Attitude

This category explored the views of the practitioner regarding women’s inclination and feelings towards mammography screening and breast cancer. In figure 5.1., other categories such as fear, education and government responsibilities directly influence

women’s attitude towards mammography screening. The components of this category

are women’s attitude towards cancer, attitude towards the gender of the practitioner

and the culture of non-disclosure of problems.

5.2.1. Attitude towards cancer

The participants gave an account that women in Lagos are aware of cancer as a

medical ailment, but their knowledge about the disease is vague. Therefore, when they see or hear about women suffering from cancer, they get ‘petrified’. This might be a result of the lack of awareness of the disease, as they are not educated on what to check for in their breasts; therefore, these women do not check their breast for any signs and symptoms of breast cancer. It is important for these women to know how their breasts look and feel naturally so as to identify any abnormality that might

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hospitals in Nigeria; therefore, the cancer might have progressed by this time and at this point, it might get late for a good prognosis.

Furthermore, a practitioner mentioned that the women’s knowledge about breast

cancer symptoms was sourced from the information they might have heard from family and friends - they assume that all breast lumps are cancerous and will lead to death (this is analysed in greater detail in section 5.3.4). Therefore, the lack of clear understanding that some breast lumps could be benign in nature or, if detected at early stages before its progression into a malignant tumour, could still be treated, exists amongst these women.

‘Of course they do know what cancer is, even if they don’t really know what cancer is. They know that it is something bad and so they are scared, when they say if you go to the market and you say someone has cancer, they all know that it is something bad, whether educated or not.’ (Margaret, line 58).

5.2.2. Culture of non-disclosure of problems

Participants reported that women within the state do not attend mammography screening because they believe that it will definitely reveal an abnormality in their breast and the psychological effect of this discovery might lead to their death.

Furthermore, another reason is that these women are intrinsically shy, that is they do not want to let other people know about their problems. Even when they experience some symptoms of breast cancer, they prefer to keep it to themselves. This shyness could be attributed to the fear of stigmatisation or social exclusion that might be associated with the notion of suffering from breast cancer (an in-depth analysis of this fear is reported in section 5.3.1.). Therefore, an awareness programme might not be enough to help improve participation in the mammography-screening programme.

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One participant cited an example of a practitioner whom she believed would have a clear understanding about the benefit of a mammogram, but chose not to undergo the procedure because she was shy of letting people know about her problems when she noticed a lump in her breast. In addition, a practitioner mentioned that the cost of a

mammogram might not affect women’s attendance in the mammography screening

programme, given the fact that some women would choose not to have the procedure even when it is free of charge.

‘We used to have one staff who resigned, Person X had a growth on her breast, okay

you have a growth on your breast; why don’t you want to come in to see doctor? She

would say she is shy. Since I work here, how can I come and expose myself; she is taking native medicine. Some people might be shy because they don’t want people to know.’

(Angela, line 62).

5.2.3. Attitude towards the gender of the practitioner

Furthermore, the practitioners mentioned that the gender of the individual conducting the mammography examination might also be important, as a male practitioner might discourage women from having the mammogram done. This may happen regardless of when they have made the efforts to attend the programme because of the sensitive nature of this procedure. During the study, they pointed out that they try sincerely to reassure the women that they are not going to be attended to by a male practitioner. They noted that their cultural and religious background influences these women’s

concerns. Furthermore, relevant information that could be of diagnostic importance which they had not divulged to their doctor might be revealed by these women during

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the procedure, as they might feel more comfortable to discuss these issues with a female practitioner.

‘At least in Lagos, first of all, they ask who actually is going to do it for them and we

tell them that it is a woman who is going to attend to them, and that gives them a little

bit of more confidence to come.’ (Barbara, line 77).