How "Breast Aware" are the Indian Women? A Study among the Women Visiting a Tertiary Care, Referral, and Teaching Hospital.

Introduction: "Who will educate us" lamented a School Principal after she took part in our study and education session. There is palpable low breast cancer (BC) literacy with rising incidence and disproportionate mortality rates.
Methodology: Breast Cancer Awareness Measure (BCAM) developed by Cancer Research UK was administered to 944 women. BCAM measures knowledge, age-related risk, and reported frequency of breast checking and other components. A woman is BC aware if she identified five or more nonlump symptoms, age-related risk, and reported breast checking once a week/month. At the end, each participant was given "Be Breast Aware" education; what/how to look for demonstrated on a model.
Results: 2.8% health professionals. 3.1% BC survivors. 78.8% had lump knowledge and 55.3% had non-lump knowledge of BC, 10% had age-related risk knowledge. 24.3% check breasts once a week/month. 41.9% aware BC is common after 50 years. 14/944 (1.5%) had BC awareness. 59.9% had breast symptoms, but never consulted a doctor, 31.1% were embarrassed, and 29.4% were scared to consult. Nearly 43% heard of breast screening, 28.4% had mammography, 26.3% had ultrasound. About 44.1% knew family history risk. Those practicing breast checking looked for a size change (24.5%), nipple position (17.4%), discharge (22.1%), pain (32.5%), and lump (24.7%) in standing (17.8%), supine (8.5%) using finger pads (15.8%) fingertips (21.6%), using circular movements (16.4%), and pinching breast tissue (19.6%).
Conclusion: Health-care workers and BC survivors lack breast awareness which is alarming and indicates the need for BC awareness and post-BC treatment follow-up care education in these two groups and the general population. Some practice the wrong method (e.g., pinching tissue) of breast checking, which may lead to anxiety and unnecessary investigative costs. "Be Breast Aware" education based on the National Health Service 5-point plan given to 944 participants.
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