Breast rural areas of Bangalore. 2. To determine

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

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 shown that
approximately 10% of breast cancers diagnosed in patients’ aged ?40 years, were
diagnosed during the pregnancy. It is a dangerous myth that women who are
pregnant or breastfeeding cannot get breast cancer. It is important to
check the breast even during pregnancy. More than 80% of breast cancer cases
are discovered when the woman feels a lump 3.

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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 are ongoing about how
valuable Breast Self Examination is in detecting breast lesions, the procedure
can be very useful 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 health care services have been recognized
as the reasons for the poor uptake of BSE 4. BSEs have been seen to be very beneficial and essential
screening strategy in combination with regular physical examination by a doctor
and mammography.

This
study emphasizes on the importance of creating awareness and accurate knowledge
about BSE to pregnant women and thus help in early detection of breast lesions.

 

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 palpation and visualization of the breast by oneself for texture, size,
lumps, shape and contour. The purpose of BSE is to learn the topography of one’s
breasts, know how their 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 7.

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