cancer, including Sub-Saharan Africa. Over 60% of Nigerian patients present late due to lack of awareness and

utilization of mammography screening. This study assessed prediagnosis awareness and practice of

mammography screening in breast cancer patients at the MEDSERVE-LUTH Cancer Centre.

MEDSERVE-LUTH Cancer Centre. Structured questionnaires for socio-demographic factors, awareness about

mammography, knowledge and practice of BSE, and health-seeking attitudes were employed for data collection.

Data analysis was done using SPSS v27, and descriptive statistics was employed.

was known to only 10.1%, the most common sources being family/friends (3.5%) and social media (4%). Only

despite the major usage of breast self-examination as the first and only method of detection. There is a need for

intervention involving health education, utilization of health professionals, cost control, and increased access to

mammography to enhance earlier diagnosis and survival.

 Breast cancer, Mammography, Awareness, Prediagnosis, Early detection, Nigeria



Breast cancer is the most frequently diagnosed cancer and a primary cause of cancer-related fatalities among

women globally, with its impact growing rapidly in sub-Saharan Africa (SSA), where patients often present with

more advanced stages of the disease and have worse survival rates compared to high-income regions (1,2). More

than a million women are diagnosed with breast cancer each year, leading to approximately 410,000 deaths from

the disease (3–5). Some research indicates that breast cancer is the most significant cause of cancer-related deaths

Mammography is the recognized imaging technique for breast cancer screening and has been linked to earlier

diagnoses and decreased mortality where organized screening programs are in place. Nonetheless, in many low-

and middle-income countries (LMICs), including Nigeria, organized mammography initiatives are few, and the

uptake of opportunistic mammography is low due to various obstacles such as lack of awareness, cost, limited

equipment availability, shortage of trained staff, and sociocultural factors hindering participation (7,8). Research

conducted in Nigeria and other SSA locations consistently identifies a lack of awareness about mammography

as a significant barrier, even if geographic access is available, highlighting a crucial gap between availability

and utilization (9).

Crucially, the awareness and previous use of mammography among women ultimately diagnosed with breast

cancer—who could have benefited from earlier screenings—remains low in several hospital-based studies within

patients attending MEDSERVE-LUTH will aid in identifying missed opportunities for earlier detection and

inform targeted interventions, which may include healthcare provider training, community awareness

campaigns, and policy initiatives to enhance affordable access to screening. Assessments at the population level

suggest that enhancing facility capabilities must be complemented by demand-side initiatives aimed at

improving knowledge and acceptance of screening to facilitate earlier diagnosis and better outcomes.

This study seeks to assess the pre-diagnosis awareness and practice of mammography screening among women

diagnosed with breast cancer at the MEDSERVE-LUTH, explore the sources of information and understanding

about mammography, and identify perceived and structural barriers that hindered prior participation.



therapy, chemotherapy, and pharmacy treatments.

A descriptive cross-sectional study was conducted to assess levels of awareness of mammography screening

among breast cancer patients at the MEDSERVE -LUTH Cancer Centre before diagnosis.

The study population was conducted among female breast cancer patients at the Department of Clinical and

All patients diagnosed with histologically proven breast cancer.

Patients who gave consent and were willing to participate in the study.

n = z

2

pq/d

2

Where;

n = Sample size

z = Standard deviation (1.96 for 95% confidence interval)

p = best estimate of the population prevalence (10% = 0.1)

q = 1-p

d = Tolerable error (0.05)

2

1.96

x 0.1 x 1 – 0.1 = 138.30

A purposive sampling technique was used to select respondents who met the inclusion criteria.

Data were collected with the aid of a structured questionnaire, and information was obtained from the patients.

The study questionnaire was based on the research objectives and contained important information about the

patients, which included socio-economic and demographic characteristics, awareness of mammography

screening. Knowledge and practice of breast self-examination (BSE), diagnosis and treatment seeking behaviors,

family history and risk factors, and lifestyle and hormonal factors.

Prior to data analysis, the data were collected with the aid of the questionnaire and manually entered into

The mean age of the breast cancer patients was 43.63 ± 10.19 years. The largest proportion of patients was within

the 30–39 years age group (33.2%), followed by those aged 50–59 years (31.2%) and 40–49 years (24.6%),

while only 3% were within the 60–69 years group. Regarding religion, most patients were Christians (62.1%),

while 36.9% were Muslims and 0.5% practiced traditional religion. Regarding ethnicity, Yoruba patients

constituted the majority (75.8%), followed by Igbo (15.2%), with Hausa (1%) and other ethnic groups (8.1%)

making up the remainder. Regarding occupation, most patients were self-employed or engaged in business

(42.4%), 39.4% were classified under other forms of occupation, 12.6% were civil servants, and 4.5% were

private employees. Educational attainment showed that 46% had secondary education, 36.9% had tertiary

education, 13.6% had primary education, and 3% had no formal education. Considering the duration of

diagnosis, 68.4% of patients had been diagnosed for less than six months, 24.8% between 7 months and one

delayed for a few years. Most patients (89.4%) believed regular mammography screening could have facilitated

earlier detection, and almost all (97.5%) indicated they would encourage other women to undergo regular

mammography screening for early detection of breast cancer. Regarding treatment history, 12.6% of patients had

undergone previous surgery, 94.4% had received radiotherapy, and 98.5% had received chemotherapy. Targeted

therapy had been administered to 39.4% of patients, immunotherapy to 14.1%, and hormonal therapy to 12.1%.

Table 4: Diagnosis and Treatment Seeking Behaviors of BC Patients

11, 15, or 16 years. The majority of patients (96%) had children, with the age at first childbirth most frequently

between 21–25 years (49.6%), followed by 26–30 years (32.4%) and 16–20 years (12.6%). Most patients

(65.7%) had between 3 and 4 children, while 15.1% each had 1–2 children or 5–6 children. Breastfeeding

practices were also common, as 94.9% of patients reported breastfeeding their children. Among them, the

majority breastfed for 7 months to 1 year (65.1%), followed by 1–2 years (29.3%), while only 0.5% breastfed

for less than 6 months.

Table 5: Family history and Risk factors of BC Patients