ABSTRACT This was a descriptive study to investigate the knowledge and practice of breast self examination among women of child bearing age in Utu-Abak, Abak Local Government Area, Akwa Ibom State. It had been noticed that some women in child bearing age did not practice breast self examination. The significance was to help women of child bearing age to realize the importance of carrying out breast self examination regularly and reporting changes to the health personnel. Four research questions guided the study assessing the level of knowledge of the women on breast self examination investigating if embarrassment of touching one’s breast, fear of detecting a mass and how personal attitude influence the practice of breast self examination.  Data for this survey was collected through 24 items structured questionnaire, grouped into section A and B. the theoretical framework used was Health Belief Model. Data were analyzed using frequency tables, percentages and graph. Findings revealed that 61% of the respondents were aware of breast self examination, 59.8% were not embarrassed with manipulation of their breast, 72.7% said that fear of detecting a mass in the breast spore them up to practice, while 62% were in the notion that personal attitude does not influence their practice of breast self examination. The researcher therefore recommended that the government should organize enlightenment campaign seminars and workshops for women on breast self examination and emphasize the need to practice it regularly.

CHAPTER ONE

INTRODUCTION

Background of the Study

            The breast is the tissue overlying the chest (pectoralis) major muscle, and are stabilized by suspensory ligaments. Women’s breast are made of specialized tissue that produces milk (glandular) tissue as well as fatty tissue. The amount of fat determines the size of the breast. The milk-producing part of the breast is organized into 15 to 20 sections, called lobes. Within each lobes are similar structures, called lobules, where milk is produced. The milk travels through a network of tiny tubules called ducts. The duct connects and come together to form larger ducts which eventually exit the skin in the nipple. The dark area of the skin around the nipples is called areolar (Weiss, 2010).

            According to Ogunbode, Fatiregun, Ogunbode and Adebusoye (2013), Breast self examination (BSE) is a process whereby women examine their breast regularly to detect any abnormal swelling or lump in order to seek prompt medical attention. The American Cancer Society (A.C.S) (2009) stated that we must keep in mind the fact that at least 90% of the women who develop breast cancer discover the tumours themselves. There is a strong consensus that the effectiveness of breast self examination critically depends on careful training by skills professionals and that confidences of Breast self examination is enhanced with annual clinical breast examination by an experienced professional by using structured individual training. Breast self examination is independent and can be carried out by the client herself compared to other form of examinations (clinical breast examination and mammography).

            It involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling and reporting the findings to the health professionals. Breast self examination can be taught in a variety of settings either on a one to one basis or in a group (Smeltzer, Hinkle, Bare & Cheever, 2010).

            Breast self examination is carried out once monthly between 5-7 days of menstrual cycle. It helps to detect breast cancer at early stages of growth when there is low risk of spread. This ensures a better prognosis when treated (kayode, Akande & Osagbemi, 2011).

            According to American cancer society (2009), in the 1950s and 1960s, a film demonstrated breast self examination which was co-sponsored by the American cancer society and the National cancer institute was shown to millions of American women. American cancer society recommended in 2013 that women in their 20s should be told about the benefits and limitation of breast self examination.

            However, breast self examination offers women a chance to learn what is normal for them so that they can recognize any change earlier. Teaching breast self examination and issue about breast cancer as early as possible help to encourage positive behaviour towards breast self examination, create a breast awareness consciousness and can lead to seeking regular breast self examination or screening later in life (Isara & Ojedokun, 2011).

            It was found that mortality has fallen by 31% after 6years for women age 40-70 at the beginning of the trial. Unfortunately despite the benefits of regular breast self examination it is discovered that only few women actually examine themselves, infact majority does not even know who to do breast self examination. (Smith, Cokkinides & Brawley, 2011).   

            It was observed that lack of breast self examination increases women development of breast problems like cancer and lump. It is therefore necessary to investigate on the knowledge and practice of breast self examination among women of child bearing age in Utu-Abak, Abak Local Government Area.

Statement of Problem

            One of the best way of ensuring early detection of breast cancer in women is to be aware of their breast, that is understand and know how the breast look and feel under normal circumstance so that women can be able to seek early medical attention if they have any deviation from normal. Since most advance techniques for early detection are not readily available to most women in developing countries, breast self examination is appealing as a routine screening method because the examination has no financial cost apart from the initial instruction session. Therefore it is important to empower women on breast self examination as a primary tool in screening the breast cancer and its early detection. From the above statement it proved that prevention remains the cornerstone of the fight against the disease (breast cancer and other breast abnormalities) worldwide and an indispensable tool for developing country like Nigeria. Despite the advent of modern screening methods, more than 90% of breast abnormalities is detected or discovered through breast self examination stressing its important.

            Due to the increasing rate of breast cancer and breast self examination being the primary tool for early detection, it therefore moved the researcher to carry out a study on breast self examination in other to assess the level of knowledge and factors that influence the practice of breast self examination among women of childbearing age in Utu-Abak, Abak. 

 Objectives of the Study

            This study is undertaken to assess the knowledge and the factors influencing the practice of breast self examination among women of child bearing age. The specific objectives are:

  1. To assess the level of knowledge of women of child bearing age on breast self examination in Utu-Abak, Abak.
  2. To assess if the embarrassment associated with manipulation of the breast can affect the practice of breast self examination.
  3. To examine if fear detecting a mass in the breast can influence the practice of breast self examination by women of child bearing age in Utu-Abak, Abak.
  4. To examine if personal attitude influences the practice of breast self examination

Significance of the Study

  1. It helps to reduce the morbidity and mortality rate of women of child bearing age.
  2. The study will help women of child bearing age to realize the importance of carrying out breast self examination regularly and reporting changes to the health professionals.
  3. It will serve as a source of information for health workers and the other researchers who may be interested in the study.
  4. It will serve as a guide to the health workers to give health talk to patients and client.

Research Question

  1. What is the level of knowledge of women of child bearing age on breast self examination in Utu-Abak, Abak?
  2. In what way is the embarrassment associated with manipulation of the breast affect the practice of breast self examination.
  3. How does fear of detecting a mass in the breast make women to shy away from breast self examination.
  4. How does personal attitude influence the practice of breast self examination.

Scope of the Study

            This study is limited to all women of childbearing age in Utu-Abak, Abak Local Government Area. The study will focus on the knowledge of these women on breast self examination and the factors that may influence their practice of breast self examination.

Operational Definition of Terms

Knowledge: Information or idea a person has about breast self examination.

Practice: This is the act of performing b breast self examination.

Breasts: Are female accessory reproductive organ that secret milk for the baby.

Breast Self Examination: The process of an individual observing and feeling her breast for detecting of any abnormality.

Woman: An adult female human.Child bearing Age: The age range to which women can reproduce (give birth) and it ranges from 15-49 years.