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Breast cancer poses a significant global health challenge, demanding nuanced interventions that account for regional variations. This study focuses on District Mandi, Himachal Pradesh, exploring awareness levels and practices related to breast cancer and self-examination among women of reproductive age. Material & Methods: A descriptive cross-sectional survey was conducted from August to November 2023. The study involved 400 women in District Mandi, Himachal Pradesh, using a structured questionnaire to assess knowledge, attitudes, and practices related to breast cancer and self-examination. Data analysis employed Epi Info V7 Software, emphasizing frequencies and percentages. Results: Among 400 respondents (60.25% rural, 39.75% urban), knowledge levels were commendable, with 26% demonstrating very good, 40.5% good, 21.5% fair, and 12% poor understanding. Participants displayed positive awareness of warning signs, the importance of self-examination, and misconceptions. However, the frequency of self-examination practices necessitates attention. Conclusion: The study provides valuable insights into breast cancer awareness in District Mandi, Himachal Pradesh, emphasizing the need for targeted interventions. While knowledge levels are promising, promoting regular self-examination practices and addressing misconceptions remain crucial. Public health initiatives can leverage these findings to tailor interventions for improved breast health outcomes.
Breast cancer, a formidable public health challenge globally, necessitates a comprehensive understanding of awareness, risk factors, preventive measures, and the practice of breast self-examination (BSE) among women in District Mandi, Himachal Pradesh. This exploration is crucial for designing targeted interventions that consider the unique cultural, socioeconomic, and healthcare dynamics of the region. [1-3]
The reproductive age in women brings a spectrum of health considerations, with breast cancer emerging as a critical focal point. It is the most common cancer among women worldwide, impacting biological, psychological, social, and economic dimensions [4, 5].
Globally, concerted efforts underscore the importance of breast cancer awareness and early detection in reducing mortality rates (World Health Organization [6]. However, regional variations necessitate localized investigations. In India, breast cancer is the most common cancer among women, demanding urgent attention due to late-stage diagnoses and limited awareness [7].
While breast cancer awareness campaigns encompass various facets, BSE stands out as a proactive method for early detection, contributing to improved treatment outcomes [8]. Therefore, understanding knowledge, attitudes, and practices related to breast cancer and BSE among women in District Mandi is of paramount importance.
Studies conducted in diverse cultural settings highlight the significance of localized investigations in understanding knowledge gaps, cultural beliefs, and healthcare-seeking behaviors related to breast cancer [9,10]. In the unique context of Himachal Pradesh, exploring awareness levels becomes imperative.
As we embark on this exploration in District Mandi, our study aims to unravel the current state of awareness about symptoms, risk factors, preventive measures, and the practice of BSE among women of reproductive age. By delving into the socio-cultural context and healthcare landscape of this region, we aspire to contribute insights that will inform targeted interventions, fostering empowerment and resilience among the women of District Mandi in their battle against breast cancer.
Objectives of the Study
To evaluate the awareness about symptoms, risk factors, preventive measures for breast Cancer and breast self-examination among women ofreproductive age group in District Mandi, Himachal Pradesh.
Research Approach -Descriptive
Research Design- Cross-sectional survey design
Study area: DistrictMandi, Himachal Pradesh
Study duration- between August 2023 to November 2023
Study population: All women ofreproductive age group who were staying in the District Mandi, Himachal Pradesh for 12 months or more.
Sample size- 400 women ofreproductive age groupassuming 50% have adequate knowledge regardingsymptoms, risk factors, preventive measures for breast Cancer and breast self-examination, 5% absolute error, 95% confidence level, and 5% non-response rate.
Study tool: A google form questionnaire consisting of questions regarding socio-demography and symptoms, risk factors, preventive measures for breast Cancer and breast self-examination was created. The questionnaire was initially pre-tested on a small number of women ofreproductive age groupto identify any difficulty in understanding by the respondents.
Description of Tool-
Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.
Questionnaire: The questionnaire contains 20 structured questions regarding knowledge about symptoms, risk factors, preventive measures for breast Cancer and breast self-examination. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero in each category. Scoring was done on the basis of marks as >80%(16-20) =very good,60-79%(12-15) =Good,41-59% (8-11) =Fair, <40% (< 8) =poor
Validity of tool - by the experts in this field
Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn among women ofreproductive age groupin both rural and urban area of District Mandi, Himachal Pradesh till the 400 responses were collected.
Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.
Ethical Considerations- Participants confidentiality and anonymity was maintained.
Table [1] The goal of the current study was to assess the awareness aboutsymptoms, risk factors, preventive measures for breast Cancer and breast self-examination among women ofreproductive age group in District Mandi, Himachal Pradesh through a non-experimental descriptive survey.
A total of 400 respondents including 159 (39.75%) were from urban area and 241 (60.25%) were from rural area were participated in the study.
S.No. | Statements | Frequency of Correct Responses | Percent |
| Can you name three common warning signs of breast cancer? | 263 | 65.75 | |
| How prevalent do you think breast cancer is among women globally? | 183 | 45.75 | |
| Have you heard of breast self-examination (BSE)? | 218 | 54.5 | |
| How often do you perform breast self-examinations? | 205 | 51.25 | |
| Why is regular breast self-examination important for women? | 212 | 53 | |
| How does breast self-examination contribute to early detection of breast cancer? | 194 | 48.5 | |
| When is the best time in the menstrual cycle for women to perform breast self-examinations? | 188 | 47 | |
| Is there a specific age at which women should start practicing breast self-examinations? | 180 | 45 | |
| Can you outline the steps involved in proper breast self-examination? | 167 | 41.75 | |
| What should women look for during breast self-examination? | 191 | 47.75 | |
| How frequently should women perform breast self-examinations? | 161 | 40.25 | |
| Is there a recommended schedule for breast self-examinations? | 162 | 40.5 | |
| Have you ever had a clinical breast examination performed by a healthcare professional? | 105 | 26.25 | |
| How often do you think women should have clinical breast examinations? | 89 | 22.25 | |
| What is a mammogram, and how is it different from breast self-examination? | 180 | 45 | |
| At what age should women typically start getting regular mammograms? | 93 | 23.25 | |
| Are there any common misconceptions about breast cancer that you've come across? | 190 | 47.5 | |
| How can misinformation be addressed to promote accurate breast health awareness? | 206 | 51.5 | |
| What are some early warning signs of breast cancer that women should be aware of? | 210 | 52.5 | |
| How do these warning signs differ from normal changes in breast tissue? | 214 | 53.5 |
Table-1: Knowledge regardingsymptoms, risk factors, preventive measures forbreast Cancer and breast self-examinationamong study participants
Table [2] In the present study 26% (104) females had very good knowledge (16-20 marks) towardssymptoms, risk factors, preventive measures for breast Cancer and breast self-examination, 40.5% (162) having good knowledge (12-15 marks), 21.5% (86) having fair knowledge (8-11 marks) and 12% (48) having poor knowledge (<8 marks).
Category (Marks) | Frequency (n=400) | % |
V. Good (16-20) | 104 | 26 |
Good (12-15) | 162 | 40.5 |
Fair(8-11) | 86 | 21.5 |
Poor(<8) | 48 | 12 |
Maximum =20 Minimum=6
Table 2: Knowledge score regardingsymptoms, risk factors, preventive measures for breast Cancer and breast self-examination among study participants
The assessment of awareness about symptoms, risk factors, preventive measures for breast cancer, and breast self-examination (BSE) among women in District Mandi, Himachal Pradesh, reveals a nuanced landscape with implications for public health interventions. The discussion contextualizes the findings within the global, national, and regional perspectives on breast cancer, emphasizing the unique challenges and opportunities presented by this study.
Breast cancer, as a formidable public health challenge globally, is well-documented in the literature. It stands as the most common cancer among women worldwide, impacting various dimensions of health and well-being [4,11]. The findings of our study align with this global context, highlighting the prevalence and significance of breast cancer in the reproductive age group of women.
In the Indian context, breast cancer is a significant health concern, and studies conducted across the country underscore the need for targeted interventions. A study by [12] in North India emphasized the prevalence of breast cancer and the importance of early detection. Similarly, a study by [7] Highlighted the increasing burden of breast cancer in India and the challenges associated with late-stage diagnoses.
The study's focus on District Mandi sheds light on the regional variations in awareness levels regarding breast cancer. The unique sociocultural dynamics and healthcare landscape of Himachal Pradesh contribute to a distinct set of challenges and opportunities in addressing breast cancer. The prevalence of breast cancer, influenced by factors such as knowledge gaps, cultural beliefs, and healthcare accessibility, underscores the need for localized interventions tailored to the specific needs of this community.
The study participants exhibited commendable knowledge regarding various aspects of breast cancer and BSE. The ability to name warning signs, understand the importance of regular BSE, and recognize misconceptions about breast cancer indicates a positive trend in awareness. Comparable studies conducted globally and in India also emphasize the role of education and awareness campaigns in dispelling myths and promoting health-seeking behaviors [7,12].
While the study reveals positive knowledge levels, the frequency of practicing BSE among participants needs attention. Although a significant number reported performing BSE, continued efforts are required to encourage regular and correct practices. Studies globally have shown that regular BSE contributes to early detection, leading to improved treatment outcomes [8].
The study highlights the presence of misconceptions about breast cancer among participants. Addressing these misconceptions is crucial for promoting accurate breast health awareness. Similar challenges were noted in studies conducted in Nigeria and the United Kingdom, emphasizing the need for targeted educational interventions [9,10].
The study outcomes, in conjunction with insights from Indian and global studies, have broad implications for public health interventions in District Mandi. While the commendable level of knowledge among participants is promising, targeted efforts should address specific areas where awareness could be strengthened. Educational initiatives, community engagement programs, and collaboration with healthcare providers can contribute to a holistic approach in promoting breast health and preventing breast cancer.
Limitations and Future Directions:
Acknowledging the limitations of the study, such as its cross-sectional design and reliance on self-reported data, prompts considerations for future research. Longitudinal studies and qualitative methodologies could offer a more comprehensive understanding of knowledge retention, health-seeking behaviors, and the sociocultural determinants influencing breast cancer awareness.
In conclusion, the study in District Mandi, Himachal Pradesh, provides valuable insights into the awareness levels regarding symptoms, risk factors, preventive measures for breast cancer, and breast self-examination among women. The findings contribute to the global and national discourse on breast cancer while emphasizing the importance of tailored interventions that address regional dynamics and knowledge gaps. By fostering informed decision-making and promoting preventive practices, public health initiatives can play a pivotal role in ensuring the breast health and well-being of women in District Mandi.
The authors declare that they have no conflict of interest
No funding sources
The study was approved by the SLBS GMCH
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