A STUDY OF NIGERIAN UNDERGRADUATE PERCEPTION OF BREAST LUMP

Abstract

Breast lumps are a very common complaint for women of all ages. Breast lumps may occur spontaneously or gradually and may be accompanied by other symptoms such as breast pain, changes in the skin or changes in the nipple. A breast lump may or may not be noticeable to the patient; normal breast tissue can be quite lumpy in some women and some lumps can be small or located deep in the breast. Special tests such as a mammogram often detect breast lumps that cannot be felt. Over 90% of breast lumps are caused by benign breast disease, a range of non-cancerous conditions.

CHAPTER ONE

INTRODUCTION

1.1Â Â Â Â Â Background of the study

Any noticeable change, thickening, or localized swelling in your breast that wasn’t there before may be a lump. Most breast lumps are not cancerous and most women will experience a benign lump sometime in their lives. The following are common breast problems that appear as lumps. These are the most common cause of breast lumps in women age 35 to 50, and are responsible for at least half of all breast operations performed. This condition, formerly called fibrocystic breast disease, is not an actual disease, but probably an overreaction by the mammary glands, ducts, and fibrous tissue to normal hormonal changes. As a result, multiple pockets of fluid (called sacs or cysts) develop, and an increase in fibrous tissue may form. In some instances, a lump may consist only of fibrous rubbery tissue (a condition called mammary dysplasia). Tenderness and lump size commonly increase during the week before menstruation and decrease the week after. Many women experience decreased tenderness with the elimination of caffeine from their diet. Vitamin E supplements have been recommended in dosages of 200-400 I.U./day (consult your doctor). Some home remedies such as wearing a supportive bra, reducing salt intake to minimize fluid retention, and using ice packs to ease discomfort—may alleviate swelling and pain. Fibrocystic changes usually disappear after menopause. Breast lumps are a common finding in women of all ages, but are particularly common during the reproductive years (from first menstruation until menopause). One study examined 40 to 69 year old women presenting with breast complaints – 40% of these were for breast lumps or lumpiness. In those complaining of a lump, breast cancer was found in 11% of patients. Breast cancer is the most common among women (excluding skin cancers) and constitutes 27.7% of all cancer diagnoses in women. In Nigeria, 35 women are diagnosed with breast cancer every day. Rates of breast cancer are highest in the age group 60–64, but can affect women of all ages. Two out of three breast cancers are diagnosed in women aged 40–69.

Having a breast lump does not automatically mean a patient has breast cancer, as only 11% of people presenting with breast lumps turn out to have breast cancer. Additionally, many breast cancers are localised and can be treated effectively if diagnosed early. Most breast lumps are benign breast disease, a range of conditions that can cause breast lumps but are not cancerous. However, some benign breast diseases are associated with a slightly increased risk of cancer in the future, depending on that patient’s medical history, family history and risk factors. See your doctor for further advice and appropriate investigations for a breast lump.

The following conditions are common, benign causes of breast lumps and do not increase your risk of breast cancer in the future.Â

• Breast cyst – blocked ducts in the breast create a small, fluid-filled sac – these are common around the time of menopause. They can sometimes be painful, and are easily managed by drainage with a needle;
• Mastitis – usually due to an infection, the breast develops an area of inflammation that can be hard, red or tender. They are common during breastfeeding and can range from simple infections to complicated abscesses that require aggressive treatment. Mastitis that does not respond to treatment should be investigated further with biopsy to ensure correct diagnosis;
• Lipoma – a benign tumour of fat cells that can occur anywhere in the body. They are common and generally soft and painless.

Some benign breast diseases are not themselves cancerous but can carry a slight increase in the risk of breast cancer in the future. The level of this risk depends on the patient’s medical and family history. These include:

• Fibroadenomas – areas of overgrowth of normal breast tissue due to hormonal stimulation that are common in younger women. They are generally painless, soft and mobile. They are removed if larger than 2 cm, growing rapidly, or causing distress to the patient;
• Intraductal papilloma – benign tumours of the tissue lining milk ducts in the breast. They can be single or multiple and can cause a discharge of fluid from the nipple. They are not usually associated with cancer and are most commonly seen in women aged 30 to 50;
• Tubular adenomas – benign tumours of cells of breast glands, they are rare but most common in younger women;
• Phyllodes tumour – rare tumours of breast tissue that can be difficult to diagnose. They appear similar to fibroadenomas but have a greater tendency to recur. Rarely, a Phyllodes tumour can be cancerous and spread to distant tissues and are therefore surgically removed if diagnosed. Â

Many other rare conditions can present as a breast lump.
Malignant causes of breast lumps Breast cancer is the most common cancer in women (excluding skin cancers) and second most common cause of cancer deaths in women. The main risk factors for the development of breast cancer include age, age at first menstruation, age at first childbirth, hormonal factors, family history and a history of abnormal breast biopsies.

Breast cancer can first present as a palpable breast lump (can be felt by pressing a hand on the site) and may be painless. Any changes in breast or skin appearance, nipple discharge, nipple inversion and breast pain should be reported to your family doctor for further investigation. Breast cancer is broadly classified as ductal (originating from the milk ducts inside the breast) or lobular (originating from the breast tissue surrounding the ducts). Breast cancer is preceded by a series of stages of cellular change; normal breast cells take an abnormal shape (atypical hyperplasia), develop into localised areas of cancerous cells (carcinoma-in-situ) and then into frank breast cancer that can spread to other areas of the body. These changes are also classified by the area (ductal or lobular), hence the terms ductal carcinoma-in-situ (DCIS) and lobular carcinoma-in-situ (LCIS). Approximately 80% of breast cancers are ductal in origin and 12% are lobular, with the remaining cases are made up by the more rare causes of breast cancer

1.2Â Â Â Â Â STATEMENT OF THE PROBLEM

Part of a preventive role for our bosom buddies is to be informed about breast lumps, their possible causes and when to seek medical help. Infections, injuries, non-cancerous growths, cysts, fibrocystic changes, xenohormones and even parasites all play a role in breast lumps. But painless lumps, nipple discharge, and rashes or skin inflammation on the breast can all signal breast cancer. It is in view of the above that the researcher decide to investigate Nigerian undergraduate perception of breast lump in Ajayi crowder university

1.3Â Â Â Â Â OBJECTIVE OF THE STUDY

The main objective of the study is to investigate undergraduate student perception of breast lump in Ajayi crowder university. But to aid the successful completion of the study, the researcher intends to achieve the following specific objective;

i)Â Â Â Â Â Â Â Â Â Â Â Â To investigate the health effect of breast lump among Nigerian undergraduate female student

ii)Â Â Â Â Â Â Â Â Â Â To examine the dangers of breast lump on the health of Nigerian undergraduate student

iii)Â Â Â Â Â Â Â Â Â To investigate if there is any relationship between breast lump and breast cancer

iv)Â Â Â Â Â Â Â Â To examine if lump in the breast is a symptoms of breast cancer among female student

1.4Â Â Â Â Â RESEARCH HYPOTHESES

 To aid the completion of the study, the following research hypotheses were formulated by the researcher;

H0: breast lump has no health effect among Nigerian undergraduate student

H1: breast lump has health effect among Nigerian undergraduate student

H02: there is no relationship between breast lump and breast cancers

H2: there is a relationship between breast lump and breast cancers

1.5Â Â Â Â Â significance of the study

It is believed that at the completion of the study, the findings will be of great importance to the management of universities on the need to carry out a sensitization programs for the female students of the institution on the challenges and dangers of breast lump. The study will also be useful to the female undergraduate students as the study seek to explore the benefit of self-breast examination for early detection and control. The study will also be useful to researchers who intends to embark on a study in a similar topic as the study will serve as a reference point to further research. Finally the study will be of importance to researchers, students, academia, lecturers and the general public as the findings will contribute to the pool of existing literature

1.6Â Â Â Â Â SCOPE AND LIMITATION OF THE STUDY

The scope of the study covers Nigerian undergraduate student perception of breast lump in Ajayi crowder university. In the cause of the study, there were some factors which limited the scope of the study;

a)    AVAILABILITY OF RESEARCH MATERIAL: The research material     available to the researcher is insufficient, thereby limiting the study.

b)    TIME: The time frame allocated to the study does not enhance wider        coverage as the researcher has to combine other academic activities       and examinations with the study.

c)    FINANCE: The finance available for the research work does not    allow for wider coverage as resources are very limited as the       researcher has other academic bills to cover.

1.7 OPERATIONAL DEFINITION OF TERMS

Breast

The breast is one of two prominences located on the upper ventral region of the torso of primates. In females, it serves as the mammary gland, which produces and secretes milk to feed infants

Lump

Compact mass of a substance, especially one without a definite or regular shape.

Breast lump

A breast lump is a growth of tissue that develops within your breast. Different types of breast lumps can vary in the way they look and feel.

Breast cancer

Breast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump

1.8 ORGANIZATION OF THE STUDY

This research work is organized in five chapters, for easy understanding, as follows Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study is based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding. Chapter five gives summary, conclusion, and recommendations made of the study.