Abstract
IntroductionIn Botswana, breast cancer, the second most common malignancy amongst women, is often diagnosed late, with 90% of patients presenting at advanced stages at Princess Marina Hospital (PMH) Gaborone, the only referral hospital with an operational oncology department. The reasons for this late presentation have not been studied. Determination of these reasons is critical for the formulation of strategies to reduce morbidity and mortality from breast cancer in Botswana. The aim of this study was to explore existing knowledge about breast cancer and the reasons for late presentation amongst patients attending the oncology unit of Princess Marina Hospital.MethodA descriptive qualitative study using free attitude interview was performed. Twelve breast cancer sufferers were purposefully selected and eleven interviews conducted. Interviews were audio-taped, transcribed verbatim and translated. Thematic analysis of data was performed.ResultsThis study found that breast cancer sufferers had had poor knowledge of the disease prior to the diagnosis. Their knowledge improved markedly during their attendance to the oncology clinic. Screening methods such as breast self-examination (BSE) were not used frequently. The majority of participants had delayed going to the hospital because of a lack of knowledge, fear of the diagnosis and fear of death, misinterpretation of the signs, the influence of lay beliefs and advice from the community. In some cases, however, advice from family and friends resulted in a timely medical consultation. The poor clinical practices of some health workers and the inadequate involvement by decision makers regarding the issue of cancer awareness discouraged patients from seeking and adhering to appropriate therapy.ConclusionsAwareness and knowledge of breast cancer was found to be poor amongst sufferers prior to their diagnosis, but their awareness and knowledge improved after the diagnosis. There was limited use of screening methods and a generally delayed seeking of medical attention. The need for increased awareness and use of screening practices was identified to be essential for early diagnosis of the disease and for improved outcomes of breast cancer management in Botswana.
Highlights
In Botswana, breast cancer, the second most common malignancy amongst women, is often diagnosed late, with 90% of patients presenting at advanced stages at Princess Marina Hospital (PMH) Gaborone, the only referral hospital with an operational oncology department
The majority were classified as stage three of the disease
Emerging themes Themes emerging from the interviews included an understanding of risk factors for developing breast cancer, hospital attendance, diagnosis of breast cancer, patients’ knowledge, information and misconception about breast cancer, delay in seeking help, poor screening activities, health practitioners’ laxity, the influence of traditional healers, emphasis on Human immunodeficiency virus (HIV) and limited access to care in rural areas
Summary
In Botswana, breast cancer, the second most common malignancy amongst women, is often diagnosed late, with 90% of patients presenting at advanced stages at Princess Marina Hospital (PMH) Gaborone, the only referral hospital with an operational oncology department. The reasons for this late presentation have not been studied. Au Botswana, le cancer du sein, la deuxième cause d’infections malignes chez les femmes, est souvent diagnostiqué tardivement, 90% des patientes se présentant à un stade avancé de la maladie à l’hôpital Princess Marina (PMH) de Gaborone, l’unique hôpital de référence doté d’un service d’oncologie. Breast cancer deaths in Botswana reached 0.30% of total deaths; death rate was 9.09 per 100 000 of population.[4]
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