotedar, et al., 2013; Akhtari-Zavare, Juni, Said & Ismail, 2013).
Breast self-examination involves the woman herself looking at and feeling the breast for
lumps or other abnormalities. There is evidence that, women who correctly practice BSE monthly are
more likely to detect a lump in the early stage, with early diagnosis and treatment yielding better
survival (verma, et al., 2013). However, despite these benefits, few women regularly perform BSE and
many do not even know how to perform it. Meanwhile, there is evidence that women are more likely to
perform BSE effectively when taught by physicians or a nurse. Unfortunately, in one study, only 19%
of the nurses reported teaching BSE, and the major reason for not teaching was the belief that it was
not relevant to their work (Sulik & Zierkiewicz, 2014).
Breast self-examination (BSE) is a self-inspection of the breasts. During a breast exam,
eyes are used to observe the appearance, and hands are used to feel the breast. BSE gives a greater
awareness of the condition of breasts and helps identify potential breast problems. Because many
women experience tenderness and lumpiness in their breasts before menstruation, many healthcare
providers advise women to perform BSE regularly every month, 5–7 days after menses (Hinkle and
Cheever, 2014)
The American Cancer Society supports the BSE as an early detection behavior. Research
suggests that women who receive personal instruction on BSE from a healthcare professional
demonstrate greater knowledge and confidence and are more likely to practice routine BSE than those
who become aware of the method from other sources (Rezaee et al., 2018).
 CHAPTER 3
METHODOLOGY

This chapter will discuss the research method employed, the research locale, the subject
respondents, the instrument used, and the data gathering techniques.

Research Design
The researchers used descriptive-survey method of research. This type of research design will be
used to provide an accurate description of observations of a phenomenon. It provided an accurate
portrayal or account of characteristics of particular individuals, situations, or groups as well
as will offer researchers a way to discover new meaning, describe what exists, determine the
frequency with which something occurs, and categorize information. The purpose of this study is
to assess the awareness and practice of breast self-examination of women in reproductive age in
Poblacion 1 and 2, Sagay City.
Respondents
The respondents of the study are the women in reproductive age, specifically (20-24
years old) from Poblacion 1 and 2, Sagay City.
Research Locale
The study is conducted on Poblacion 1 and 2 Sagay City, Negros Occidental.
Sampling Technique

Stratified Random Sampling will be utilized to select the respondents of the study. In
this sampling method, a population is divided into subgroups to obtain a simple random sample
from each group and complete the sampling process. Since the Respondents are female who are in
reproductive age. The small group is created based age group in the population. After
dividing the population into smaller groups, the researcher randomly selects the sample. Each
female individual who are in reproductive age in the population has an equal and likely
possibility of getting selected in the sample. Slovin’s formula will be use with 5% margin of
error.

Slovin’s formula:
Research Instrument
The researchers will use a self-made questionnaire Research instruments is divided into three (2)
parts; first will be used to gather the profile of the respondents. The second part will be used to
measure the level of breast cancer awareness of women from Poblacion 1 and 2, Sagay City.
RESPONDENT’S PROFILE QUESTIONNAIRE. This questionnaire aims to inquire on the profile of the
respondents. It is divided into 3 categories namely: Age, Educational Attainment, Financial Income,
and How frequent does the respondents perform breast self-examination?
LEVEL OF BREAST CANCER AWARENESS OF WOMEN IN REPRODUCTIVE AGE QUESTIONNAIRE. In order to gather the
data on the, the researchers will create a 10 items questionnaire. Each statement will be rated
according to its weighted mean and scale. Every scale has its own corresponding interpretation.
Table 1: Level of breast cancer awareness of women in reproductive age questionnaire

Mean Range Scale Interpretation

Weighted
Mean

5 4.21 – 5.00 Strongly Agree (SA) Means that you accept the truth of
the statement fully and absolutely
4 3.41 – 4.20 Agree (A) Means that you accept the truth of
the major part of the statement.
3 2.61 – 3.40 Neither Agree nor Means that you neither accept nor
Disagree (NAD) deny the truth of the statement.

2 1.81 – 2.60 Disagree (D) Means that you deny the major part
of the statement.

1 1.00 – 1.80 Strongly Disagree Means that you deny the statement
(SD) in it’s entirely.
Data Gathering Procedure
To collect the data for this study, researchers allocate a lot of time, effort, and coordination to
develop questionnaires with explicit words to serve the expected respondents.
Data will be collected using a self-administered questionnaire. The survey will use appropriate
questions from relevant research and individual questions formed by researchers. There will be 10
questions developed. All were on 1–5 Likert scales, which range from strongly agree to strongly
disagree. Participants were asked to check on the option that best describes their current status
about having a practice of breast self-examination. A questionnaire will be distributed to the
identified household of Poblacion 1&2, Sagay City. Participants will be given enough time to respond
and then the researchers will collect the survey questionnaires.
The data collected from the research tools will be collected and sorted based on the respondents'
answers. After collecting all the data, the researcher will use statistical tools to interpret the
data being collected.

Ethical Consideration
The researchers include the statements that consider the following:
Informed consent (that the participants agreed to participate in the survey voluntarily);
• Anonymity of the respondents (for privacy purposes);
• Confidentiality of the data;
• Disposal of survey materials.

Data Analysis
Frequency count and percentile will be used. In analyzing on the data, all the data was reliability
and analyzed.
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Questions Strongly Agree Agree Neither Agree nor Disagree Strongly Disagree
Disagree

Have you
performed breast
self-examination?
How often do you
practice Breast
Self-Examination?
Breast Self-
Examination could
be done during
menstruation?

Are you aware that

there’s Breast Self-
Examination?

Breast Self-
Examination could
be by doctor?
Breast Self-
Examination is a
useful for early
detection
Have you been
thought about
Breast-Self-
examination?
Have participated
Breast care
awareness
symposium?