KNOWLEDGE OF BREAST CANCER AND PRACTICE OF BREAST SELF-EXAMINATION AMONG POSTNATAL WOMEN ATTENDING THE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY

ABSTRACT

Breast cancer remains one of the leading causes of cancer-related morbidity and mortality among women globally, with developing countries experiencing increasing incidence and poorer survival outcomes due to delayed diagnosis and inadequate awareness. In Nigeria, breast cancer constitutes a major public health challenge, particularly among women of reproductive age, where inadequate access to screening services and limited health education contribute significantly to late presentation. Breast Self-Examination (BSE) has continued to be recognized as a simple, affordable, and accessible strategy for promoting early detection of breast abnormalities, especially in resource-constrained settings where advanced diagnostic facilities may not be readily available. This study examined the level of knowledge of breast cancer and the practice of breast self-examination among women attending the postnatal clinic at the University of Benin Teaching Hospital (UBTH), Benin City.

A descriptive cross-sectional research design was adopted for the study. Data were collected using a structured questionnaire administered to postnatal women attending the clinic. The instrument elicited information on socio-demographic characteristics, awareness and knowledge of breast cancer, knowledge of breast self-examination techniques, frequency of practice, and factors influencing compliance with BSE. Data obtained were analyzed using descriptive and inferential statistical methods to establish relationships between respondents’ socio-demographic variables, level of knowledge, and practice of BSE.

Findings from the study revealed that although a substantial number of respondents had heard about breast cancer, comprehensive knowledge regarding its risk factors, warning signs, preventive measures, and early detection strategies remained inadequate. Knowledge concerning the correct timing, procedures, and techniques of breast self-examination was also limited among many participants. The study further showed that the regular practice of BSE among postnatal women was considerably low, with only a minority of respondents demonstrating adequate and consistent self-examination practices. Major barriers identified included poor awareness, lack of confidence in performing BSE, fear of discovering breast abnormalities, inadequate health education, and misconceptions associated with breast cancer.

The study concluded that significant gaps exist in both the knowledge of breast cancer and the practice of breast self-examination among postnatal women attending UBTH, Benin City. These deficiencies may contribute to delayed diagnosis and poor treatment outcomes among women affected by breast cancer. The study therefore recommends intensified public health education, integration of breast cancer awareness programmes into maternal and postnatal healthcare services, and continuous sensitization campaigns aimed at improving women’s knowledge and encouraging regular practice of BSE for early detection and prevention of breast cancer-related complications.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Breast cancer has continued to pose a serious global health challenge, particularly among women, due to its increasing incidence, high mortality rate, and profound socioeconomic impact on families and healthcare systems. Globally, it is recognized as one of the most frequently diagnosed cancers among women and remains a major contributor to cancer-related deaths despite significant advancements in medical technology, diagnosis, and treatment approaches. According to the World Health Organization, breast cancer accounts for a substantial proportion of newly diagnosed cancer cases annually, with developing nations increasingly bearing the burden of mortality because of delayed diagnosis and inadequate access to quality healthcare services (WHO, 2023).

In many low- and middle-income countries, including Nigeria, breast cancer has emerged as a growing public health concern due to poor awareness, weak health infrastructure, poverty, and inadequate access to early screening and treatment facilities. Although developed countries report higher incidence rates, mortality rates are considerably higher in developing countries because many women present to healthcare facilities at advanced stages of the disease when treatment outcomes are often poor. This situation has intensified concerns among healthcare professionals, researchers, and policymakers regarding the urgent need for effective strategies that promote early detection and prevention.

Breast cancer develops from abnormal and uncontrolled growth of cells within the breast tissue, leading to the formation of malignant tumors capable of spreading to surrounding tissues and distant organs through metastasis. While the disease can affect both males and females, women remain disproportionately affected due to biological and hormonal factors. Several risk factors have been associated with the development of breast cancer, including advancing age, family history, genetic mutations, obesity, hormonal imbalance, alcohol consumption, physical inactivity, reproductive history, and environmental influences (Bray et al., 2021). However, studies have shown that lack of awareness and delayed detection remain among the most significant contributors to the high mortality associated with the disease in sub-Saharan Africa.

Early detection plays a critical role in improving the prognosis, survival rate, and quality of life of breast cancer patients. One of the most accessible and cost-effective methods of early detection is Breast Self-Examination (BSE), a procedure through which women examine their breasts regularly in order to identify unusual changes such as lumps, swelling, pain, skin dimpling, or nipple discharge. Although BSE does not replace clinical screening methods such as mammography or clinical breast examination, it serves as an important health-promoting behavior that encourages women to become familiar with the normal appearance and texture of their breasts, thereby facilitating early reporting of abnormalities to healthcare professionals.

In resource-limited settings such as Nigeria, where access to advanced diagnostic technologies may be limited, Breast Self-Examination remains a practical and affordable approach to promoting breast cancer awareness and early identification of suspicious symptoms. Unfortunately, several studies conducted in Nigeria have demonstrated poor knowledge and inadequate practice of BSE among women, particularly among those residing in rural and semi-urban communities (Afolayan et al., 2022). Cultural beliefs, fear of diagnosis, low educational attainment, lack of exposure to health information, and poor health-seeking behavior have been identified as major factors influencing poor compliance with breast cancer screening practices.

The postnatal period represents an important phase in women’s healthcare because mothers frequently interact with healthcare providers during routine postnatal visits. This period provides a strategic opportunity for health education and awareness creation regarding breast cancer prevention and early detection practices. Women attending postnatal clinics are often more receptive to healthcare information aimed at improving both maternal and family wellbeing. Integrating breast cancer education into postnatal healthcare services could therefore contribute significantly to improving women’s awareness and encouraging positive preventive health behaviors such as regular breast self-examination.

Despite ongoing awareness campaigns and public health interventions, many Nigerian women still possess limited knowledge about breast cancer and do not practice BSE regularly or correctly. Consequently, breast cancer cases are frequently diagnosed at advanced stages, resulting in increased morbidity, mortality, emotional trauma, and financial burden on affected individuals and families. Understanding the level of knowledge and practice of BSE among postnatal women is therefore essential for designing effective health education programmes capable of promoting early detection and reducing the burden of breast cancer.

It is against this background that this study seeks to assess the knowledge of breast cancer and the practice of breast self-examination among postnatal women attending the University of Benin Teaching Hospital (UBTH), Benin City. The study aims to identify existing gaps in awareness and practice while providing evidence-based recommendations for improving breast cancer education and preventive healthcare among women.

1.2 Statement of the Problem

Breast cancer has remained one of the leading causes of death among women worldwide despite advancements in medical research, diagnostic technologies, and treatment interventions. In Nigeria, the burden of breast cancer continues to rise steadily, with many women presenting at healthcare facilities only when the disease has progressed to advanced stages. This trend has contributed significantly to poor treatment outcomes, reduced survival rates, and increased healthcare costs associated with cancer management.

One of the major factors responsible for the high mortality associated with breast cancer in Nigeria is inadequate awareness regarding the disease and poor participation in early detection practices such as Breast Self-Examination. Although BSE is considered a simple, non-invasive, and cost-effective method for detecting abnormalities in the breast, evidence suggests that many women either lack adequate knowledge of the procedure or fail to practice it regularly and correctly. This deficiency limits opportunities for early diagnosis and timely medical intervention.

Postnatal women constitute a particularly important population for breast cancer awareness because they frequently engage with healthcare services during the post-delivery period. However, despite regular contact with healthcare professionals, many postnatal mothers still demonstrate insufficient knowledge regarding breast cancer risk factors, symptoms, and preventive practices. Inadequate education during maternal healthcare visits may therefore contribute to poor awareness and low adoption of preventive behaviors among women.

Furthermore, socioeconomic challenges such as poverty, low educational attainment, cultural misconceptions, fear of diagnosis, and limited access to healthcare information continue to hinder women’s participation in breast cancer screening practices. The persistence of these barriers underscores the need for continuous assessment of women’s knowledge and behaviors relating to breast cancer prevention.

Although previous studies have examined breast cancer awareness among different categories of women in Nigeria, limited attention has been given to postnatal women attending tertiary healthcare facilities such as the University of Benin Teaching Hospital. There is therefore a need to investigate the extent of breast cancer knowledge and the level of breast self-examination practice among this population in order to identify knowledge gaps and develop effective educational interventions. This study seeks to address this gap by evaluating the knowledge of breast cancer and the practice of breast self-examination among postnatal women attending UBTH, Benin City.

1.3 Research Questions

The following research questions guided the study:

1. What is the level of knowledge of breast cancer among postnatal women attending UBTH, Benin City?
2. What is the level of awareness and practice of Breast Self-Examination among these women?
3. What factors influence the practice of Breast Self-Examination among postnatal women attending UBTH?
4. What relationship exists between knowledge of breast cancer and the practice of Breast Self-Examination among the respondents?

1.4 Aim and Objectives of the Study

Aim of the Study

The aim of this study is to assess the knowledge of breast cancer and the practice of Breast Self-Examination among postnatal women attending the University of Benin Teaching Hospital, Benin City.

Objectives of the Study

The specific objectives of the study are to:

1. Determine the level of knowledge of breast cancer among postnatal women attending UBTH, Benin City.
2. Assess the level of practice of Breast Self-Examination among the respondents.
3. Identify factors affecting the practice of Breast Self-Examination among postnatal women.
4. Examine the relationship between knowledge of breast cancer and the practice of Breast Self-Examination among the respondents.

1.5 Research Hypothesis

The following hypothesis was formulated to guide the study:

H0: There is no significant relationship between knowledge of breast cancer and the practice of Breast Self-Examination among postnatal women attending UBTH, Benin City.

H1: There is a significant relationship between knowledge of breast cancer and the practice of Breast Self-Examination among postnatal women attending UBTH, Benin City.

1.6 Scope of the Study

This study focuses on assessing the knowledge of breast cancer and the practice of Breast Self-Examination among women attending the postnatal clinic at the University of Benin Teaching Hospital, Benin City. The study specifically examines respondents’ awareness of breast cancer, understanding of risk factors and symptoms, knowledge of Breast Self-Examination procedures, frequency of practice, and factors influencing compliance with BSE practices. The study is limited to postnatal women receiving healthcare services at UBTH during the period of data collection.

1.7 Significance of the Study

The findings of this study will be beneficial to several stakeholders within the healthcare system and academic community. For healthcare professionals, particularly nurses, midwives, and public health practitioners, the study will provide valuable insight into the level of awareness and preventive health behaviors among postnatal women. This information can assist in designing targeted educational interventions aimed at promoting early detection of breast cancer.

The study will also be beneficial to hospital administrators and policymakers by providing evidence-based data that can support the integration of breast cancer education into maternal and postnatal healthcare services. Such interventions may improve women’s health literacy and encourage routine screening behaviors capable of reducing breast cancer-related mortality.

For women and the general public, the study will contribute to increased awareness regarding the importance of Breast Self-Examination and early detection practices. Improved awareness may encourage positive health-seeking behavior, prompt medical consultation, and increased participation in cancer screening programmes.

Academically, this research will serve as a useful reference material for students, researchers, and scholars interested in women’s health, oncology, maternal healthcare, and preventive medicine. It may also stimulate further research on breast cancer awareness and screening practices in Nigeria and other developing countries.

1.8 Operational Definition of Terms

Breast Cancer

Breast cancer refers to a malignant disease characterized by uncontrolled growth of abnormal cells within the breast tissue, which may spread to surrounding tissues and other parts of the body if not detected and treated early.

Breast Self-Examination (BSE)

Breast Self-Examination is a self-screening technique through which a woman systematically examines her breasts regularly to detect unusual changes or abnormalities that may indicate the presence of breast cancer.

Knowledge

Knowledge refers to the level of awareness, understanding, and information possessed by respondents regarding breast cancer, its risk factors, symptoms, prevention, and Breast Self-Examination practices.

Practice

Practice refers to the actual performance and frequency of Breast Self-Examination by the respondents.

Postnatal Women

Postnatal women are women who have recently delivered a baby and are within the postpartum period, usually extending up to six weeks after childbirth.

Early Detection

Early detection refers to the identification of breast abnormalities or cancerous changes at an early stage before the disease progresses to advanced stages.

Awareness

Awareness refers to the extent to which individuals are informed about breast cancer, its symptoms, risk factors, and preventive measures.

Risk Factors

Risk factors are conditions, behaviors, or characteristics that increase an individual’s likelihood of developing breast cancer.

Healthcare Providers

Healthcare providers refer to trained professionals such as doctors, nurses, midwives, and other medical personnel responsible for delivering healthcare services and patient education.

Morbidity

Morbidity refers to the condition of illness or disease and its impact on an individual’s health and wellbeing.

Mortality

Mortality refers to the occurrence of death resulting from a disease or health condition.

References

Afolayan, J. A., David, O. O., & Lawal, F. O. (2022). Breast cancer awareness and breast self-examination practices among women in Nigeria. African Journal of Health Sciences, 35(2), 112–124.

Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249.

Okobia, M. N., Bunker, C. H., Okonofua, F. E., & Osime, U. (2006). Knowledge, attitude and practice of Nigerian women towards breast cancer: A cross-sectional study. World Journal of Surgical Oncology, 4(11), 1–9.

Parkin, D. M., Bray, F., Ferlay, J., & Pisani, P. (2005). Global cancer statistics, 2002. CA: A Cancer Journal for Clinicians, 55(2), 74–108.

Russel, R. C. G. (2007). Bailey and Love’s Short Practice of Surgery (24th ed.). London: Hodder Arnold.

World Health Organization (WHO). (2023). Breast Cancer Fact Sheet. Geneva: World Health Organization.  GET MORE NURSING PROJECT TOPICS AND MATERIALS