Breast cancer is the most common cancer and the major cause of cancer death among women world-wide as well as in Bangladesh. It is leading incident cancer amongst women in Bangladesh. The inci-dence of BC is increasing in the developing world due to increase life expectancy, increase urbani-zation and adoption of western lifestyles (Forazy and Khatun, 2015). Although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where BC is diagnosed in very late stages (Nigar et al., 2018). Therefore, early detection in order to improve BC outcome and survival remains the cornerstone of BC control. Limited resource settings with weak health systems where BC incidence is relatively low and the majority of women are diagnosed in late stages have the option to implement early diagnosis program based on awareness of early signs and symptoms and prompt referral to diagnosis and treatment (Islam et al., 2018; Sama et al., 2017; WHO, 2020).

Both male and female can have BC but BC in male seems rare compared to women. In developing countries including Bangladesh, most of the BC patients are diagnosed at an advanced stage due to lack of awareness and inadequate access to health care facilities (Hossain et al., 2015). Inadequate knowledge about BC is a crucial obstacle in diagnosis and treatment initiation which ultimately increases the morbidity and mortality rate (Muha-mmad et al., 2015). More than 3 months delay in diagnosis and treatment from first detection of symptomatic BC may result in diagnosis of the disease at an advanced stage, poor treatment out-come and decreased survival length (Laura, 2019).

When BC is diagnosed at an early stage, prognosis is believed to be good with reduced morbidity and mortality. Therefore, steps should be taken to ensure early detection and timely treatment. Two vital strategies for early detection include early diagnosis and screening. An important aspect of early dia-gnosis includes increasing the awareness of early signs of cancer among physicians, nurses, other healthcare workers as well as the general population. Screening, on the other hand, includes employing simple tests to identify individuals with cancer even before symptoms appear. BSE, CBE, and mammo-graphy are well recognized screening methods for BC. Since there is no national registry of cause of death in Bangladesh or of patients follow-up systems in hospitals, it is not possible to know about the mortality and survivorship of BC. 

Nonetheless, GLOBOCAN has estimated that 7142 women died of BC in Bangladesh in 2012 (ASR 11 per 100,000) (NIPORT, 2011; Nas et al., 2020). Apart from this, a maternal health survey estimated that cancer was responsible for 21% of all womens deaths in the reproductive age range (IHME, 2011). Another verbal autopsy study showed that 62% of all deaths associated with BC were in women less than 50 years old (Godfrey et al., 2015).

Justification of the Study

The study included only female students of Bangla-desh University of health science. This study separately assessed the scores of individual with being taught about awareness, knowledge and practice of breast screening methods for early dete-ction of BC and had a message to institution, as well, in necessity of addition to knowledge and awareness about BC and breast screening methods in their university curriculums (Olugbenga- Bello et al., 2011; Atta et al., 2018; and Carol, 2019).

Research Questions

How much knowledge and awareness do the students have about BC, diagnosis and screening of BC, mammography and practice of breast self-examination?

Objectives of the Study 

The main objective of this study was to find out the knowledge, awareness about BC, diagnosis and screening of BC, mammography and practice of breast self- examination. 

This was a preliminary descriptive cross sectional study among 90 students of Bangladesh University of health sciences in Dhaka city. 

Tool of data collection: The study was conducted through a well-structured self-administered question-naire consisting of four parts –

a) First Part: Socio- Demographic data (age, sex, level of education and marital status, menstruation cycle). 

b) Second Part: Knowledge regarding mammo-graphy (9 question).

c) Third Part: awareness about BC and practice of breast self-examination (12 questions).

d) Fourth part: perception on delayed breast screening and suggestion for improvement (4 questions).

Method of the study

Explanation about the objectives of the study and the benefit of its findings was provided to each study participant before submitting the questionnaire. Responses were only based on their subjective data and recent attitudes without referring to any books. Questionnaire forms were directly distributed to all female students individually who are studying under this university and only 90 students participated in this study and completed the forms.

Ethical considerations

All participants were consented verbally to fill the questionnaires and join the study and no names or any personal data were available to publish. 

Data Analysis

Data was analyzed using excel and statistical package for social sciences program (SPSS) version 16.00. Then results achieved in tables.

Table 1: Socio- demographic characteristics of the respondent

Table 1 shows 43.3% of respondents are from (18-22) age range and 82.2% are students of under graduation and 65.6% have experience menarche at the age of 14 years old.

Table 2: Knowledge of participants regard mammography 

Table 2 shows 52.2% have ever heard of mammo-graphy and among them 82.6% knows the correct purpose of mammography where as 48.90% believes mammography is done in clinical laboratory and only 40.4% knows mammography is done after 35 years old or above.

Table 3 shows 93.3% have ever heard of BC among them 39.30% respondents source was from television. 66.7% knows there are screening methods for BC, 18.9% have ever felt abnormalities in breast like lymph and only 33.3% have practice BSE. 

Table 3: Awareness, knowledge of BC and practice of breast screening methods

Table 4: Perceptions for breast screening and suggestion for improvement

Table 4 shows 55.60% of respondent believes women should examine her breast after marriage and 49.30% believes due to embarrassment of sharing such issues they do not go for breast screening.

This study shows out of 90 respondents, age range was 18 to 35 years with a mean age 26.5 years, most of them are unmarried (60%). 65.6% had experience of menarche at the age of 14 years. Among study respondent 93.3% had ever heard of BC and 66.7% of any screening methods of BC. Most of them have heard about BC from television and hospital 66.4%. Although early screening of BC was very important according to 66.7% respondents and BSE procedure was known to 45.1%, only 33.3% actually performed BSE. A few respondent 18.9% have ever feel any kind of abnormalities in their breast and the abnormalities were Lymph (58.8%). 90% think BC can be detect early and have proper treatment (CDCP, 2019). According to 60.97% respondent, a woman should start to examine her breasts after marriage. 85.37% respondent thinks that women do not use to go for breast screening because of feeling discomfort to share such issue. Regarding mammography only 52.2% had ever heard of mammography and 42.2% knew correctly the purpose of mammogram and 48.9% know that there is a side effect of mammography (Khokhar, 2015). Moreover, they know that mammography should be done at the age of 35 plus (21.1%) and examined it annually (32.2%). Suggestion from this study responder regarding how women can be encouraged to go for BC screening was Enlightenment by government and NGOS, and Awareness program should be held according to 58.54% and 79.27% respondent respectively. 

The result of this survey shows the need for educating Bangladeshi young females about BC to improve their knowledge level and to increase their practice of early screening strategies as well as their confidentiality should be increase so that they can share any kind of issues or abnormalities related to their breasts. Health education programs, especially the BC awareness program, have the potential to increase BC awareness and down staging of disease. 

This study shows that though there was good awareness of BC among respondent but poor practice of BC screening methods. Even myths about examine breast and uncomfortable in sharing such issues have been seen in this study. Young females as well as women of all age should be educated about awareness of BC and practice of BC screening.  Knowledge about BSE should be given specially to young females for early detection of any abnor-malities in breast and BC further (Okobia et al., 2006). Awareness and knowledge seems to play vital role in early detection of BC. Due to short period of time, this study could not generalize data of all the female students of this university. This study only included 90 female students of this university.

This research behind it would not have been possible without the exceptional support of my supervisor, her enthusiasm; knowledge and exacting attention to detail have been an inspiration and kept my work on track from my first encounter with the questionnaire to the final draft of this paper. It is also my greatest pleasure to acknowledge my deep respect and grati-tude to Head, Dept. of Biomedical Engineering & Medical Physics, BUHS, Dhaka, Bangladesh for their valuable suggestions and encouragement during the course of the study. 

The authors declare that there is no conflict of interest.