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 Table of Contents  
ORIGINAL ARTICLE
Year : 2015  |  Volume : 3  |  Issue : 1  |  Page : 18-23

Awareness of female breast cancer among adult males in Mumbai, India


1 Department of Physiotherapy, Dr. D. Y. Patil University, Sector 5 ,Nerul, Navi Mumbai, Maharashtra, India
2 Padmashree, Dr. D. Y. Patil University, Sector 5 ,Nerul, Navi Mumbai, Maharashtra, India

Date of Web Publication13-Apr-2015

Correspondence Address:
Dr. Shivani Chowdhury Salian
Department of Physiotherapy, Padmashree Dr. Dnyandeo Yashwantrao Patil University, Sector 5, Nerul, Navi Mumbai - 400706
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.154920

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  Abstract 

Background: Breast cancer is a major killer disease in females globally and in developing regions, where the early cancer detection facilities are unavailable, prognosis is even worse. Awareness about this disease can lead to early detection and thereby decrease the morbidity and mortality. Materials and Methods: In a longitudinal prospective survey, 150 adult males were interviewed regarding their awareness about occurrence of breast cancer in females using a self designed and validated questionnaire. A battery of questions aiming to assess the levels of awareness of adult males regarding risk factors, signs and symptoms, importance of early detection, methods of detection, treatment options and importance of exercise were considered. Results: This study presented demographic and qualitative information about the levels of awareness about a disease that is alarmingly increasing in women population in India. The results showed that 18% of the targeted adult male population had good awareness, 45% of males had an average awareness and 37% of adult males had poor awareness about breast cancer in females with respect to the domains considered in the survey questionnaire. Conclusion: Breast cancer awareness is very low among men in a metropolitan city like Mumbai. In the absence of breast cancer screening clinics, there is a dire need to take measures to improve breast cancer awareness in men so that they can play a role in early detection of this disease and thereby improve the outcome in this disease.

Keywords: Breast cancer, cancer awareness, males


How to cite this article:
Salian SC, Narsinh F, Yardi S. Awareness of female breast cancer among adult males in Mumbai, India. Arch Med Health Sci 2015;3:18-23

How to cite this URL:
Salian SC, Narsinh F, Yardi S. Awareness of female breast cancer among adult males in Mumbai, India. Arch Med Health Sci [serial online] 2015 [cited 2019 Dec 14];3:18-23. Available from: http://www.amhsjournal.org/text.asp?2015/3/1/18/154920


  Introduction Top


Breast cancer is globally one of the major killer diseases in women. [1] In economically deprived regions of the world, lack of awareness about breast cancer and less availability of specific breast clinics, results in delay in seeking medical care, and hence in poorer prognosis. [2] Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. The disease occurs almost entirely in women, but men can get it, too.

Spouse or a mate is the one person who is physically and emotionally intimate to a woman and can become a great medium in early detection of breast cancer in females, but this is possible only if males are aware about the features of female breast cancer. In Indian society, women mostly depend on males who take them to healthcare facility. In literature, most of the studies have concentrated in studying the level of breast cancer awareness in females only and awareness of male breast cancer in males. Few studies are available regarding female breast cancer awareness in males. [3] On reviewing the literature; it was found that virtually all the studies are directed at detection and means to improve awareness among females and very few studies where awareness of this disease in males has been studied. [3] It was against this background, this study was undertaken to assess the female breast cancer awareness among males. This study was undertaken to study the level of awareness regarding breast cancer among males in a metropolitan city like Mumbai.

Objective

To find out awareness of breast cancer within male population regarding risk factors of female breast cancer, signs and symptoms, importance of early detection, methods of detection, treatment options, and importance of exercise.


  Materials and Methods Top


A study was conducted in the Department of Physiotherapy, Padmashree Dr. Dnyandeo Yashwantrao Patil University, Nerul, Navi Mumbai, India over a period of 9 months from September 2012 to May 2013, to assess the level of awareness regarding breast cancer in adult men. It was a longitudinal, prospective study in which participants were selected randomly. A total of 150 adult males who were 18 years and above were explained the purpose of the study as per the ethical guidelines of Helsinki. Ethics committee of the university granted a clearance to perform the survey study after thorough review of the synopsis. The people who agreed to participate in the study were requested to answer a self-designed questionnaire after assuring them of confidentiality. The questionnaire included basic signs and symptoms of breast cancer. The questionnaire was designed after referring textbooks of general surgery. [4] Attempt was made to simplify the questionnaire with the aim of getting insight into level of knowledge with minimum possible consumption of time of the participants. The questionnaire was also validated by the Director of Department of Physiotherapy, the guide, and a gynecology surgeon before sending the same to the ethics committee. The features related to breast cancer in the questionnaire and awareness regarding each feature earned 1 point and no point was awarded if the man was unaware. Accordingly, three categories of breast cancer awareness were defined as per the total scores as depicted in [Table 1].
Table 1: Self design questionnaire regarding breast cancer to assess the awareness. Points were allotted in the following way


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Statistical analysis

Statistics was done using the Statistical Package for Social Sciences (SPSS) version 16. A frequency table was formulated and the analysis was done using pie chart representation of the population of adult males and their characteristics through the system.

Ethical issues

Purpose of the study was explained to all the participants and a written informed consent was obtained from them. The study protocol was accepted and passed through the ethics committee of Padmashree Dr. Dnyandeo Yashwantrao Patil University, Nerul, Navi Mumbai, India.


  Results Top


A cross-sectional awareness survey was undertaken comprising 150 adult males who were interviewed for their awareness on various aspects of occurrence of breast cancer in females. The distribution of male subjects in our study was as shown in [Figure 1] and as depicted from [Table 2]. Majority of subjects fell in the age group of 18-35 years of age.
Figure 1: Graphical representation of percentage of male subjects classified into three age groups


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Table 2: Classification of number of adult males according to three age groups


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Out of 150,101 males are married and 49 unmarried. Of which 87 married males and 47 unmarried males were aware of breast cancer [Figure 2].
Figure 2: Graphical representation of distribution of adult males according to their marital status


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It was observed that for most of the males, major source of awareness about breast cancer in females was the media. The other sources of information regarding breast cancer were as seen in [Figure 3].
Figure 3: Graphical representation of various modes of media through which the males obtained information regarding breast cancer in females


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The survey yielded information regarding awareness of males about the various risk factors associated with breast cancer and it was noted that 19% men are unaware of any of the risk factors. The distribution of number of males being aware of the various risk factors is depicted in [Table 3] and presented graphically as in [Figure 4].
Figure 4: Graphical representation of distribution of number of males being aware of the various risk factors associated with breast cancer


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Table 3: Number of males being aware of the risk factors associated with breast cancer


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From our survey it was evident that 24% men were unaware of any of the signs and symptoms associated with breast cancer. The signs and symptoms and the number of males aware of the samewas as seen in [Table 4] and awareness as depicted from [Figure 5].
Figure 5: Graphical representation of distribution of number of males being aware of the various signs and symptoms associated with breast cancer


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Table 4: Number of males being aware of the signs and symptoms associated with breast cancer


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It was also observed that 95 (63%) males were aware of importance of early detection of breast cancer, 91 (61%) males were aware that breast cancer is curable, whereas, 27 (18%) men mentioned that they thought breast cancer had no cure and 32 men (21%) did not know whether it was curable or not.

When the subjects were asked whether they were aware of the various methods of detection of breast cancer, it was observed that a few of them ascertained that they were aware of more than one means of detection technique for breast cancer. [Table 5] and [Figure 6] shows the number of subjects and the tests that they were aware for detection of breast cancer.
Figure 6: Graphical representation of distribution of number of males being aware of the various detection tests for breast cancer


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Table 5: Number of males being aware of the methods of detection of breast cancer


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With regards to treatment,26% men are unaware of the treatment options available for breast cancer patients [Table 6] and [Figure 7]. About 78 males, that is, about 14% were aware of importance of exercise in improving quality of life of the patients suffering from breast cancer. Forty-three percent men were unaware of the parallel treatments that can be made available for women suffering from cancer [Table 7] and [Figure 8]. On calculating the total scores according to the scale, overall only 18% of men could be graded having good awareness about breast cancer and various aspects associated with it. Forty-five percent of men had an average awareness and 37% of men had poor awareness of the same. The levels of awareness in males regarding breast cancer in females are depicted in [Table 8] and [Figure 9]. Awareness was higher in males who had higher education [Table 9] and [Figure 10].
Figure 7: Graphical representation of distribution of number of males being aware of the various treatments available for breast cancer patients


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Figure 8: Graphical representation of distribution of number of males being aware of the various parallel treatments available for breast cancer patients


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Figure 9: Graphical representation of overall awareness levels of males regarding breast cancer in women


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Figure 10: Graphical representation of classification of level of awareness of breast cancer in women according to their education


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Table 6: Awareness of types of treatments available for breast cancer patients


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Table 7: Awareness of types of parallel treatments available for breast cancer patients


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Table 8: Overall awareness levels of males regarding breast cancer in women


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Table 9: Overall awareness levels of males according to their education regarding breast cancer in women


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  Discussion Top


Breast cancer is the commonest cause of cancer in females in most of the states of India as per the recent statistics. [5] But the facilities of breast clinics for early detection of breast cancer are not available to a major percentage of the population. This has been found to result late reporting of patents to healthcare facility and ultimately poorer prognosis. In such circumstances, the only viable method to make early reporting of patients possible is by spreading awareness regarding this disease. [6] On review of literature, we found that virtually all the studies are directed at detection of the level or ways and means to improve breast cancer awareness among females and we could not find any study where awareness of this disease in males has been studied. It was against this background, this study was undertaken to assess the female breast cancer awareness among male population.

From our study, we found that only 18% of males had average to good awareness and 37% had poor awareness about this disease. These figures are worrisome keeping in view the fact that like other parts of Indian subcontinent, spouse is the closest relation physically and emotionally. Since spouse has the privilege to feel the body of his partner, awareness about the abnormalities could result in early detection of pathology. Besides, since in our society, husband plays a major role in bringing the patient to the healthcare facility and breast cancer of a lady affects the male partner emotionally and financially, it becomes all the more important to include males in awareness programs regarding this disease.

When studied on the basis of level of formal education, graduates and above were better aware than less or uneducated group. Similarly teachers, office goers, and students were better aware though the difference was not significant. Besides most of these relatively better aware groups also belonged to graduate and above educational group. But the fact that 37% had poor awareness about breast cancer needs a serious attention and improvement. But it needs to be mentioned that the literature shows that even in economically developed regions of the world, health education has not been made a constant part of certification programs.

India is getting more and more westernized, so not only married men but also unmarried males come in contact with females should be targeted, and hence, we included subjects in the range from 18 years onwards. Hence, it becomes more important to spread awareness even in unmarried males regarding female breast cancer.

As far as the sources of information are concerned, health-related programs on local radio, television, and articles in local newspapers were sources of information. Since these sources are widely available, impetus needs to be laid on focused utilization of these means of education to improve breast cancer awareness among masses. By establishing a definite role for colleges and teachers in promotion of health, positive results have been achieved as is evident from literature.

Screening for breast cancer can help in early diagnosis. Hence, it is very important that females who are 40 years and above should go for screening regularly. [7] Fromour study we found out that only 37 out of150 males are aware of the age at which the screening is done. From our study we also found out that only 14% of the males are aware of importance of exercise. Hence, measures need to be taken to spread the awareness and importance of exercise in improving the quality of life of patient suffering from breast cancer. [8],[9]


  Conclusion Top


Breast cancer awareness is very low among men in a metropolitan city like Mumbai. In the absence of breast cancer screening clinics, there is a dire need to take measures to improve breast cancer awareness in men so that they can play a role in early detection of this disease and thereby improve the outcome in this disease.

Recommendation

Awareness of breast cancer in women can be enhanced by means of conducting seminars, workshop, surveys, and studies involving larger group of males from both urban and rural areas. Also awareness can be improved by conducting camps, interviewing males accompanying the females visiting outpatient department (OPD), not only physiotherapy but other OPDs like surgery, medicine, gynecology on one-to-one basis regarding female breast cancer. From research point of view, publishing various articles in health magazine, newspaper, and journals regarding breast cancer, importance of early detection, importance of screening, and also regarding role of physiotherapy and importance of exercise in improving quality of living of patient suffering from breast cancer.

 
  References Top

1.
Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000: The global picture. Eur J Cancer 2001;37Suppl 8:S4-66.  Back to cited text no. 1
    
2.
Rao RS, Nair S, Nair NS, Kamath VG. Acceptability and effectiveness of a breast health awareness programme for rural women in India. Indian J Med Sci 2005;59:398-402.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Salati SA, Rather A. Awareness regarding female breast cancer in males-a study. OJHAS Online J Health Allied Sci 2009;8.  Back to cited text no. 3
    
4.
Tjandra JJ, Collins JP. Breast Surgery in the Text book of Surgery. 3 rd ed. USA: Blackwell Publishing Ltd; 2006. p. 273-93.  Back to cited text no. 4
    
5.
Murthy NS, Chaudhry K, Nadayil D, Agarwal UK, Saxena S. Changing trends in incidence of breast cancer: Indian scenario. Indian J Cancer2009;46:73-4.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.
Richards MA, Westcombe AM, Love SB, Littlejohns P, Ramirez AJ. Influence of delay on survival in patients with breast cancer: A systematic review. Lancet 1999;353: 1119-26.  Back to cited text no. 6
    
7.
Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American Cancer Society Breast Cancer Advisory Group. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 2007;57:75-89.  Back to cited text no. 7
    
8.
Kisner C, Colby LA. Breast cancer related lymphatic dysfunction. Therapeutic Exercise foundation and techniques, 5 th ed. India: F.A. Davis Company; 2007. p. 838-43.  Back to cited text no. 8
    
9.
Box R. Rehabilitation after breast cancer. In: Sapsford A, Markwell, editors. Women's health, 1 st ed. India: Harcourt Brace & Company Asia Pvt Ltd; 1998. p. 454-64.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]



 

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Introduction
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