Teaching Rural Women in Nicaragua the Principles of Breast Health

Abstract

Breast cancer has emerged as an important health condition worldwide, including developing countries. Screening is limited or non-existent in resource-poor areas. The purpose of this study was to assess knowledge, attitudes, and practices of self (SBE) and clinical (CBE) breast examinations among 198 rural Nicaraguan women. Ten (5.1%) had performed a SBE, and 16 (8.1%) had a CBE. CBE was significantly associated with a pre-instruction total score of 70% or greater (OR = 13.7, 95% CI = 1.26, 149.70, p = 0.03). Family history of breast cancer was significantly associated with performing a SBE (OR = 5.5, 95% CI = 1.10, 27.81, p = 0.037) and a CBE (OR = 7.1, 95% CI = 1.40, 35.94, p = 0.018). A CBE is a significant determinant of pre-existing breast health knowledge. Physicians or physician extenders should be encouraged to perform a CBE as a routine component of health care delivery and cancer screening for women.

Knowledge, Beliefs, and Attitudes About Breast Cancer Screening in Latin America and the Caribbean: An In-Depth Narrative Review

“… 16 However, according to one article from Brazil, this knowledge was not always associated with BSE knowledge or practice. 27 Although research in Nicaragua pointed to a positive association between FH and BSE, more than half of women studied believed they did not have a personal BCA risk, 12 although the converse was found in a study from Chile, where participants overestimated their risks. 7 …”

“…The reviewed articles revealed the range of women’s knowledge about BCA and prevention, including the finding that knowledge seems to be related to the degree to which screening and diagnosis are delayed. 20 A study found that Nicaraguan women who were more knowledgeable about breast health were significantly more likely to have a CBE 12 ; in Mexico, most women in one study reported having received vague information about BCA and were most knowledgeable about physical changes associated with its presentation. 26 Women in Brazil, when questioned about specific screening tests, revealed that approximately 77% were aware of at least one screening modality, but nearly 40% were not able to correctly name the examination, and approximately 20% were not aware of any examination.…”

“…Women in Nicaragua and Brazil with positive FH tended to be more aware of BCA risk factors 28 and to perform BSE. 12 More than three quarters of Trinidadian women knew that FH is a risk factor for BCA. 16 However, according to one article from Brazil, this knowledge was not always associated with BSE knowledge or practice.…”

“…In addition to studies from Brazil, studies from Colombia, Grenada, Mexico, Nicaragua, and Tobago were reviewed about BSE. 9 - 12 , 23 , 26 Articles from Colombia found that between 34% and 73% of women knew how to perform BSE and that 68% to 96% believed that BSE should be performed by all women 9 , 35 In Tobago, 60% of the study population had received education on BSE technique, but only approximately 40% regularly performed it. In Peru, some performed BSE only when they experienced an abnormal sensation in the breast.…”

Breast Self-examination and Health Beliefs in Grenadian Women

“…19 The study concluded that the intention to seek preventive health behaviors was found to have a strong influence on BSE. Another study utilized a community-based health project to increase breast health awareness in rural Nicaraguan women 20 and found that women who participated in the program were receptive to learning about breast health and agreed to perform a BSE monthly; the community-based program was also effective for BSE training and breast health promotion in the LMIC setting. In another community-based interventional study in Pakistan, health education on BSE and testicular self-examination was successful, 21 with post-intervention assessments showing a significant improvement (of 83% and 72%, respectively; P G .001) in self-examination knowledge among study participants.…”