Breast Cancer: Patient awareness and Hormonal Status in Addis Ababa, Ethiopia

Purpose: Breast cancer is the leading cause of cancer morbidity accounting for one-third of all cancers among women and one in five of all cancers (1). Awareness about breast cancer risk factors, symptoms, diagnosis, and treatment is unknown.

Methodology: A descriptive questionnaire-based survey was done on patients recently diagnosed with breast cancer and presented to St. Paul’s Hospital from April 2021 to June 2022. A questionnaire consisting of 55 variables was prepared. Demographic data and general cancer information were collected from the patient charts. After obtaining informed consent, patients were interviewed with 22 questions related to the knowledge, symptoms, risk factors, early detection methods, and management options of breast cancer. Descriptive statistics (mean, SD, frequency, percentage) and chi-square results were generated by using SPSS version 25. The level of significance was obtained at 0.05.

Results: 96 patients (all females) fulfilled the inclusion criteria. The median age was 45 (25-87), and the majority 52 (53.8%) were in the age group between 25-49 years. More than half (51%) live in the capital, Addis Ababa. Almost two third are married. Half of the participants are housewives and 31(32.3%) completed higher education. 79(82.3%) patients had at least one live birth with a median of 3 (0-8). 80.3% of the patients had breastfed with an average duration of two years. 13(13.5%) had a family member with breast cancer. Breast lump was the first symptom identified by 89(92.7%) patients, 77 (80%) could recall the time of presentation; and 32 (33.3%) went to see a health professional within 1 month of symptom onset. The most common histologic type was Ductal carcinoma in 74 (77.1%), and 34 (35.4%) had stage IV breast cancer at presentation. Hormonal status was available for 36 (37.5%) patients: 22 (61.1%) were ER-positive, 20 (55.6%) PR-positive, 16(44.4%) HER2 positive, 9 (9.4%) triple positive and 6 (6.3%) were triple negative.
The total knowledge score is moderate with an average of 12.9 (out of 22 questions). There was a lack of knowledge about risk factors with an average risk factor score of 4.7 (low) out of 11 questions. The knowledge score for the symptoms of breast cancer was 6.2 out of 9 which is relatively better compared to the knowledge of risk factors. The knowledge score for treatment options and early detection methods was high.

Conclusions: Our study demonstrated that breast cancer patients coming to SPHMMC lack knowledge about risk factors for breast cancer but have a moderate level of knowledge about breast cancer symptoms and a good level of knowledge about early detection methods and treatment options.

References: 1.Memirie ST, Habtemariam MK, Asefa M, Deressa BT, Abayneh G, Tsegaye B, et al. Estimates of Cancer Incidence in Ethiopia in 2015 Using Population-Based Registry Data. J Glob Oncol. 2018;4:1-11.