Influence of a Teaching Session on Breast Self-Examination and Adherence Among Pregnant and Lactating Women in Ibadan, Nigeria

Abstract

Educating women on how to examine their breasts can raise breast cancer awareness and early detection rates, especially in low- and middle-income countries. In this study, the influence of a teaching session on breast self-examination (BSE) during pregnancy was evaluated. A quasi-experimental study design was used. A total of 1,248 pregnant women whose pregnancies had a gestational age of 26 weeks or less were recruited from three antenatal clinics representing three tiers of the health care system in Nigeria. They were interviewed using a structured questionnaire, including BSE practice, and taught how to perform BSE using the MammaCare technique at recruitment. At 6 months postpartum, 729 participants were available for phone interview on BSE practice. Adherence to BSE was measured as a binary outcome comparing BSE performances at recruitment with follow-up. Conditional logistic regression analysis was used to determine the differences in BSE practices pre- and postintervention. Multiple logistic regression was used to identify predictors for adherence to BSE training at α = 0.05. Participants’ mean age was 30.4 ± 4.9 years, 401 (55.0%) attended a secondary health facility for antenatal care, and 78 (10.7%) had breast disorders at recruitment. Two hundred fifty-three (34.7%) said they practiced BSE before recruitment, and 380 (52.1%) did so at follow-up (odds ratio, 1.91; CI, 1.51 to 2.42). Women less likely to adhere were those with breast disorders detected at recruitment (adjusted odds ratio [aOR], 0.55; CI, 0.32 to 0.95) and women recruited from primary and secondary health facilities compared with those from a tertiary health facility (aOR, 0.41; CI, 0.17 to 0.98; aOR, 0.18; CI, 0.11 to 0.29, respectively). Educational interventions can significantly improve screening practices, even if only one session, and should serve as an integral control for breast cancer.