Assessing the level of breast cancer awareness among recently diagnosed patients in Ain Shams University Hospital.
Breast cancer is the leading female malignancy among Egyptian women. The majority of Egyptian breast cancer patients present at late stages of the disease with a large tumor size compared to Western countries. Low breast cancer awareness, social and cultural factors were suggested to play crucial role in late presentation of breast cancer among Egyptians. The aim of our present study is to establish a questionnaire-based survey that can assess levels of breast cancer awareness among Egyptians. Patients enrolled were interviewed and answered 60 questions related to knowledge, symptoms, risk factors, prevention and management options of breast cancer. We evaluated our interactions with breast cancer patients and defined the level of awareness gained from education and culture of Egyptian women. Our results described that Egyptian breast cancer patients lack knowledge about their illness and condition. The lowest levels of awareness were related to age, education and culture. We concluded that breast cancer public awareness and women education programs covering factors identified in our study is warranted among Egyptian population. Overview


OBJECTIVE
To assess breast cancer awareness among recently diagnosed breast cancer Egyptian patients.


METHODS
Among 289 interviewed breast cancer patients we enrolled 45 patients who fulfilled the study inclusion criteria. Participants were asked to answer a validated 60-item questionnaire that inquires about socio-demographic characteristics, knowledge of breast cancer symptoms, risk factors, symptoms, prevention, general management and willingness to participate in awareness campaigns. The average of interview time was about 45 min, depending on patient's age and education level.


RESULTS
The mean age of included patients was 48.2 ± 10.19 years. Geographical distribution revealed that 66.7% patients were from Cairo and the rest were from other governorates, including Aswan, Sharqia, Mansora, Qena, Kalyobia, Elminya and Sohag. Among interviewed patients 85% were non-working housewives, 42.2% of them were illiterate. Questions about knowledge of breast cancer revealed that 53.33% of patients knew an acquaintance with breast cancer; however, they spent a median time of 3 months to seek medical advice after recognizing the first symptom with a delay range between a month and 72 months. We found that 73% of the participants presented to a physician with the same first recognized symptom and 75.6% didn't think of cancer then as a possible diagnosis. Total breast cancer knowledge scores had an average of 13.3 (out of 35 knowledge points), with 93% of the patients recognizing "painless breast mass" as a breast cancer symptom and 44% only recognized the concept of breast self examination. Interestingly, 61.4% identified breastfeeding as a risk factor for breast cancer, 60% did not recognize mammography as an early detection method, and 57.7% agreed that clinical breast examination (CBE) is important for early detection. Regarding management, 75% said breast cancer was potentially curable and 60% said medical care could be helpful regardless the age of presentation.


CONCLUSIONS
Egyptian breast cancer patients knew little about their condition. Less awareness was related to age and education level. Low knowledge of risk factors, early detection and management of breast cancer should be addressed by designing patient education programs, where less educated patients are supported by health care professionals to participate in the management of breast cancer. Moreover, we found that 67% and 97% of enrolled breast cancer patients were willing as well to participate in spreading awareness among their community and among their own families, respectively.
Department of General Surgery, Faculty of Medicine, Ain Shams University, Abbassia, 11566 Cairo, Egypt. Electronic address: mohamedshinawi@hotmail.com.
Mohamed
M
El-Shinawi
Almoatazbellah
A
Youssef
Mohammad
M
Alsara
Mohamed K
MK
Aly
Mohamed
M
Mostafa
Ahmed
A
Yehia
Marc
M
Hurlbert
Reda Abd
RA
El-Tawab
Mona M
MM
Mohamed
D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D055088:Early Detection of Cancer; D004522:Educational Status; D004534:Egypt; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires
Awareness; Breast cancer; Early detection; Egypt; Egyptian; Questionnaire; Recently diagnosed; Risk factors