Breastcancer affects approximately 1 in 3000 pregnant women and is the second mostcommon malignancy affecting pregnancy 1.Presently 75,000 new casesoccur in India every year. The first noticeable symptom of breast cancer istypically a lump that feels different from the rest of the breast tissue 2.PregnancyAssociated Breast Cancer PABC is defined as breast cancer diagnosed duringpregnancy or in the first postpartum year.
It is one the most commontumour of reproductive age group. Previous studies have suggested thatapproximately 10% of breast cancers diagnosed in patient’s aged ?40 years werediagnosed during the pregnancy. It is a dangerous myth that women who arepregnant or breastfeeding cannot get breast cancer. It is important tocheck the breast even during pregnancy. More than 80% of breast cancer casesare discovered when the woman feels a lump 3.BreastSelf Examinations BSE or regularly examining your breasts on your own, can bean important step for early detection of breast lesions and making them morelikely to be treated successfully and it has been positively linked to adecrease in mortality and morbidity.
Though debates have been going on abouthow valuable Breast Self Examination is in detecting breast lesions, the procedurecan be very useful to women of the rural population who lack the means toproper healthcare or general mammography.Multiple socio-demographic factors, myths,cultural beliefs, lack of accessibility to the health care services have beenidentified as the reasons for the poor uptake of BSE 4 . BSEs have been seen to be very beneficial and essentialscreening strategy in combination with regular physical examination by a doctorand mammography. Thisstudy emphasizes on the importance of creating awareness and accurate knowledgeabout BSE to pregnant women and thus help in early detection of breast lesions OBJECTIVES OF THESTUDY:1. Toassess the awareness and practice of Breast Self Examination among pregnant womenresiding in an urban and rural areas of Bangalore. 2. To determine the socio demographic factors affectingthe awareness and practice towards Breast Self Examinations in pregnant women. METHODOLOGY:STUDY AREA:1.
Pregnantwomen attending the OBG OPDs at M.S Ramaiah hospitals2. Rural Field practice area of Ramaiah Medical College. INCLUSIONCRITERIA:1.
All pregnant women attending theOBG OPDs at Ramaiah hospitals and the rural centres attached to the Community Medicinedepartment of Ramaiah Medical College who give consent to participate. EXCLUSION CRITERIA:1. Pregnant women who have already been diagnosed withbreast cancer. STUDY DURATION: 2 monthsSTUDY DESIGN: Cross sectional studySAMPLE SIZE- 97 in eachgroup (194)RATIONALE FORSAMPLE SIZE:Based on the literature review, in a previous studyconducted by Anantha Lakshmi Satyavathi Devi Kommula, Surendranath Borra andVani 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 levelregarding Breast Self Examination between rural and urban pregnant women;considering power of 80% and confidence level of 95%, the sample size workedout to be minimum of 97 pregnant women in each group.
STATISTICALANALYSIS:Qualitative variables like socio-demographiccharacteristics of the participants and practice regarding BSE will be presentedusing frequency and percentages. Quantitative variables like awareness scoreswill be analysed and presented using descriptive statistics like mean and SD.The knowledge scores of urban and rural women will be computed and tested forstatistical significance difference using Mann Whitney U test. Chi Square testwill be used to find the association between knowledge level and select sociodemographic factors. SPSS version 17 will be used for statistical analysis. STUDY DURATION: 2 monthsSTUDY DESIGN: Cross sectional PROCEDURE:The study subjects will be recruited from the OBG OPDsat Ramaiah hospitals and its attached rural centres. The study questionnaire istranslated into the local language and the subject is requested to fill it. Ifthe subject is not literate, the investigator will ask the questions orally andfill the questionnaire for the subject.
Subjects are requested to assembleindividually or in groups at a convenient common point where health educationabout Breast Self Examination BSE, its advantages will be explained by theinvestigator through pictorial references. This will be followed by aninteractive session where their doubts on BSE will be clarified. If they arealready aware of BSE, a demonstration is asked of the subject, where they arecorrected if needed, while those unaware are taught the complete process. Thesessions are expected to last for a period of approximately 15-20 minutes. IMPLICATIONOF THE STUDY:Literature review suggests that pregnant women in whomdiagnosis was delayed or treatment deferred have a lower survivalrate. BSE involves visualization and palpation of the breast by oneselffor lumps, shape, texture, size and contour. The purpose of BSE is to learn thetopography of her breasts, know how her normal breasts feel and be able toidentify changes in them should they occur in the future 6.
It iscost effective and more readily available than any other method of earlydetection of breast cancer in our environment 7.
