This research was done with the aim of assessing the level of awareness of women of child bearing age (20 – 55 years) in Isiala Ngwa South Local Government Area of Abia state, Nigeria, about screening mammography. This was in view of the increased incidence and mortality among women with breast cancer. Self-administered questionnaire was used as the instrument for data collection. 123 female secondary school teachers were recruited for the study; however 117 respondents completed and returned the questionnaires and were analyzed. The level of awareness of the respondents about screening mammography was assessed and scored. Only 48(41.0%) respondents had heard about screening mammography, with only 8(6.8%) of the respondents having accurate knowledge of what screening mammography is all about. This study has demonstrated that more than half of the respondents have not heard of screening mammography and even the ones that have heard of it, their knowledge of it is very superficial. Breast cancer screening awareness campaign is therefore necessary to improve awareness and early detection.
TABLE OF CONTENTS
Title Page i
Certification ii
Approval Page iii
Dedication iv
Acknowledgement v
Abstract vii
Table of Content viii
List of Table xi
List of Figure xii
CHAPTER ONE
INTRODUCTION
1.0 Background of the Study 1
1.1 Statement of Problem 3
1.2 Purpose of Study 4
1.3 Significance of Study 5
1.4 Scope of Study 5
1.5 Literature Review 6
CHAPTER TWO
THEORETICAL BACKGROUND
2.1 Brief Anatomy of the Breast 14
2.2 Breasts Diseases 16
2.2.1 Benign Disease 16
2.2.2 Malignant Disease 19
2.3 Breast Cancer 20
2.3.1 Breast Cancer Incidence 22
3.3.2 Stages Of Breast Cancer 23
2.3.3 Breast Cancer Risk Factors 25
2.3.3.1 Controllable Risk Factors 25
2.3.3.2 Uncontrollable Risk Factors 27
3.3.4 Symptoms of Breast Cancer 30
2.3.5 Types of Invasive Breast Cancer 31
2.4 Mammography 32
2.4.1 Screening Mammography 33
2.4.2 Dedicated Mammography Equipment 34
2.5 Awareness 34
CHAPTER THREE
RESEARCH METHODOLOGY
3.0 Research Design 36
3.1 Study Population 36
3.2 Area of the Study 36
3.3 Inclusions/ Exclusion Criteria 36
3.4 Instrument for Data Collection 37
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
4.0 Data Analysis 38
4.1 Data Presentation 38
CHAPTER FIVE
DISCUSSION AND CONCLUSION
5.0 Discussion 48
5.1 Conclusion 54
5.2 Recommendations 55
5.3 Areas of Further Research 57
5.4 Limitations of Study 57
References
Appendix
LIST OF TABLE
TABLE 1: Age distribution of respondents 38
TABLE 2: Family history of breast cancer versus history of mammography 39
TABLE 3: Responses on their awareness about mammography and mammography screening 40
TABLE 4: Response on whether screening mammography detects early breast cancer. 41
TABLE 5: Response on sources of Information about screening mammography 42
TABLE 6: Response on whether they have ever practiced screening mammography 43
TABLE 7: Response on reason for not engaging in screening mammography 43
LIST OF FIGURE
Fig I: Diagram of the Mammary Gland 14
Fig II: Diagram of Benign Lumps 16
Fig III: A Radiograph Showing Malignant Lesions. 19
Fig IV: A pie chart showing the respondents response on the use of screening mammography 44
Fig V: A multiple bar-chart showing the response of the respondents on what they feel about screening mammography. 45
Fig VI: A pie-chart showing the respondents response on whether they would like to start practicing screening mammography
in future. 46
Fig VII- A pie chart showing the respondents response on whether they have done any breast screening before other than mammography screening 47
INTRODUCTION
Mammography is an X-ray procedure for detecting or mapping tumours of the breast. It is an invaluable tool for breast screening1. Breast cancer is one of the most lethal caners in women, and it is one of the leading causes of death in American women between the ages of 40 and 50 years and their counterparts in the developing countries2. In this research work, our basic interest is on screening mammography.
Screening mammography is a type of mammography that can be used to check for breast cancer in women who have no signs or symptoms of the disease3. It usually involves two X-ray pictures (mammograms), or images of each breast. The X-ray image makes it possible to detect tumours that cannot be felt. Screening mammography can also find micro-calcifications (tiny deposits of calcium) that sometimes indicate the presence of breast cancer4. In many cases, screening mammography can detect small, still localized tumours many months, or even years before they can be found by other methods of examination1.
Detection at such an early stage substantially increases the chances of successful treatment of the cancer. As a result of this, the number of women who live for at least 10 years following treatment has increased from 25% to over 95%1.
Screening mammography brings about potential decrease in breast cancer mortality and this is its most important benefit5. Mammography plays a central part in early detection of breast cancer because it can show changes in the breast up to two years before a patient or physician can feel them6.
The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to genetic history of breast cancer should seek expert medical advice about whether they should begin screening with mammography before the age of 40 and about the frequency of screening7. Breast cancer appears to be increasing at a faster rate in the population of developing countries that once enjoyed a low incidence of the disease.
According to Russell, the most effective step for a woman to prevent breast cancer is to schedule regular check-ups, screening mammography and to learn how to perform her own Breast Self-Examination (BSE) as well as acquiring all the information she can about the subject8. Through effective and qualitative awareness, such pieces of information can be passed through print media, televisions, radio stations, churches, women meetings and other organizations9.
Indeed, awareness programme has begun in Nigeria by many bodies e.g. Nigeria Cancer Society10.
Despite all these efforts, the breast cancer incidence is still on the increase. The major reason for this may not just be inaccessibility to mammographic equipment and screening centres as used to be the case in the past but could be traced to lack of awareness, poor knowledge of screening mammography and its attendant benefits as well as various misconception beliefs of these women about breast cancer, mammography and its harmful effects to health.
This study is undertaken to assess how aware the women of child bearing age in Isiala Ngwa south Local Government Area of Abia State, Nigeria are about screening mammography and its attended benefits in early detection of breast cancer as well as its role in reducing the number of deaths from breast cancer among women, especially for those over age 50.