• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5349-5357
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• 2015

Background: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. Materials and Methods: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. Results: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6857-6862
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• 2013

Background: Breast cancer is the most common cancer in women. All ages are susceptible and more than 90% of the patients can be cured with early diagnosis. Breast self-examination (BSE) and mammography can be useful for this aim. In this study we examined the components of the Champion health belief model to identify if they could predict the intentions of women to perform such screening. Materials and Methods: A total of 380 women aged 30 and above who had referred to health-care centers were assessed for use of breast cancer screening over the past year with a modified health belief model questionnaire. Logistic regression was applied to identify leading independent predictors. Results: In this study 27% of the women performed BSE in the last year but only 6.8% of them used mammography as a way of screening. There were significant differences regarding all components of the model except for perceived severity between women that underwent BSE. over the past year and those that did not. Findings were similar for mammography. Regression analysis revealed that intentions to perform BSE were predicted by perceived self-efficacy and perceived barriers to BSE while intentions to perform mammography were predicted by perceived barriers. Conclusions: This study indicated that self-efficacy can support performance of BSE while perceived barriers are important for not performing both BSE and mammography. Thus we must educate women to increase their self-efficacy and decrease their perceived barriers.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10749-10755
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• 2015

Background: In both developed and developing countries; breast cancer is the major cancer observed in women. The aim of this study was to assess the effect of nursing and mammographic intervention on women with breast cancer between the ages of 50 and 70. Materials and Methods: A training program, which was quasi-experimental and had a pretest-protest design, was applied in Kemalpaaa district of Izmir, between October 2008 and August 2010. The target population was women between the ages of 50 and 70, who were registered in the list of 3rd Family Medicine Unit in Izmir's Kemalpasa metropolis. A total of 106 women who were in conformity with the study criteria participated in the study. Research data were collected through home visits that included face-to-face interviews; Ministry of Health education material and video films were modified and used for the training. Data analysis was performed through 82 women who were paired at the first and the second phase. Results: It was observed that although the rate of breast self examination significantly increased after the training (p=0.022), the rate of clinical breast examination (p=0.122) and mammographic screening (p=0.523) did not. Differences in the stages of change after training were found to be statistically significant (p<0.001) and the group showed a progression in the stages of change in general (46.3%). In women mean scores of breast cancer awareness (p<0.000), severity (p<0.000), health motivation (p<0.000) and perception of the benefits of mammography (p<0.000) increased significantly and mean score of perception of mammography barriers decreased significantly (p<0.000) after the training. Conclusions: After the training on breast cancer and mammography it was determined that nursing interventions provided positive progression of stages of change of women, affected health beliefs positively and significantly increased BSE incidences. However, it did not have a significant effect on CBE and mammographic screening.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8719-8724
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• 2014

Background: Breast cancer incidence is increasing among South Asian migrants to the United States (US). However, their utilization of cancer screening services is poor. This study characterizes attitudes of South Asians towards breast health and screening in a community sample. Materials and Methods: A cross-sectional survey based on the Health Belief Model (HBM) was conducted among South Asians (n=124) in New Jersey and Chicago. The following beliefs and attitudes towards breast cancer screening were assessed-health motivation, breast self-examination confidence, breast cancer susceptibility and fear, and mammogram benefits and barriers. Descriptive statistics and Spearman rank correlation coefficients were computed for HBM subscales. Findings: Mean age of participants was 36 years with an average 10 years stay in the US. Most women strived to care for their health ($3.82{\pm}1.18$) and perceived high benefits of screening mammography ($3.94{\pm}0.95$). However, they perceived lower susceptibility to breast cancer in the future ($2.30{\pm}0.94$). Conclusions: Increasing awareness of breast cancer risk for South Asian women may have a beneficial effect on cancer incidence because of their positive attitudes towards health and breast cancer screening. This is especially relevant because South Asians now constitute one of the largest minority populations in the US and their incidence of breast cancer is steadily increasing.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8135-8142
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• 2014

Background: Breast cancer is the most common cancer in Iranian women and usually features delayed presentation and late diagnosis. Interpretation of symptoms, as the most important step, has a significant impact on patient delay in seeking treatment. There is a dearth of studies on symptom appraisal and the process leading to seeking help in breast cancer patients. This study explored the perceptions and experiences of Iranian women with self-detected possible breast cancer symptoms. Materials and Methods: A qualitative method was conducted involving in-depth semi-structured interviews with 27 Iranian women with self-discovered breast cancer symptoms. Participants were purposefully selected from women who attended Cancer Institute of Tehran University of Medical Sciences during June 2012 to August 2013. The audiotaped interviews were transcribed and analyzed using conventional content analysis with MAXQDA soft ware version 10. The trustworthiness of the study was verified by prolonged engagement, member validation of codes, and thick description. Results: The main concepts emerging from data analysis were categorized in four categories: symptom recognition, labeling of symptoms, interactive understanding, and confronting the fear of cancer. Symptom recognition through breast self-examination, symptom monitoring and employing prior knowledge distinguished normal from abnormal symptoms and accompanied with perception of being at risk of breast cancer led to symptom labeling. Social interaction by selective disclosure and receiving reassurance from a consultant led to confirmation or redefinition of the situation. Perceived seriousness of the situation and social meanings of breast cancer as a stigmatized and incurable illness associated with loss of femininity were reasons for patient worries and fear. Conclusions: This study emphasized that entangled cognitive, emotional and socio-cultural responses affecting understanding of symptom seriousness require further investigation. It is suggested that programs aimed at shortening patient delay in breast cancer should be focused on improving women's knowledge and self-awareness of breast cancer, in addition to correcting their social beliefs.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.161-166
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• 2016

Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature.