This study assessed the knowledge of breast cancer and early detection measures of reverend sisters in Anambra State. Eight objectives and eight research questions were raised to guide the study. Cross-sectional descriptive survey design was used. A sample size of 324 respondents was drawn from an estimated population of 794 sisters of the various congregations living in communities located in Anambra State through stratified, proportionate and convenient sampling techniques. Data were collected by administration of a 17-item self-developed questionnaire through personal contacts by the researcher and 3 research assistants. Data were analysed descriptively using frequencies and percentages. Unpaired t-test was used to compare the responses of the two groups of respondents. There was significant difference in the knowledge of breast cancer preventive measures among the respondents. Only 61 (18.8%) of the sisters described breast cancer as uncontrolled multiplication of breast tissue. As many as 52 (16.0%) of the respondents had no idea of what breast cancer means. Painless lump was identified by 141 (43.5%) respondents as the early warning sign of breast cancer. There was no significant difference in the awareness of early warning signs/symptoms of breast cancer among the two groups (0.7438>p0.05) and what the two groups knew as breast examination (0.8608>p0.05). Most popular breast cancer early detection practices identified was breast self examination. More sisters in the active group seem to be aware of this than the contemplatives. A good number of them had never done breast self examination 50 (15.4%) and clinical breast examination 158 (48.8%). As many as 148 (45.7%) respondents were not aware of where to obtain the services, and 73 (22.5%) avoided the detection measures because of fear of lumps. Not being aware of where to obtain the services was a factor to reckon with, while at the same time, the sisters preferred to live in ignorance for fear of a lump being detected. Congregations should establish policy guidelines aimed at promoting adequate and urgent dissemination of all relevant information about breast cancer; and, integrate breast cancer screening procedures into their curriculum. There should be free access to screening services in the government health institutions.
Background to the study
Breast cancer (BCa) is a malignant tumour that has developed from breast cells, which has no cure at present. However, it can be managed with modern technological tools, and one’s life can be prolonged. In the last four decades, with the introduction of screening programmes that efficiently detect cervical cancer in its early stage, BCa has been seen to overtake cervical cancer in incidence and has become number one neoplasm among women (Okolie, 2012). BCa has therefore become a worldwide major health problem. The vast majority of it occur invasively in women (National Cancer Society [NCS], 2013). It accounts for 16% of all female cancers, and 22% of it are invasive. In both men and women, it accounts for 18.2% of all cancer deaths (NCS, 2013). Adebamowo and Ajayi (2006) corroborate the opinion of NCS and maintain that BCa is the commonest cancer among women in the world and in Nigeria too.
Adebamowo and Ajayi (2006) opine that it has become the commonest malignancy affecting Nigerian women. Also, according to Smeltzer, Bare, Hinkle and Cheever (2010), among the ten leading types of cancers by gender determined on the basis of estimated new cases and deaths in the United States in 2004, BCa accounts for 32% and the highest in female while prostate cancer accounts for 33% in males, which is the highest among them. Some of its common threats to physical wellbeing according to Adejumo and Adejumo (2009) include effects of treatments, recurrence and metastasis, fatigue, arm and shoulder discomfort, as well as lymphedema.
Unfortunately, Nigeria (which is the home country of the reverend sisters that are the focus of this study) remains ill-equipped to deal with the complexities of cancer detection and care as the testing and care facilities are still very few. The prevalence of BCa within the country is 116 per 100,000, and 27,840 new cases were expected to develop in 1999 (Adebamowo & Ajayi, 2006). In 2005, between 7 and 10,000 new cases of BCa developed.
This increasing incidence of BCa in Nigeria is in line with the situations in other developing countries, and even those advanced countries that used to have a low incidence now record high incidence. The relative frequencies of BCa among other female cancers, from Cancer Registries in Nigeria were 35.3% in Ibadan, 28.2% in Ife-Ijesha, 44.5% in Enugu, 17% in Eruwa, 37.5% in Lagos, 20.5% in Zaria and 29.8% in Calabar (Banjo, 2004 ). Similarly, in all the centres, except Calabar and Eruwa, BCa rated first among other cancers.
Further reports showed that majority of cases occurred in premenopausal women, and the mean age of occurrence ranged between 43–50 years across the regions. The youngest age recorded was 16 years, from Lagos (Banjo, 2004). This trend was attributed to several factors such as: the acceptance of fine needle aspiration as an accurate diagnostic evaluation, and increased awareness about BCa and usefulness of breast self-examination (Thomas, 2000).