A STUDY ON KNOWLEDGE, ATTITUDE AND

PRACTICE (KAP) OF BREAST SELF

EXAMINATION IN FEMALE POPULATION
BETWEEN THE AGE GROUP OF
30 TO 60 YEARS.
 INTRODUCTION
• Breast cancer is the most common cancer among women,
with an estimated 1.67 million new cases in the year
2012,accounting for about 25% of all cancers worldwide. 1
• In India, breast cancer is the second most common cancer
among women with a steady increase in incidence
especially in the metros. It accounts for 19-34% of all
cancers among Indian women.It is estimated that at least
one out of every seven women either has or will develop
breast cancer during her lifetime.3
• Though it can be detected early by self and clinical breast
examination or mammography, in our country only 15%
patients present in the early stage (stage 1); 75% have
already progressed to stages 2 or 3 while the remaining 10%
are categorised under stage 47.
• At the home level, Breast Self Examination is by far the best
method to detect any abnormalities in the breast. Even though BSE
is simple, quick and cost free procedure, the practice is low.
Several reasons like lack of time, lack of self confidence in their
ability to perform the technique correctly, fear of possible
discovery of a lump, embarrassment associated with the
manipulation of the breast, absence of symptoms have been cited
as reason for not practicing BSE in spite of knowing the procedure.
• Breast self examination (BSE) seems to be an important viable
optional substitute for early detection of cancer by women
themselves even without having to be dependent on physicians.
• All women should be strongly encouraged to examine their
breasts. The minimum benefit of this practice is the greater
likelihood of detecting a mass at a smaller size when it can be
treated with more limited surgery and conservative management.
Hence the assessment of practise of BSE among women is
essential as it serves as a basic and less sophisticated parameter for
 OBJECTIVES

PRIMARY OBJECTIVE: To assess the knowledge,

attitude, and practice (KAP) regarding breast self-
examination (BSE) among women aged 30-60 years
attending Master Health Checkup Clinic at
Govt.Stanley Hospital.

SECONDARY OBJECTIVE: To find out various

factors contributing to the practice of breast self
examination (BSE).
 METHODOLOGY

STUDY DESIGN:
Cross sectional study
STUDY POPULATION:
Women of age group 30 to 60years
STUDY PERIOD:
July 2016 to September 2016.
INCLUSION CRITERIA:
• Women of age group 30 to 60 years of
any marital status.
• Women who were willing to participate
in the study
EXCLUSION CRITERIA:
• Women who have underwent
mastectomy.
• Women who are not willing to participate.
STUDY AREA:
Master Health Checkup Clinic, Govt.Stanley
Hospital
SAMPLE SIZE:
Based on a study by Pravin.N.Yerpude (prevalence-
30.89%),
Sample size calculated using the formula Z2pq/d2
Sample size 563 women aged 30-60 years.
SAMPLING METHOD:
Women attending Master Health Check-up Govt.
Stanley Hospital were randomly selected
.
METHOD OF DATA COLLECTION:
After obtaining consent from the participant, a face
to face interview were conducted using a
structured questionnaire.
 Those who aware of the procedure of BSE were
asked to demonstrate the procedure maintaining
strict confidentiality and privacy with their
consent.
The participant were issued a pamphlet regarding
the steps of breast self examination at the end of
the session.
INSTRUMENTS USED:
 Using a pretested structured questionnaire.
 The questionnaire had two parts
1st part - Socio-demographic details,
2nd part - History of breast problems, breast
cancer awareness and
knowledge, attitude and
practice of BSE.
STATISTICAL ANALYSIS:
 The data collected were entered in the Microsoft excel
computer program and checked for any inconsistency
 Analysed using SPSS software version 23.
 The test of significance was calculated with the aid of Chi-
square test and a p value of less than 0.05 was
RESULTS: AGE
31-40

18% 41-50

51-60
45%

37%
 SOCIO ECONOMIC CLASS
SOCIO ECONOMIC FREQUENCY PERCENT
STATUS
UPPER 4 0.7%

UPPER MIDDLE 179 31.8%

LOWER MIDDLE 167 29.7%

UPPER LOWER 208 36.9%

LOWER 5 0.9%

TOTAL 563 100%

 Widowed
MARITAL STATUS
Divorced 11%
1%
Unmarried
1% Married
Unmarried
Divorced
Widowed

Married
87%
 PARITY
550

450

350
Frequency

250

150

50

1 or more children No children

Frequency 523 40
BREAST PROBLEMS
YES
9%
Yes
No

No
91%
 BREAST CANCER AWARENESS

25 75 125 175 225 275 325 375 425 475

Aware Unaware
Frequency 439 124
Aware 439

Unaware 124
 SOURCE OF CANCER AWARENESS
189

112
90

42

SOURCES
 QUESTIONS POSITIVE PERCENTAGE
RESPONDERS

Is breast cancer 81 14.40%

hereditary?

Is breast communicable? 316 86.1%

Can breast cancer be 283 50.30%

detected early?

Does breast cancer have 359 85.80%

better survival rate if
detected early?
 AWARENESS ON BSE

25 75 125 175 225 275 325 375

Aware Unaware
Frequency 199 364
Aware 199

Unaware 364
 SOURCE OF BSE AWARENESS
85 83

17
9
5

SOURCES
Frequency
 BSE PRACTISE
28%

Yes No
72%

PROCEDURE DONE CORRECTLY

35%
Yes

65% No
Sales

1st Qtr
2nd Qtr
3rd Qtr
4th Qtr
 FREQUENCY OF BSE PRACTISE

35
30
30
25
20 19

15
10
5 4
2
0 Daily Weekly Monthly Annually
Frequency
INTERVALS IN PRACTICING BSE
 REASONS FOR LACK OF PRACTISE
Didn’t know how to do it 10

Didn’t think it was important 62

Didn’t have any symptoms 57

Thought they could never develop

any breast problems 6

Others 8

Frequency
WILLINGNESS TO EDUCATE OTHERS

Yes

6% No

94%
 AGE AND BSE AWARENESS
160
143 147
140
120 109
Frequency

100
80 74
61
60
40 29
20
0
31-40 41-50 51-60

Age group
Aware Unaware
 BREAST PROBLEMS AND
BSE AWARENESS
180

Absent 335

19

Present 29

50 150 250 350 450 550

Present Absent
Aware 19 180
Unaware 29 335
 AGE AND BSE PRACTICE
90
80 81
70
60
50
FREQUENCY

44
40
30 28
20 17 19
10
10
0 31-40 41-50 51-60

AGE

Practising Not practising

 SOCIO ECONOMIC STATUS AND BSE PRACTICE

70
62
60

50 46
40
34
30
24
20 17
12
10
1 2 1 0
0
Upper Upper Lower Upper Lower
middle middle lower

Practising Not practising

 BREAST CANCER AWARENESS AND BSE PRACTICE

Practice Unaware
12% 55%

Unaware

Don't
Practice

Practice
Don't Practice
32%
 LIMITATIONS

The findings and interpretation of our study are limited

to the women belonging to age group 30 to 60 years
attending Master Health Checkup at Stanley Medical
College Hospital, Chennai.
 CONCLUSION
From these study it can be concluded that the
awareness of BSE was very low(28%). Practice
rate of BSE also very low. However, their
attitude towards BSE and its practice is good.
Hence continuous reinforcement and education
at all levels about the procedure is likely to bring
about a positive change thereby reducing the
burden of the disease in the community.
 RECOMMENDATION
The findings of this study reinforce among health care personnel
to create awareness about practise of BSE as the percentage of
women practising it is very low. Future researches must
concentrate on creating awareness on BSE and educating women
regarding the importance of practicing BSE.
 DISCUSSION
• Of the 563 women, only 35.3% which accounts as 199
women were aware of BSE. This is similar to the results of
Pravin et al3 in which 30.89% of women were aware of
BSE. The results are better than Ananthalakshmi et al 7
where only 16.5% were aware. On comaprison with AS
Nithya’s9 study, where awareness was around 71% our
results are considered poor.
• Mass media played an important role in creating awareness
on BSE(42.7%) in our study and the study conducted
among UG in the University of Buea19. Contrasting results
was found in a study done in Turkey17, where health
professionals were the major source
• Of the women aware about BSE, it was found that a
very small proportion of women(28%) practiced
BSE, of whom 65% knew the procedure of the same
correctly. The results of Pravin et al3 was also
similar (22.61%). Whereas the practice rates were
much lower in Ananthalakshmi et al 7 study(2.4%).
The results were better among female teachers in
Ethiopia15
• In our study, 65% knew the correct procedure of
BSE compared to AS Nithya’s study(56%)9.
• Among the reasons cited for lack of practice, the
women’s attitude that the procedure was not important
ranked first (62 women) followed closely by the reason
that they did not have any symptoms(57 women). Lack
of knowledge of the procedure was the reason given in
University of Buea study19.
• Commenting on their attitude, an enormous number of
527 women(94%) had a positive attitude towards BSE,
when educated about it. They also expressed their
willingness to educate other women on the importance
of practicing BSE. The attitude of the respondents of our
study is much greater than the studies done in University
of Buea19 and among dental students in Hyderabad10.
• THANK YOU