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Research Article | Volume 14 Issue: 4 (Jul-Aug, 2024) | Pages 927 - 932
Impact Of Health Education On Breast Self-Examination Among Women -A Community Based Interventional Study In Urban Field Practice Area Of Kurnool”.
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1
Associate Professor of Community Medicine, S V Medical College, Tirupati, Andhra Pradesh, India-517507.
2
Assistant Professor of Community Medicine, Kurnool Medical College, Kurnool, Andhra Pradesh, India-518002.
3
Associate Professor of Community Medicine, Dr YSR Govt Medical College, pulivendula, Andhra Pradesh, India-516390
4
Professor & HOD, Dept. Of Community Medicine, Kurnool Medical College, Kurnool, Andhra Pradesh, India-518002.
5
Assistant Professor of Anatomy, Govt Medical College, Madanapalle, Andhra Pradesh, India-517325.
6
Final year MBBS student, Kurnool Medical College, Kurnool, Andhra Pradesh, India-518002.
Under a Creative Commons license
Open Access
Received
July 30, 2024
Revised
Aug. 5, 2024
Accepted
Aug. 20, 2024
Published
Aug. 27, 2024
Abstract

Background: For the past few decades, the world is encountering significant reduction in incidence of different kinds of communicable diseases whereas the prevalence of various non-communicable diseases (NCDs) is reaching its peak and India is not an exemption for this trend. Epidemiological studies have shown that the global burden of Breast cancer is expected to cross almost 2million by the year2030. Breast Self-Examination (BSE) is simple, non-invasive and quick, the practice of BSE is very low among women due to various reasons like not knowing the correct technique how to perform it, lack of time, lack of confidence and fear of being diagnosed with breast cancer. Therefore, the present study is aimed at improving the knowledge and practices o n BSE and impact of health education on breast self-examination among women. Research question: What is the impact of health education on breast self-examination among women residing in urban field practice area of KMC, Kurnool? The setting of the study was at a community urban field practice area, Kurnool Medical College, Kurnool, Andhra Pradesh. A six months observational study was conducted during the period from September 2023 to February 2024 on about 227 women aged 30- 60 years who are residing at UHTC Sriram Nagar, Kurnool by studying their socio-demographic profiles including literacy & occupation and  Evaluating their Knowledge and Practice related to BSE  by analyzing the data collected through pre & posttest questionnaire comparatively etc; Results: Pre-test knowledge mean scores were 0.55±0.55, practice mean scores were 0.17±0.84. After the educational intervention, a significant improvement was observed in women’s knowledge and practice. The impact of health education was reflected on post-test mean scores of knowledges and practice being 7.53±1.76, 5.32±1.85 respectively. Conclusion: This study showed the importance of regular awareness activities at community level to enhance the BSE practices among women for early detection of breast cancer.

Keywords
INTRODUCTION

Over the past few decades, there has been a notable global decline in the incidence of major communicable diseases, but the prevalence of numerous non-communicable diseases (NCDs) has peaked, with India being no exception. Cancer is one of the non-communicable diseases that are becoming more prevalent and burdening society. These diseases are becoming more important as public health issues in both developed and developing nations1. According to the Globocan 2022 study, breast cancer is the second most common cancer in the world and the fourth in terms of mortality. Globally, breast cancer (BC) is associated with an incidence of 22,96,840 cases and a mortality of 6,66,103 deaths per year2. In India, breast cancer ranks first both in terms of incidence and mortality, with an incidence of 1,92,020 cases and a mortality of 98, 337 deaths per year2.

 

As breast cancer treatment is getting expensive, primary prevention is the key to breast cancer management. Breast cancer has a one hundred percent success rate if detected early and a high survival percentage till the middle stages. Approximately half of all breast cancer patients in India are in stages 3 and 4, when the chances of survival are exceedingly low and treatment costs are considerable3. According to the ICMR, fewer than 5% of women undergo breast screening in India. The reasons are lack of awareness about the importance of early detection and the absence of an organised nationwide breast cancer screening programme4. The reasons for late detection of breast cancer includes low awareness, presence of stigma, fear about pain during screening and fear about the disease, gender inequity, lack of screening test and infrastructure, low literacy, and low-income levels5,6.Breast   cancer   occurs   in   an   observable   organ, thus awareness regarding its symptoms can help in its early detection and treatment. Breast self-examination (BSE), clinical breast examination (CBE), and mammography are three techniques that can aid in early detection of breast cancer; the latter two require time to visit a doctor for examination, while BSE can be performed at home at your convenience7.

 

BSE is a simple, inexpensive, quick, noninvasive, nonhazardous intervention. In nations with limited resources, where access to more effective screening techniques is limited, this could be a helpful approach for early detection of breast cancer. The test's sensitivity was shown to be 78%8. Therefore, the present study is aimed at improving the knowledge, practice on BSE and impact of health education on breast self-examination among women.

MATERIAL & METHODOLOGY

The setting of the study was at a community urban field practice area, Kurnool Medical College, Kurnool, AndhraPradesh. A six months observational study was conducted during the period from September ,2023 to February, 2024 on about 227 women aged 30 - 60 years who are residing at UHTC SriramNagar, Kurnool by studying their socio-demographic profiles including literacy & occupation and  Evaluating their Knowledge and practice related to BSE  by analysing the data collected through pre & post test questionnaire comparitively etc; The sample size was determined using a single population proportion formula. Awareness on Breast Self-examination from the Ranjan Kumar Prusty, Shahina Begum et al study, Mumbai, India (49%)9, with the assumption of 7% of absolute error,95%CI and 10% non- response, the sample size was collected as follows

By using systematic random sampling technique, women above 30 years of age who are the residents of SriramNagar were selected until final sample size is reached. All the women who are residing in that community during the above period up to reach the required sample size was included in the study as study subjects after duly following the inclusion and exclusion criteria as indicated below. Inclusion criteria: Women aged 30-60years of age who were willing to participate were included in the study.Exclusion criteria: Women who were already diagnosed with breast cancer and under treatment, pregnant woman and lactating women were excluded from the study. Objectives:1.To study the sociodemographic profiles & risk factors  2.To study the impact of health education on Breast Self –Examination among the study subjects in terms of Knowledge and Practice.  After receiving the Ethical committee clearance from the institution with IEC No: 390/2023 the study was began and the required data was collected by using a predesigned, pretested and a self administered closed ended questionnaire proforma pertaining to their socio-demographic profiles including literacy & ocupation and their Knowledge and Practice related to BSE before & after intervention of health education. Informed consent was obtained from all individual participants included in the study.

 

Initially all the participants were assessed about knowledge and practices related to breast self-examination through questionnaires with the help of ASHAS and ANMS at their homes itself prior to give the educational intervention (pretest). After that women were informed about the awareness sessions that were planned to be conducted a day before itself. Then sessions were conducted to all selected women on breast cancer, importance of Breast Self-Examination and then demonstrated the technique of breast self- examination by using slide show, video clips with the help of laptop and provided handouts to everyone. All the sessions were conducted in separate room of UHTC SriramNagar, each day for about 20-25 women. This was continued for a period of 10 days until the sample size was reached. After 4 weeks, during the second visit all the selected women who were initially educated about BSE were reassessed regarding their knowledge and practice levels on breast self-examination by using the same validated questionnaire and recorded their responses to study the impact of educational intervention among the selected women of age 30-60 years.

 

Finally the collected data was entered into Microsoft Excel and analyzed by using appropriate statistical tools like percentages, proportions, measures of central tendency, measures of dispersion, standard error of mean  and tests of significance by using SPSS version 21computer software etc.  The study results were compared and discussed in the light of published material of various similar studies belongs to different authors and there by conclusions and recommendations was framed.

 

OBSERVATIONS & RESULTS

GRAPH 1: DISTRIBUTION OF STUDY PARTICIPANTS ACCORDING TO AGE

Mean ± 2 SD = 43.73± 14.4, 29.33 - 58.13

  • It was observed from the above graph that, 37% women belonged to 30-40 years age group, 43.6% women belonged to 41-50 years age group and 19.4% women belonged to 51-60 years age group.

 

GRAPH2: DISTRIBUTION OF STUDY PARTICIPANTS ACCORDING TO EDUCATIONAL STATUS

 

  • It was noticed that out of 227, most of the study participants 118 (52%) belonged to 1-10th class group. 94 (41.4%) were illiterates and 15(6.6%) were studied above 10th

 

GRAPH3: DISTRIBUTION OF STUDY PARTICIPANTS ACCORDING TO OCCUPATION

 

  • With reference to ocupation about 160 (70.5%) women were house makers/ unemployed, 48 (21.14%) women were unskilled workers, and 19 (8.36%) women were skilled workers.

 

TABLE 1: COMPARISION OF PRE AND POST TEST KNOWLEDGE QUESTIONS

Knowledge variable

correct response-number (percentage)

Mean

SD

t value

p value

Breast Self Examination should be done by whom

post-test

227(100)

1

0

36.45

<0.0001

pre-test

33(14.53%)

0.145

0.35

Is family history of breast cancer being a risk factor for developing breast cancer among women

post-test

213(93.83%)

0.94

0.24

32.50

<0.0001

pre-test

26(11.45%)

0.114

0.319

Breast Self-Examination is useful in early diagnosis of breast cancer

post-test

213(93.83%)

0.94

0.24

35.21

<0.0001

pre-test

21(9.25%)

0.092

0.29

Which age group are more prone to breast cancer

post-test

213(93.83%)

0.94

0.24

35.817

<0.0001

pre-test

20(8.81%)

0.09

0.28

Need to observe any unusual changes in the shape and size of the breast

post-test

213(93.83%)

0.94

0.24

47.084

<0.0001

pre-test

7(3.08%)

0.031

0.173

Retraction of the nipple is a warning sign that should be observed

post-test

213(93.83%)

0.94

0.24

47.084

<0.0001

pre-test

7(3.08%)

0.031

0.173

Oral contraceptive pills may increase the risk of breast cancer

post-test

213(93.83%)

0.94

0.24

47.084

<0.0001

pre-test

7(3.08%)

0.031

0.173

Early menarche and late menopause increase the risk of breast cancer

post-test

213(93.83%)

0.94

0.24

50.9902

<0.0001

pre-test

5(2.20%)

0.02

0.132

               
  • It was also observed that almost all women had low knowledge on symptoms, risk factors of breast cancer and BSE. But most of the women improved their knowledge on BSE after educational intervention and it was a significant improvement.

 

TABLE 2: COMPARISION OF PRE AND POST TEST PRACTICE QUESTIONS

Practice

Variable

Correct response

Number (percentages)

Mean

SD

t - value

P-value

Do you practice Breast Self Examination

post-test

203(89.42%)

1

0

70.1694

P<0.0001

pre-test

8(3.52%)

0.04

0.20

What is the time for Breast Self Examination

post-test

204(89.86%)

0.90

0.30

35.8667

P<0.0001

pre-test

7(3.08%)

0.03

0.17

I undress until the waist when doing BSE

post-test

202(88.98%)

0.89

0.31

35.8299

P<0.0001

pre-test

7(3.08%)

0.03

0.17

Finger pulps are used to examine any lumps or thickening of the skin

post-test

203(89.42%)

0.89

0.31

38.5236

P<0.0001

pre-test

6(2.64%)

0.03

0.16

I press on the nipple to check for any discharge

post-test

200(88.10%)

0.88

0.32

36.4500

P<0.0001

pre-test

6(2.64%)

0.03

0.16

I frequently search for the information regarding BSE from internet, magazines, newspaper

post-test

201(88.54%)

0.89

0.32

37.8008

P<0.0001

pre-test

5(2.20%)

0.02

0.15

  • The above table showed that very less women were practicing Breast Self-Examination. But after educational intervention most of the women were practicing BSE and doing it correctly. There was a significant improvement of BSE practices among women.

 

TABLE 3: OVERALL, KNOWLEDGE AND PRACTICE SCORES

Variable

Mean

SD

t value

p value

Knowledge

post-test

7.53

1.76

47.2580

<0.0001

pre-test

0.55

1.54

Practice

post-test

5.32

1.85

38.3397

<0.0001

pre-test

0.17

0.84

  • Pre-test mean knowledge scores were 0.55±1.54 and the mean practice scores were 0.17±0.84 which revealed that women had very low levels of knowledge about the risk factors of breast cancer and techniques of breast self-examination. Poor knowledge leads to poor practice.
  • However, after the educational intervention, a significant improvement was noted in women’s knowledge and practice. The impact of health education was reflected on post-test mean scores of knowledge and practice being 7.53±1.76, 5.32±1.85 respectively.
DISCUSSION

Present study was conducted among 227 women in the urban field practice area of Kurnool medical college, Kurnool to assess knowledge and practices on Breast Self-Examination and impact of health educational intervention. Initially before the intervention the knowledge and practices regarding breast cancer and breast self-examination were assessed.

 

The current study found that just 14.53% of women were aware of the term BSE, but only 3.52% practicing it. All other Indian community-based, college-based, and health centre-based studies among the general population had comparable findings10,11,12,13,14,15,16,17. On the contrary, studies showed higher knowledge and practices of BSE among nursing students and healthcare workers18,19,20. So, the current study advocated the relevance of BSE knowledge and procedures to all women of reproductive age at the school, college, and community levels, with the active participation of primary health care field workers.

 

According to the current study, only 8.81% of women knew that getting older was a risk factor of breast cancer, 3.08% knew that using oral contraceptives would raise the risk of breast cancer, and 2.2% knew that menopause late in life and early menarche also increased the risk of breast cancer. In the current study, 11.45% knew that family history was a risk factor.

 

In an urban resettlement colony in New Delhi, a study by Somdattta and Baridalyne found that 4.9% of women knew that growing older and 8% knew that using OCP increased the chance of breast cancer11. According to the Khokar study, 7.7% of women were aware that early menstruation is a risk factor21. Except for family history, nearly all previous Indian research findings on general women revealed comparable results in terms of risk factor awareness. However, the current study revealed that women were unaware about the family history could be a risk factor22,23,24,25. In the current study, fewer participants (11.45%) knew that a family history of breast cancer in first-degree relatives is a major risk factor prior to the intervention, but their knowledge improved by 93.83% after the intervention. Similarly, in a study by D.V. Bala et al. 27.6% of participants knew that a family history of breast cancer is a major risk factor prior to the intervention and their knowledge improved by 62% after the intervention14. According to comparable research by Apeksha P. Paunikar et al. 45 out of 150 participants knew that having a positive family history is a significant risk factor for breast cancer24. In present study only 3.08% of the participants had knowledge about oral contraceptive pills as a risk factor before the intervention whereas in a study conducted by D.V.Bala et al had pretest percentage of 27.6%14.In present study there was increase in the levels of knowledge about risk factors after the intervention by 90.75% , but in the study by D.V.Bala et al had an increased by 58.8%14. A study conducted by Apeksha P. Paunikar et al. showed that 38.57% women had knowledge that oral contraceptives are major risk factors for breast cancer24.

 

Current study showed only 3.08% participants had knowledge regarding symptoms of breast cancer like changes in the shape and size of the breast and nipple changes. On contrary, a study conducted in Aurangabad by Paunikar et al among women residing in field practice area showed that 78.57% of women had aware of symptoms and signs of breast cancer24. Singh etal study showed 40.20% of women had aware of breast changes as sign and symptom of breast cancer26. This showed that present study participants were very poor knowledge of symptoms and signs of breast cancer.In the present study 3.52% participants practiced BSE before the intervention but in a study done by Apeksha P. Paunikar et al. showed that 14% of the participants practiced self-breast examination24. A study by Shalini, Divya Varghese, et al showed that 8.5% of participants practiced BSE15.

 

In the present study, showed that the mean knowledge of pretest is 0.55±1.54 and practice is 0.17±0.84, which showed that awareness about knowledge and practices of breast self-examination was very poor. In this study after the health education intervention there was significant increase in the knowledge and practices of breast self-examination, with mean post-test values of knowledge 7.53±1.76 and practice being 5.32±1.85. Average of all the scores had enhanced after the intervention. The results of the study showed that, there is a need of demonstration for increasing the awareness and improve the correct techniques practicing regarding breast self-examination.

 

In the present study, after educational intervention, for all knowledge variables post test scores were increased above 90% and for all practice variables post test scores were increased up to 90%.

 

In a study done by Shankar etal at Jaipur and Mumbai College teachers found that knowledge scores were increased from 69.8% to 100%23. But in our study pre test knowledge scores were low because our study was conducted at field practice area of Kurnool. In a study conducted by Bala and Gameti etal at urban health centre, Ahmedabad found that knowledge scores were increased from 26.8% to 90.8%14. Similar findings were noted in current study. An Educational intervention study done by Gupta etal at Jabalpur among women self help group found that knowledge scores were increased from 16% to 59%12. On contrary, the present study post test knowledge scores were above 90%. In a study conducted by Madhukumar etal among Bengaluru college students found that knowledge scores were increased from 18% to 93% and practice scores were increased from 10% to 90%27. Similar findings were noted in the present study.

CONCLUSIONS AND RECOMMENDATIONS

The present study highlights the low levels of awareness of BC risk factors and also reveals the low levels of awareness on BSE in the community. We therefore stress once more how urgently awareness campaigns are needed at all levels of healthcare in order to increase understanding of BC. In a nation with low resources, such as India, BSE can be a helpful supplement to identify any changes in the size and shape of the breasts. In order to enable them to teach women in the community how to diligently do BSE, health care providers desperately need to be adequately trained.

 

This will enable early diagnosis of BC, particularly in settings with limited resources.

 

The bottomline: Be breast aware, checking from an early age, and going to the doctor if you see any change at all. It’s likely to be nothing, but if there’s something there, you’ll have caught it in time. Regular Health Education about risk factors and preventive measures like breast-feeding practices, reduction in prolonged usage of OCPs, reducing obesity development etc.

 

Source of Funding: This research project is selected and approved by the Dr. NTRUHS, Vijayawada, AP under the Under Graduate Student Research Schloarship programme 2023(UGSRS 2023). (Selected Candidate Application number: 23M385, University Roll Number: 20M102003018) .

 

Conflict of Interest: Nil

REFERENCES
  1. Kumarasamy, H., Veerakumar, A. M., Subhathra, S., Suga, Y., and Murugaraj, R. "Determinants of Awareness and Practice of Breast Self-Examination among Rural Women in Trichy, Tamil Nadu." Journal of Mid-life Health, vol. 8, 2017, pp. 84-88.
  2. Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L., Piñeros, M., Znaor, A., Soerjomataram, I., and Bray, F. "Global Cancer Observatory: Cancer Today." Lyon, France: International Agency for Research on Cancer, 2024. Available from: https://gco.iarc.who.int/today, accessed 12-09-2024.
  3. Barathe, P. C., Haridas, H. T., Soni, P., et al. "Cost of Breast Cancer Diagnosis and Treatment in India: A Scoping Review Protocol." BMJ Open, vol. 12, e057008, 2022. doi: 10.1136/bmjopen-2021-057008.
  4. Indian Council of Medical Research. "Available: https://main.icmr.nic.in/sites/default/files/ICMR_News_1.pdf."
  5. Taplin, S. H., Ichikawa, L., Yood, M. U., Manos, M. M., Geiger, A. M., Weinmann, S., et al. "Reason for Late-Stage Breast Cancer: Absence of Screening or Detection, or Breakdown in Follow-Up?" Journal of the National Cancer Institute, vol. 96, 2004, pp. 1518-1527.
  6. Agarwal, G., and Ramakant, P. "Breast Cancer Care in India: The Current Scenario and the Challenges for the Future." Breast Care (Basel), vol. 3, 2008, pp. 21-27.
  7. Shrestha, S., Chhetri, S., and Napit, J. "Awareness on Breast Self-Examination among Reproductive Age Women." JCMS Nepal, vol. 13, no. 4, 2017, pp. 425-429.
  8. Lam, W. W., Chan, C. P., Chan, C. F., Mak, C. C., Chong, K. W., et al. "Factors Affecting the Palpability of Breast Lesion by Self-Examination." Singapore Medical Journal, vol. 49, 2008, pp. 228-232.
  9. Prusty, R. K., Begum, S., Patil, A., et al. "Knowledge of Symptoms and Risk Factors of Breast Cancer among Women: A Community Based Study in a Low Socio-Economic Area of Mumbai, India." BMC Women's Health, vol. 20, 2020, p. 106. https://doi.org/10.1186/s12905-020-00967-x.
  10. Rao, R. S. P., Suma, N., Nair, N. S., et al. "Acceptability and Effectiveness of a Breast Health Awareness Programme for Rural Women in India." Indian Journal of Medical Sciences, vol. 59, 2005, pp. 396-402.
  11. Somdatta, P., and Baridalyne, N. "Awareness of Breast Cancer in Women of an Urban Resettlement Colony." Indian Journal of Cancer, vol. 45, 2008, pp. 149-153.
  12. Gupta, S. K., Pal, D. K., Garg, R., et al. "Impact of Health Education Intervention Program Regarding Breast Self-Examination by Women in a Semi-Urban Area of Madhya Pradesh, India." Asian Pacific Journal of Cancer Prevention, vol. 10, 2009, pp. 1113-1117.
  13. Garg, P., Bansal, M., Garg, M., et al. "Creating Awareness about the Pain-less Nature of Early Breast Cancer Lump Is Important in Low-Income Countries." Breast Journal, vol. 16, 2010, pp. 101-102.
  14. Bala, D. V., and Gameti, H. "An Educational Intervention Study of Breast Self-Examination in 250 Women Beneficiaries of Urban Health Centres of West Zone of Ahmedabad." Healthline, vol. 2, 2011, pp. 46-49.
  15. Shalini, Varghese, D., and Nayak, M. "Awareness and Impact of Education on Breast Self-Examination among College Going Girls." Indian Journal of Palliative Care, vol. 17, 2011, pp. 150-154.
  16. Sharma, P. K., Ganguly, E., Nagda, D., et al. "Knowledge, Attitude and Preventive Practices of South Indian Women Towards Breast Cancer." The Health Agenda, vol. 1, 2013, pp. 16-21.
  17. Kommula, A. L. S. D., Borra, S., and Kommula, V. M. "Awareness and Practice of Breast Self-Examination among Women in South India." International Journal of Current Microbiology and Applied Sciences, vol. 3, 2014, pp. 391-394.
  18. Fotedar, V., Seam, R. K., Gupta, M. K., et al. "Knowledge of Risk Factors and Early Detection Methods and Practices Towards Breast Cancer among Nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh, India." Asian Pacific Journal of Cancer Prevention, vol. 14, 2013, pp. 117-120.
  19. Pujar, T. V., Linganagouda, G., Benakanakondi, S., et al. "Assessing the Importance of Breast Self-Examination and Breast Cancer Awareness among Health Care Professionals." Journal of Evidence Based Medicine and Healthcare, vol. 2, 2015, pp. 4201-4208.
  20. Sujindra, E., and Elamurugan, T. P. "Knowledge, Attitude and Practice of Breast Self-Examination in Female Nursing Students." International Journal of Educational Psychology Research, vol. 1, 2015, pp. 71-74.
  21. Khokar, A. "Level of Awareness Regarding Breast Cancer and Its Screening amongst Indian Teachers." Asian Pacific Journal of Cancer Prevention, vol. 10, 2009, pp. 247-250.
  22. Paul, S., Solanki, P. P., Shahi, U. P., et al. "Epidemiological Study on Breast Cancer Associated Risk Factors and Screening Practices among Women in the Holy City of Varanasi, Uttar Pradesh, India." Asian Pacific Journal of Cancer Prevention, vol. 16, 2015, pp. 8163-8171.
  23. Shankar, A., Rath, G. K., Roy, S., et al. "Level of Awareness of Cervical and Breast Cancer Risk Factors and Safe Practices among College Teachers of Different States in India: Do Awareness Programmes Have an Impact on Adoption of Safe Practices?" Asian Pacific Journal of Cancer Prevention, vol. 16, 2015, pp. 927-932.
  24. Paunikar, A. P., Khadilkar, H. A., Doibale, M. K., et al. "Knowledge, Attitude and Practices of Women Towards Breast Cancer in the Field Practice Area of Urban Health Training Centre, Aurangabad, Maharashtra." International Journal of Community Medicine and Public Health, vol. 4, 2017, pp. 3659-3663.
  25. Srikanth, J., Upadhya, K. G., and Kumar, P. "Awareness of Cervical and Breast Cancer among Women Attending OBG Out-Patient Department of a Medical College Hospital, Bangalore." International Journal of Community Medicine and Public Health, vol. 5, 2018, pp. 2104-2108.
  26. Singh, S., Pal, A., Srivastava, N. K., and Thakur, P. "Level of Awareness and Practices of Women Regarding Breast Cancer in Chhattisgarh, India: An Institution-Based Survey." International Journal of Medical Public Health, vol. 8, 2018, pp. 145-151.
  27. Madhukumar, S., Thambiran, U. R., Basavaraju, B., et al. "A Study on Awareness about Breast Carcinoma and Practice of Breast Self-Examination among Basic Sciences College Students, Bengaluru." Journal of Family Medicine and Primary Care, vol. 6, 2017, pp. 487-490.
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