CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Breast cancer (BCa) is a malignant tumour that develops from the cells of the breast. It can be treated, and the outcome depends strongly on how early the disease is found. Globally there were about 2.3 million new cases and 685,000 deaths from breast cancer in 2020 (Arnold et al., 2022), and in 2022 it was the most commonly diagnosed cancer in women in 157 of 185 countries (World Health Organization [WHO], 2024). The difference that early detection makes is large. In the United States the average five-year survival rate is about 91%, whereas in Nigeria it has been estimated at only 24% to 33%. Contributing factors include poor awareness and knowledge of the disease, low socio-economic status, late presentation, poor follow-up care and limited access to treatment, so that most Nigerian women come to a clinic for the first time at an advanced stage (Omo & Isara, 2025).

In high-income countries breast cancer screening is usually done with mammography. Mammography is not widely available to most women in sub-Saharan Africa, and national screening programmes in Nigeria are not well established. In such settings breast self-examination (BSE) remains a practical and feasible alternative (Omo & Isara, 2025). A woman who knows the normal look and feel of her own breasts is more likely to notice a change that needs attention, and BSE can be combined with clinical breast examination (CBE) by a health professional and, where available, imaging such as ultrasound and mammography.

Young women deserve particular attention. Most students in Nigerian higher institutions are adolescents or young adults, and these formative years are the best time to make women “breast-aware” through low-cost detection methods such as BSE (Omo & Isara, 2025). Yet studies of students show gaps. Among female students of a college in Asaba, Delta State, about 89% had heard of breast cancer, but knowledge of its risk factors was poor: fewer than half recognised a breast lump as a symptom, and risk factors such as family history, exposure to ionising radiation, smoking, oral contraceptive use, obesity and a late first pregnancy were each identified by a minority (Omo & Isara, 2025). Just over half of those students had ever performed BSE, and practice was significantly higher among older students, those at higher levels of study and those with a family history of the disease (Omo & Isara, 2025). In a study at Ebonyi State University, 55.3% of female undergraduates were found to be knowledgeable about BSE (Ossai et al., 2019). Educational intervention has been shown to improve the knowledge, attitude and practice of BSE among female students at a private university in southern Nigeria (Uruntie et al., 2024).

Cultural factors may also play a part. Because the breast is regarded as a private part of the body, discussion of it is often considered sensitive, which may limit the role of parents and teachers in giving girls information about breast cancer (Omo & Isara, 2025). The researcher’s own observation suggests that this reticence may carry into adulthood: students who tolerate discomfort quietly may delay reporting symptoms such as breast pain, which can lead to late detection.

Early detection leads to early treatment and better chances of survival. It is therefore important to assess female students’ knowledge of the causes and risk factors of breast cancer, their perception of how it can be prevented and managed, and the factors that prevent them from practising early detection methods, so that interventions can be designed before disease reaches an advanced stage. Female students themselves have a role to play, by performing BSE regularly, seeking routine clinical breast examination, and obtaining further screening where it is advised.

1.2 Statement of the Problem

Breast cancer is a leading health problem for women in Nigeria, and the poor survival rates reported in the country are closely tied to late presentation and low awareness (Omo & Isara, 2025). Studies among Nigerian female students point to poor knowledge of risk factors and symptoms and uneven practice of BSE (Omo & Isara, 2025; Ossai et al., 2019).

The researcher’s observation indicates that a number of female students attending the hospitals commonly used by students have presented with breast changes, such as tenderness, irregularity in size and contour, swelling, visible veins, nipple retraction or discharge, and have been diagnosed with breast cancer at different stages. Most of these cases were found through routine clinical breast examination rather than through the students’ own detection. Pain, which is an obvious warning sign, may be overlooked, which contributes to late detection. Where a culture of silence about bodily complaints prevails, greater emphasis on early detection through BSE, CBE and mammography is needed. It is against this background that the present study examines the causes, management and perception of breast cancer among female students of the Faculty of Social Sciences, Delta State University.

1.3 Purpose of the Study

The main purpose of the study is to assess the causes, management and perception of breast cancer among female students of the Faculty of Social Sciences, Delta State University. The specific objectives are to:

1. ascertain the knowledge level of female students about breast cancer, its causes and risk factors, and detection measures;
2. ascertain how breast cancer can be prevented or managed, as perceived by the female students;
3. identify the female students’ sources of knowledge about breast cancer; and
4. identify the factors that prevent them from practising early detection measures.

1.4 Research Questions

The following research questions guided the study:

1. What is the knowledge level of female students about breast cancer, its causes and risk factors, and detection measures?
2. How can breast cancer be prevented or managed, as perceived by the female students?
3. What are the female students’ sources of knowledge about breast cancer?
4. What factors prevent female students from practising early detection measures?

1.5 Significance of the Study

Breast cancer is the most commonly diagnosed cancer in women in most countries of the world (WHO, 2024), and the findings of this study will benefit several groups: female students, the university and faculty administration, the university health services and counselling units, nurses, midwives and other health professionals, policy makers and future researchers.

The findings will show how much female students know about breast cancer and how far they practise appropriate health behaviours, and will provide data for assessing students on the subject. This feedback will help to identify and correct areas of weakness. The study will also give insight into students’ attitudes towards BSE and towards examination of the breast by health providers, and into the reasons some students avoid such examination.

The results will help in designing acceptable health promotion and awareness programmes, including training in BSE during orientation and in-service programmes, which have been recommended for new students (Omo & Isara, 2025), and will guide university authorities in planning workshops for the different categories of students. Because educational interventions have been shown to improve knowledge, attitude and practice of BSE (Uruntie et al., 2024), the findings can also form a basis for such interventions in the university.

1.6 Scope of the Study

The study is limited to assessing the causes, management and perception of breast cancer among female students of the Faculty of Social Sciences, Delta State University, and the factors that prevent these students from practising early detection measures.

1.7 Operational Definition of Terms

Breast cancer (BCa): a malignant tumour that develops from the cells of the breast.

Breast self-examination (BSE): a woman’s own examination of her breasts to detect any change in their look or feel.

Clinical breast examination (CBE): examination of the breasts by a trained health professional.

Mammography: an X-ray imaging technique used to screen for and detect breast abnormalities.

Early detection practices: the actions respondents take to identify signs of breast cancer early, such as breast self-examination, clinical breast examination and mammography, including how often, when and how BSE is done and what is looked for.

Knowledge of breast cancer: respondents’ ability to state the meaning of breast cancer, its risk factors and causes and its early signs, together with their sources of information and the factors that influence their practice of BSE.

Perception: respondents’ views on how breast cancer can be prevented and managed.

References

Arnold, M., Morgan, E., Rumgay, H., Mafra, A., Singh, D., Laversanne, M., Vignat, J., Gralow, J. R., Cardoso, F., Siesling, S., & Soerjomataram, I. (2022). Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast, 66, 15–23. https://doi.org/10.1016/j.breast.2022.08.010

Omo, E. N., & Isara, A. R. (2025). Knowledge of breast cancer and practice of breast self-examination among female students at Federal College of Education (Technical) Asaba, Nigeria. The Nigerian Health Journal, 25(3), 1276–1285. https://doi.org/10.71637/tnhj.v25i3.1204

Ossai, E. N., Azuogu, B. N., Ogaranya, I. O., Ogenyi, A. I., Enemor, D. O., & Nwafor, M. A. (2019). Predictors of practice of breast self-examination: A study among female undergraduates of Ebonyi State University, Abakaliki, Nigeria. Nigerian Journal of Clinical Practice, 22(3), 361–369. https://doi.org/10.4103/njcp.njcp_482_18

Uruntie, R. O., Oputa, C. H., Peters, E., & Otovwe, A. (2024). Effect of educational intervention on the knowledge, attitude and practice of breast self-examination among female students at a private university in Southern Nigeria. BMC Cancer, 24, 355. https://doi.org/10.1186/s12885-024-12116-w

World Health Organization. (2024). Breast cancer [Fact sheet]. https://www.who.int/news-room/fact-sheets/detail/breast-cancer