Results of the study

Awareness regarding risk factors for breast cancer is shown in [Table 1]. The fact that the propensity for breast cancer was genetically inherited was known to 80.95% of the respondents and 71.58% thought that breast implants increase the risk of breast cancer. If symptoms were experienced, most (85.71%) women said that they would consult a doctor rather than wait and watch (14.28%).

A majority (85.71%) of women were aware of BSE and 90.47% thought it was important. A total of 38.09% of women performed BSE as advised by their doctor. The most common frequency of BSE was monthly (in 47.63% women). A total of 61.91% of women did not perform BSE. Interestingly, 52.38% of women said that they would perform BSE if the result was beneficial and 23.80% said that they would do it the cure was known.

Women believed that breast cancer could be diagnosed by mammography (80.95%), biopsy (71.42%), computed tomography/magnetic resonance imaging (33.34%), fine-needle aspiration cytology (4.76%), and ultrasonography (1.42%). A total of 90.47% of women were willing to undergo these tests.

When asked about treatment for breast cancer, 66.67% of women thought that surgery was the best treatment followed by medicine (28.57%) and Ayurveda (23.80%). A total of 47.61% of women were willing to undergo surgical procedures for treatment.

When asked whether breast cancer was preventable, 80.95% of women agreed and thought that lifestyle modifications such as physical activity (47.61%), early diagnosis (71.42%), good nutrition such as avoiding fat-rich food (38.09%), and avoiding smoking and drinking alcohol (42.85%) would prevent it. A total of 85.71% of women viewed breast cancer disease as curable.

Discussion

This study showed that most women know that breast lump (90.47%) is a common symptom of breast cancer, but awareness regarding other symptoms was poor. A study conducted among Indian women in an urban area in 2008 showed that only 56% of women were aware of breast cancer, and among them, 51% knew at least one of the signs/symptoms, 53% were aware that breast cancer can be detected early, and only 35% had knowledge about risk factors.[7] Thus, awareness programs in India should also stress on other presentations of breast cancer and not just focus on lump in the breast. Most of them obtained this information from the media (42.85%) and thus it is essential to ensure that correct information is being circulated. Women must be encouraged to talk to their physicians about information regarding breast cancers.

Awareness was better in educated women or working women as compared to homemakers. Similar associations have been found in other studies. Education is instrumental in changing the attitude toward breast cancer and it also improves compliance toward cancer screening.[8],[9],[10] Another study which shows the importance of education was where individuals were divided into two groups as university graduates and high school lower graduates. It was found that higher educational levels were positively associated with BSE performance.[11] BSE is a simple yet effective technique of early detection of breast cancer. Awareness of BSE was high (85.71%), but only 38.09% of women performed BSE. When asked about the reason to not do it, the most common responses were “just never done it,” “never thought about it,” “my doctor didn't tell me,” etc., Another study conducted among Indian teachers showed that only 36.1% of women had heard of the term BSE, only 13.4% knew about the recommended frequency of once a month, and only 7.3% knew about the appropriate position to perform it.[12]

Doctors, especially gynecologists, play a very important role in creating awareness of breast cancer and its risk factors as majority of the women said that they would approach a gynecologist (66.67%) for symptoms experienced. Women were not against the practice of BSE as most of women said that they would perform BSE if the result was beneficial (52.38%) which again proves that awareness is extremely essential to ensure compliance. Mammography and biopsy were the most common tests known to women and most were willing to undergo these tests. This was again attributed to the education level of the women.[8],[9] Another interesting finding was that awareness regarding these tests was high among married as compared to unmarried women. When asked about the treatment for breast cancer, 66.67% of women thought that surgery was the best treatment but only 47.61% were willing to undergo surgical procedures for treatment. This could be attributed to the fear of cosmetic issues and lack of awareness about breast conservation and reconstructive surgeries.[10],[11],[12] Awareness of preventive measures such as lifestyle modification was appropriate. Another finding was 71% of women said that early diagnosis would help in diagnosis.[12] Furthermore, many women said that breast cancer is curable provided it is detected early.

In India, the media publicity and policy efforts on cancer have primarily focused on tobacco use; however, there has hardly been any discussion of other important risk factors such as use of contraceptives, alcohol, breastfeeding history, and obesity.[13] Efforts must be made to focus on these factors and there is an urgent need to explore these awareness deficits and stigma surrounding breast cancer. The limitation of this study was the cross-sectional nature of the study which did not allow for cause–effect relationship to be made, and after the study was conducted, there was no effort made to act to increase the level of knowledge among the women in whom this study was conducted.

Conclusion

Awareness is related to the education level of women and thus it is essential to develop an effective health education program which would cater to a vast variety of people coming from different educational, social, and cultural backgrounds. The results of this study can be extrapolated to acquire information regarding awareness of breast cancer in women in an urban setup. This in turn can be used to develop interventional programs with the help of health-care professionals, media, and the policymakers of the country.

Conflict of Interest

There are no conflicts of interest.

Acknowledgment

We acknowledge the work of Medical Student (Joaquim Anthony Noguer, RCSM Government Medical College, Kolhapur, India, Email: joaquimnoguer@rediffmail.com) in data collection.

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Publication History

Article published online:
23 June 2021

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