CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

According to the most recent WHO statistics (2014), breast cancer fatalities in Nigeria were 13,264, accounting for 0.70 percent of all deaths. Nigeria ranks fourth in the world with an age-adjusted death rate of 28.11 per 100,000 people. "Breast cancer is the most prevalent cancer in Nigeria, according to Adebamowo and Ajayi (1999). Breast cancer was determined to be the most prevalent cancer in Nigeria in 2005. (WHO, 2009). Breast cancer is second only to cervical cancer in the North-West geopolitical zone of Nigeria. Breast cancer accounts for 22.41 percent of new cancer cases reported in the North-central geopolitical zone in the last five years and 35.41 percent of all cancers in women (Afolayan et al., 2012). Breast cancer is the most frequently diagnosed cancer in women in Western nations, as well as the second largest cause of death and morbidity in women. The International Agency for Research on Cancer (IARC) publishes statistics on cancer incidence, prevalence, and mortality rates in 184 countries, and found that breast cancer affects women in 145 countries, including the United States, the United Kingdom, Australia, Canada, and Denmark (International Agency for Research on Cancer Breast cancer is currently the second most prevalent cancer in American women (after skin cancer), as well as the second greatest cause of cancer-related mortality, behind only lung cancer (CDC, 2010; NCI, 2009). According to current estimates in the United States, 226,870 women were diagnosed with breast cancer in 2012, with 39,510 women dying from the illness (American Cancer Society, 2012). Early detection of breast cancer is recognized to be critical not just in terms of therapy but also in terms of predicting prognosis (El Saghir et al., 2011). Levels of awareness, attitudes, and screening behaviors are some of the factors that predict variations in severity and survival rate. Breast cancer is frequently characterized by late clinical manifestations or advanced stages of the illness in developing or low-income nations, when only chemotherapy and palliative treatment are available, resulting in a high death rate (Adeniji, 1999; Anyanwu, 2000; Parkin et Late diagnosis of breast cancer has been found to affect survival differentially in wealthy and socioeconomically disadvantaged populations (Jack et al., 2009; Downing et al., 2007). Many developing nations have proven to have low awareness and health seeking behaviors, requiring the necessity for appropriate awareness campaigns (Khokhar, 2009; Montazeri et al., 2008). In comparison to older women, university students from 23 nations demonstrated low knowledge of breast cancer risk factors in a worldwide study (Peacey et al., 2006). For early detection of breast cancer, the American Cancer Society recommends a yearly mammogram starting at the age of forty, a clinical breast examination (CBE) every three years for women in their twenties and thirties, and every year for women aged forty and up, Mammography screening, on the other hand, is the most effective screening technique for early identification of breast cancer (Islam and Aziz, 2012). It is extensively used in the developed world (Onwere et al., 2009); but, because of the high cost, it is seldom used in Nigeria and other poor nations (Egwuonwu et al., 2012). Breast screening not only reduces breast cancer-related morbidity and mortality as a means of early detection (Austoker et al., 2009), it also improves the chances of survival and reduces the need for invasive treatment (Chong et al., 2002; Harmer (Noel et al., 2004). The two major methods for improving the prognosis result have been identified as ensuring the availability of early diagnostic and screening services and taking prompt action (Burgess et al., 2009; Abulkhair et al., 2010; Forbes et al., 2011). Beginning in 1960, the Nigerian government established cancer registries in an effort to reduce the threat of breast cancer illness. They may be used to conduct research, plan and execute cancer control, allocate resources for treatment and prevention, and other public health program planning (Parkin et al., 2008). Cancer registry centers provide data that may be used to influence cancer control strategies and resource allocation. Following the World Cancer Congress in 2006, the Federal Ministry of Health established a group to draft a National Cancer Policy titled "bridging the gap and converting knowledge into action." The Federal Government of Nigeria created a 5-year Nigeria Cancer Control Plan (2008-2013) in 2008, However the effect of advocacy, public awareness, cancer prevention, early diagnosis via routine screening, and cancer treatment has been minimal. At the state level, there are a variety of comprehensive health policies targeted at addressing health care delivery and breast cancer awareness campaigns. In Nigeria, there is presently no national strategy on cancer control; nevertheless, the "National policy on reproductive health and strategic framework" includes the control of reproductive malignancies (FMOH, 2004; WHO, 2006b). The goal of this systematic review is to compare all available data on breast cancer awareness, attitudes, and screening behaviors among Nigerian women.

1.2 STATEMENT OF THE PROBLEM

Breast cancer affects women of all races equally, despite the severity and survival rates being widely disparate. Breast cancer is the second leading cause of cancer mortality among women worldwide, behind lung cancer (American Cancer Society, 2008). Breast cancer is also the leading cause of cancer mortality among women in low-and middle-income countries, with 269,000 fatalities (12.7 percent of all cancer deaths) in 2008. (Ferlay et al., 2008; Lancet, 2011). The burden of breast cancer varies by country and location, including differences in incidence, death, and survival rates (Coughlin and Ekwueme, 2009; World Health Organization, 2009). Breast cancer incidence varies widely across the globe, and Africa is no exception (Ojewusi and Arulogun, 2016). Breast cancer is found in 27 percent of cancer cases in North African nations (Algeria and Egypt) and 15 percent of cancer cases in Sub-Saharan Africa (Parkin et al., 2003). Although the exact prevalence of breast cancer is unknown (Boulos et al., 2005), many studies have shown that the illness is becoming more common in various areas of Africa (Onwere et al., 2009; Anyanwu et al., 2011). Breast cancer affects people of all ages, with the chance of developing the disease increasing as they become older (Omotara et al., 2012). And not all women are aware of the causes or symptoms of cancer, hence this study.

1.3 OBJECTIVE OF THE STUDY

I.       To know the level of awareness of breast cancer among women in Nasarawa

II.    To know the symptoms of breast cancer among nursing mothers in Nasarawa.

III. To know the prevention measures for breast cancer among nursing mothers in Nasarawa.

1.4 RESEARCH QUESTIONS

I.       What is the level of awareness of breast cancer among women in Nasarawa?

II.    What are the symptoms of breast cancer among nursing mothers in Nasarawa?

III. What are the prevention measures for breast cancer among nursing mothers in Nasarawa?

1.5 SIGNIFICANCE OF THE STUDY

Breast cancer continues to spread despite intense preventative measures and broad public knowledge, presenting a public health issue. This research is important because it highlights breast cancer awareness and prevention among nursing moms, demonstrating the gap and assisting all interested parties in determining how to raise breast cancer awareness among nursing mothers. As a consequence, the study will be helpful in providing breast cancer information. Policymakers and health-related groups may use this as a starting point for developing initiatives.

1.6 SCOPE OF THE STUDY

The research focused on awareness of breast cancer among nursing mothers.The case study was Akwanga local government in Nasarawa state, Nigeria.

1.7 LIMITATION OF STUDY

Limitation This review, like any other review article, is subject to bias, such as author bias, gaps in literature research that may lead to omission of relevant research, errors in data translation from primary literature to review summarization, and misrepresentation or misinterpretation of original data sources. By carefully analyzing the original data before examining the review items, efforts were taken to reduce the impact of these possible sources of bias. We were able to evaluate and enhance the review articles because of our knowledge of the topic. We've narrowed our search to only include articles published in English. Second, rather than clinical examination and mammography, the focus of this study is on breast self-examination practice.

1.8 DEFINITION OF TERMS

Breast cancer: Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer.

nursing mothers: a mother who is breast-feeding her baby.

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