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Impact of Breast Cancer Awareness on Breast Self-Examination Practices among Women in Nigeria

Abstract

Breast cancer is one of the major public health concerns affecting women globally and remains an important cause of morbidity and mortality among women in Nigeria. Early recognition of breast abnormalities and timely presentation for clinical evaluation can improve opportunities for diagnosis and appropriate management. Breast cancer awareness involves knowledge and understanding of breast cancer risk factors, signs and symptoms, the importance of early detection, available screening methods, and appropriate healthcare-seeking behaviour. Breast self-examination (BSE) refers to the systematic practice of women examining their breasts regularly to become familiar with their normal appearance and feel and to identify unusual changes that may require professional evaluation. Although BSE is not a substitute for recommended clinical or imaging-based screening, awareness of breast changes may encourage women to seek timely medical assessment. In Nigeria, several factors may affect women's breast cancer awareness and preventive practices, including limited access to health information, misconceptions about breast cancer, fear of diagnosis, stigma, cultural beliefs, financial barriers, and limited access to healthcare services. Increasing breast cancer awareness may improve women's understanding of breast health and encourage appropriate breast self-awareness and healthcare-seeking practices. Against this background, this study investigates the impact of breast cancer awareness on breast self-examination practices among women in Nigeria. The study is anchored on the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding how breast cancer awareness may influence women's decisions to engage in breast self-examination. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioral control influence intentions and health-related behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how increased knowledge and favourable attitudes toward breast health may influence preventive practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how breast cancer awareness may influence breast self-examination practices among women in Nigeria. The study adopts a quantitative cross-sectional research design. Primary data will be collected from adult women in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Breast cancer awareness will be measured using knowledge of breast cancer risk factors, common signs and symptoms, risk reduction, early detection, available screening methods, and appropriate healthcare-seeking behaviour. Breast self-examination practices will be assessed based on whether participants have ever performed BSE, frequency of examination, consistency of practice, knowledge of appropriate examination procedures, and willingness to seek professional evaluation when abnormal breast changes are identified. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, breast cancer awareness, and BSE practices. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be employed to determine the impact of breast cancer awareness on breast self-examination practices. Appropriate diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the findings. The study anticipates that breast cancer awareness will have a significant positive impact on breast self-examination practices among women in Nigeria. Women with higher levels of awareness are expected to demonstrate greater knowledge of breast cancer symptoms and risk factors and a higher likelihood of engaging in regular breast self-examination or breast self-awareness practices. Increased awareness may also encourage women to pay attention to changes such as breast lumps, changes in breast shape or size, nipple abnormalities, skin changes, or unusual discharge and to seek appropriate professional evaluation when such changes occur. However, awareness alone may not guarantee consistent preventive practices because women may experience barriers such as fear, stigma, misconceptions, lack of privacy, limited access to healthcare information, financial constraints, and inadequate access to trained healthcare professionals. Therefore, breast cancer awareness programmes should be accompanied by accessible health services, appropriate referral systems, and culturally sensitive health education. This study is expected to contribute to the literature on breast cancer prevention, women's health, health education, and public health in Nigeria by providing empirical evidence on the relationship between breast cancer awareness and breast self-examination practices among women. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, state ministries of health, primary healthcare facilities, hospitals, cancer control programmes, women's health organizations, community health workers, development partners, and policymakers regarding strategies for improving breast health awareness. The study will also provide evidence-based recommendations for strengthening breast cancer health education, improving awareness of breast cancer signs and symptoms, promoting appropriate breast self-awareness practices, addressing misconceptions and stigma, strengthening referral systems, and improving access to professional breast health evaluation and recommended screening services among women in Nigeria.

Keywords: Breast cancer awareness, breast self-examination, breast self-awareness, women, breast cancer prevention, early detection, women's health, health education, cancer awareness, public health, Nigeria.