A total of 836 mothers completed the questionnaire making response rate 99.4 %, with the mean age of 31.09 ±7.34 SD years. Forty five percent of the study participants were illiterate. The majority, 89.0% of the study participants were married. Ninety percent of women were house wives. Regarding husband’s level of education, above half (52.5%) of them finished primary school. The majority 55.4% of respondents had monthly income of below poverty line (<1311 EB) that was $1.90. The majority 56.8% of the study participants had television or radio. Regarding their residence area, the majority 74.9% was rural. Health centers or hospitals were very closer to 79.8% of the study participants which is about five kilometers or less and take maximum journey of 2 hours on foot (Table 1).
Breast self-examination knowledge and practice
The majority, 68.8% of the respondents had sufficient knowledge about breast cancer. Regarding sources of information: television and radio were the main sources, 56.6%. Only 22.2% of participants knew the appropriate timing to perform BSE. The knowledge how BSE is performed was known to 58.7% of the study participants. The majority, 77.8% of the mothers responded that performing BSE is important. Above ninety percent of respondents have ever visited health facilities for any sickness. However, only 37.0% of the mothers were examined their breasts by health workers during the visit.
This finding was supported by qualitative study as a 19 years merchant mother reported, “…in our place there is no any awareness creating activities or education by doctors on breast problem: presence of the disease, its consequences, its sign and symptoms, and its risk factors, and an options of the treatment. We have heard some information from television and radio. Some of us are hearing even the presence of its management today from this discussion.”
A 42 years civil servant also stated that, “…I heard my neighbour complaining of a breast disease; I heard also the disease is cancer. Many women have been suffered with breast disease, yet I have not seen breast disease on me…. When I was a child I had heard a woman of my neighbour died due to breast disease. Her breast was wounded, and she was referred and taken far out of this area to get better treatment in referral hospitals. Even though she had visited many hospitals, she died as the consequence of the disease.”
During FDG a 25 years house wife also reported that, “…this breast disease is certainly present in its massive form; I have not experienced this disease on myself; it has hurt many women; and some people say it became ‘’hola‟ on a woman; some say cancer, and some other say another thing. Even at the moment, there is a women with breast problem, she has birth recently, her breast has not have milk, she has severe breast ache.”
In this study only 13.2% of the mothers performed BSE. The main reasons given by the mothers were lack of knowledge, 37.1% and feared of detecting abnormalities, 21.7% (Figure 1). Those mothers who performed BSE had detected abnormalities in their breasts such as changes in contour 32.7%, and lump in breast 26.4%. The majority, 62.7% of the respondents who detected abnormalities in their breasts did consult health workers (Table 2).
During focus group discussion of mothers about BSE, six mothers stated that breast self-examination is unknown among us. For example, 23 years civil servant women reported that, “…we won’t need to touch and examine our breast if we don’t suspicion the problem. If it develops a problem, symptoms enforce us to touch and examine the breast. It is must to see some internally felt discomfort or externally observed sign and symptoms of disease. We don’t know breast cancer. Therefore, we don’t give focus to our breast. If we have previous problem, we check the improvement of that problem time to time. Unless and otherwise, we don’t examine our breast...”
A 47 year house wife also stated, “… for example, at the moment I have pain of the breast, if all things, even children touch me, I feel pain on both breasts specially at the tip of it, before this time I haven’t ever see such things. For this reason, I have started to touch and see my breast. If somebody has such problem that woman should touch and examine own breast, otherwise it doesn’t need to touch...”
A 35 years health extension worker stated that, “…women know their breast or their body especially during a change. Breast pain is not simple, its pain is severe than other disease; therefore, it is easy to know breast problem on ourselves. However, women have seen this problem traditionally and some of them mostly seek traditional treatment because, they will not permit to expose their breast to health professionals if the disease is not sever. This thing makes the disease too fatal among our community...”
Factors associated with breast self-examination practice
Older women in the age range of 25-34, and 35-49 were more likely to practice BSE compared to those women in the age range of 15-24, AOR=3.61(95%CI: 1.13, 11.58), and AOR=9.35(95%CI: 2.31, 37.85) respectively. Participants who have finished primary education, AOR=3.88(95%CI: 1.26, 11.98), and secondary and above, AOR=11.14(95%CI: 2.48, 49.96) times more likely to practice BSE than illiterate mothers. In addition, participants who have ever breast examination history by health workers were more likely to practice BSE compared to those mothers who have not ever had breast examination by health workers, AOR=3.62 (95%CI: 1.15, 11.45) (Table 3).