Breastcancer is the second most common malignancy affecting pregnancy which affects approximately1 in 3000 pregnant women 1. Presently in India, 75,000 newcases occur every year. The first noticeable symptom of breast cancer is usuallya lump that feels different from the rest of the breast tissue 2.Pregnancy Associated BreastCancer PABC is described as breast cancer diagnosed during pregnancy or inthe first postpartum year. It is one the most common tumours ofreproductive age group.
Previous studies have shown that approximately 10%of breast cancers diagnosed in patients’ aged ?40 years, were diagnosed duringthe pregnancy. It is a dangerous myth that women who are pregnant orbreastfeeding cannot get breast cancer. It is important to check thebreast even during pregnancy. More than 80% of breast cancer cases arediscovered when the woman feels a lump 3.Breast Self Examinations BSE orregularly examining your breasts on your own, can be an important step forearly detection of breast lesions and making them more likely to be treatedsuccessfully and it has been positively linked to a decrease in mortality andmorbidity. Though debates are ongoing about how valuable Breast SelfExamination is in detecting breast lesions, the procedure can be very useful towomen of the rural population who lack the means to proper healthcare orgeneral mammography. Multiple socio-demographicfactors, myths, cultural beliefs, lack of accessibility to health care serviceshave been recognized as some reasons for the poor uptake of BSE 4. BSEs have been seen to be very beneficial and essentialscreening strategy in combination with regular physical examination by a doctorand mammography.
This study emphasizes on theimportance of creating awareness and accurate knowledge about BSE to pregnantwomen and thus help in early detection of breast lesions. OBJECTIVES OF THESTUDY:1. Toassess the awareness and practice of Breast Self Examination among pregnant womenresiding in an urban and rural areas of Bangalore. 2. To determine the socio demographic factors affectingthe awareness and practice towards Breast Self Examinations in pregnant women. METHODOLOGY:STUDY AREA:1. Pregnantwomen attending the OBG OPDs at M.
S Ramaiah hospitals2. Rural Field practice area of Ramaiah Medical College. INCLUSIONCRITERIA:1.All pregnant women attending theOBG OPDs at Ramaiah hospitals and the rural centres attached to the Community Medicinedepartment of Ramaiah Medical College who give consent to participate.
EXCLUSION CRITERIA:1. Pregnant women who have already been diagnosed withbreast cancer. STUDY DURATION: 2 monthsSTUDY DESIGN: Cross sectional studySAMPLE SIZE- 97 in eachgroup (194)RATIONALE FORSAMPLE SIZE:Based on the literature review, in a previous studyconducted by Surendranath Borra, Anantha Lakshmi Satyavathi Devi Kommula andVani Madhavi Kommula; it was found that 16.5% of the women were aware of BSE 5.
In the present study expecting a difference of 20% in the knowledge levelregarding Breast Self Examination between rural and urban pregnant women;considering power of 80% and confidence level of 95%, the sample size workedout to be minimum of 97 pregnant women in each group. STATISTICALANALYSIS:Qualitative variables like socio-demographiccharacteristics of the participants and practice regarding BSE will bepresented using frequency and percentages. Quantitative variables likeawareness scores will be analysed and presented using descriptive statisticslike mean and SD. The knowledge scores of urban and rural women will becomputed and tested for statistical significance difference using Mann WhitneyU test. Chi Square test will be used to find the association between knowledgelevel and select socio demographic factors. SPSS version 17.
0 will be used forstatistical analysis. STUDY DURATION: 2 monthsSTUDY DESIGN: Cross sectional PROCEDURE:The study subjects will be recruited from the OBG OPDsat Ramaiah hospitals and its attached rural centres. The study questionnaire istranslated into the local language and the subject is requested to fill it. Ifthe subject is not literate, the investigator will ask the questions orally andfill the questionnaire for the subject. Subjects are requested to assembleindividually or in groups at a convenient common point where health educationabout Breast Self Examination BSE, its advantages will be explained by theinvestigator through pictorial references.
This will be followed by aninteractive session where their doubts on BSE will be clarified. If they arealready aware of BSE, a demonstration is asked of the subject, where they arecorrected if needed, while those unaware are taught the complete process. Thesessions are expected to last for a period of approximately 15-20 minutes. IMPLICATIONOF THE STUDY:Literature review suggests that pregnant women in whomdiagnosis was delayed or treatment deferred have a lower survival rate. BSEinvolves palpation and visualization of the breast by oneself for texture, size,lumps, shape and contour.
The purpose of BSE is to learn the topography ofone’s breasts, know how their normal breasts feel and be able to identifychanges in them should they occur in the future 6. It is costeffective and more readily available than any other method of early detectionof breast cancer in our environment 7.