INTRODUCTION: positively linked to a decrease in mortality

INTRODUCTION:

 Breast
cancer affects approximately 1 in 3000 pregnant women and is the second most
common malignancy affecting pregnancy
1. Presently 75,000 new cases occur in India every year. The first noticeable
symptom of breast cancer is typically a lump that feels different from the rest
of the breast tissue 2.

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Pregnancy Associated Breast Cancer
PABC is defined as breast cancer diagnosed during pregnancy or in the first
postpartum year.  It is one the most common tumour of reproductive age
group. Previous studies have suggested that approximately 10% of breast
cancers diagnosed in patient’s aged ?40 years were diagnosed during the
pregnancy. It is a dangerous myth that women who are pregnant or breastfeeding
cannot get breast cancer. So, it is still vitally important to check the breast
even during pregnancy. More than 80% of breast cancer cases are discovered when
the woman feels a lump 3. Lack of awareness, no clinical breast examination
or mammography, no access to proper healthcare are risk factors for developing
breast lesions.

Breast Self Examinations BSE or
regularly examining your breasts on your own, can be an important step for
early detection of breast lesions and making them more likely to be treated
successfully and it has been positively linked to a decrease in mortality and
morbidity. Though debates have been going on about how valuable Breast Self
Examination is in detecting breast lesions, the procedure can be very
beneficial to women of the rural population who lack the means to proper
healthcare or general mammography. Multiple socio-demographic factors, myths,
cultural beliefs, lack of accessibility to the health care services have been
identified as the reasons for the poor uptake of BSE 4. BSEs
have been seen to be very useful and essential screening strategy, especially
in combination with regular physical examination by a doctor and mammography.

 

OBJECTIVES
OF THE STUDY:

1.      To assess the awareness and practice of Breast Self Examination
among pregnant women residing in an urban and rural areas of Bangalore.

 

2.     
To determine the socio
demographic factors affecting the awareness and practice towards Breast Self
Examinations in pregnant women.

 

 

 

 

 

METHODOLOGY:

STUDY
AREA:

1.      Pregnant women attending the OBG OPDs at M.S Ramaiah hospitals

2.     
Rural Field practice area of
Ramaiah Medical College.

 

 

INCLUSION
CRITERIA:

1.All pregnant
women attending the OBG OPDs at Ramaiah hospitals and the rural centres attached
to the Community Medicine department of Ramaiah Medical College who give
consent to participate.

 

EXCLUSION
CRITERIA:

1.     
Pregnant women who have already
been diagnosed with breast cancer.

 

STUDY
DURATION: 2 months

STUDY
DESIGN: Cross sectional
study

SAMPLE
SIZE-   97 in each group (194)

RATIONALE
FOR SAMPLE SIZE:

Based on the literature review, in a
previous study conducted by Anantha Lakshmi Satyavathi Devi Kommula,
Surendranath Borra and Vani Madhavi Kommula; it was found that 16.5% of the
women were aware of BSE 5. In the present study expecting a difference of 20%
in the knowledge level regarding Breast Self Examination between rural and
urban pregnant women; considering power of 80% and confidence level of 95%, the
sample size worked out to be minimum of 97 pregnant women in each group.

STATISTICAL
ANALYSIS:

Qualitative variables like socio-demographic
characteristics of the participants and practice regarding BSE will be presented
using frequency and percentages. Quantitative variables like awareness scores
will be analysed and presented using descriptive statistics like mean and SD.
The knowledge scores of urban and rural women will be computed and tested for
statistical significance difference using Mann Whitney U test. Chi Square test
will be used to find the association between knowledge level and select socio
demographic factors. SPSS version 17 will be used for statistical analysis.

 

STUDY
DURATION: 2 months

STUDY
DESIGN: Cross sectional

 

PROCEDURE:

The study subjects will be recruited
from the OBG OPDs at Ramaiah hospitals and its attached rural centres. The
study questionnaire is translated into the local language and the subject is
requested to fill it. If the subject is not literate, the investigator will ask
the questions orally and fill the questionnaire for the subject. Subjects are
requested to assemble individually or in groups at a convenient common point
where health education about Breast Self Examination BSE, its advantages will
be explained by the investigator through pictorial references. This will be
followed by an interactive session where their doubts on BSE will be clarified.
If they are already aware of BSE, a demonstration is asked of the subject, where
they are corrected if needed, while those unaware are taught the complete
process. The sessions are expected to last for a period of approximately 15-20 minutes.

 

IMPLICATION
OF THE STUDY:

Literature review suggests that pregnant
women in whom diagnosis was delayed or treatment deferred have a lower survival
rate. BSE involves visualization and palpation of the breast by oneself
for lumps, shape, texture, size and contour. The purpose of this is for a woman
to learn the topography of her breasts, know how her normal breasts feel and be
able to identify changes in them should they occur in the future 6. It is
cost effective and more readily available than any other method of early
detection of breast cancer in our environment. This study emphasizes on the
importance of creating awareness and accurate knowledge about Breast Self
Examination to pregnant women and thus help in early detection of breast
lesions 7.