World Journal of Surgery

, Volume 43, Issue 1, pp 183–191 | Cite as

Understanding and Practices of Gynaecologists Related to Breast Cancer Screening, Detection, Treatment and Common Breast Diseases: A Study from India

  • Gitika N. SinghEmail author
  • Aastha Agarwal
  • Vinod Jain
  • Priti Kumar
Original Scientific Report



The knowledge of breast cancer risk factors and screening practices in a community is largely influenced by the practising gynaecologist in that area. We assessed the understanding and knowledge of gynaecologists about breast cancer: screening, risk factors, clinical signs, management and common benign breast diseases.


This cross-sectional study was carried out in Uttar Pradesh, India, from April to September 2017. One hundred and fifty-two gynaecologists were assessed using a self-designed and validated questionnaire to assess the knowledge of risk factors, clinical signs, screening practices and management of breast cancer as well as common benign breast diseases. Further, the results were compared based on their education: undergraduates (UGs; no residency experience in obstetrics and gynaecology) versus postgraduates (PGs; residency experience in obstetrics and gynaecology).


67 and 82.2% of gynaecologists possess excellent to very good knowledge of risk factors and clinical signs of breast cancer, respectively. The knowledge of PGs seems to be better than UGs (p < 0.01). 84.9% participants were aware that breast cancer screening decreases breast cancer-related mortality, and 61.2% considered CBE as most relevant screening investigation (66.1% PGs and 41.9% UGs; p = 0.04). 30.2% regularly offer breast cancer screening at their centre. 58.5% did not consider screening mammography as cost-effective for their patients (57.9% PGs and 61.3% UGs; p = 0.72), and 41.4% considered it to be a time-consuming process (39.7% PGs and 48.4% UGs; p = 0.38). 99.3% like to follow up a patient with familial breast cancer by themselves, and 0.7% like to refer them to specialist. 51.9% gynaecologists were convinced of breast conservation surgery (BCS) as a surgical option, however 51.3% feared leaving diseased breast behind.


Despite the knowledge regarding risk factors, clinical signs and treatment of breast cancer and benign breast diseases was found adequate amongst the gynaecologists, this did not apply to their clinical practice. Structured and continuous training of gynaecologists is needed to improve the outcome of patients with breast diseases in terms of better management and reference.



We thank Dr. Uma Singh (MD), Department of Obstetrics and Gynaecology, KGMU for her contribution towards the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interests.

Supplementary material

268_2018_4740_MOESM1_ESM.pdf (25 kb)
Supplementary material 1 (PDF 25 kb)
268_2018_4740_MOESM2_ESM.docx (23 kb)
Supplementary material 2 (DOCX 23 kb)


  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386CrossRefGoogle Scholar
  2. 2.
    Thakur NA, Humne AY, Godale LB (2015) Delay in presentation to the hospital and factors affecting it in breast cancer patients attending tertiary care center in Central India. Indian J Cancer 52(1):102–105CrossRefGoogle Scholar
  3. 3.
  4. 4.
    Somdatta P, Baridalyne N (2008) Awareness of breast cancer in women of an urban resettlement colony. Indian J Cancer 45(4):149–153CrossRefGoogle Scholar
  5. 5.
    Gupta A, Shridhar K, Dhillon PK (2015) A review of breast cancer awareness among women in India: cancer literate or awareness deficit? Eur J Cancer 51(14):2058–2066CrossRefGoogle Scholar
  6. 6.
    Bekker H, Morrison L, Marteau TM (1999) Breast screening: GPs’ beliefs, attitudes and practices. Fam Pract 16(1):60–65CrossRefGoogle Scholar
  7. 7.
    Coleman EA, Lord J, Heard J, Coon S, Cantrell M, Mohrmann C, O’Sullivan P (2003) The Delta project: increasing breast cancer screening among rural minority and older women by targeting rural healthcare providers. Oncol Nurs Forum 30(4):669–677CrossRefGoogle Scholar
  8. 8.
    Lurie N, Margolis KL, McGovern PG, Mink PJ, Slater JS (1997) Why do patients of female physicians have higher rates of breast and cervical cancer screening? J Gen Intern Med 12(1):34–43CrossRefGoogle Scholar
  9. 9.
    Subbarao RR, Raja RS (2004) Gynecologist and breast cancer. J Obstet Gynecol Ind 54(5):439–448Google Scholar
  10. 10.
    Ibrahim NA, Odusanya OO (2009) Knowledge of risk factors, beliefs and practices of female healthcare professionals towards breast cancer in a tertiary institution in Lagos, Nigeria. BMC Cancer 4(9):76CrossRefGoogle Scholar
  11. 11.
    Ganesan L, Veena RS (2018) A study on inter-state disparities in public health expenditure and its effectiveness on health status in India. Int J Res Granthaalayah 6(2):54–64Google Scholar
  12. 12.
    Deo MG (2013) Doctor population ratio for India—the reality. Indian J Med Res 137(4):632–635Google Scholar
  13. 13.
    Kumar S, Imam AM, Manzoor NF, Masood N (2009) Knowledge, attitude and preventive practices for breast cancer among health care professionals at Aga Khan Hospital Karachi. J Pak Med Assoc 59(7):474–478Google Scholar
  14. 14.
    Abda N, Najdi A, El Fakir S, Tachfouti N, Berraho M, Chami Khazraji Y, Abousselham L, Belakhel L, Bekkali R, Nejjari C (2017) Knowledge, attitudes, and preventive practice towards breast cancer among general practitioner health professionals in Morocco. Asian Pac J Cancer Prev 18(4):963–968Google Scholar
  15. 15.
    Fotedar V, Seam RK, Gupta MK, Gupta M, Vats S, Verma S (2013) Knowledge of risk factors and early detection methods and practices towards breast cancer among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. Asian Pac J Cancer Prev 14(1):117–120CrossRefGoogle Scholar
  16. 16.
    Okonkwo QL, Draisma G, der Kinderen A, Brown ML, de Koning HJ (2008) Breast cancer screening policies in developing countries: a cost-effectiveness analysis for India. J Natl Cancer Inst 100(18):1290–1300CrossRefGoogle Scholar
  17. 17.
    Semiglazov VF, Moiseyenko VM, Bavli JL, MigmanovaNSh Seleznyov NK, Popova RT, Ivanova OA, Orlov AA, Chagunava OA, Barash NJ et al (1992) The role of breast self-examination in early breast cancer detection (results of the 5-years USSR/WHO randomized study in Leningrad). Eur J Epidemiol 8(4):498–502CrossRefGoogle Scholar
  18. 18.
    Thomas DB, Gao DL, Ray RM, Wang WW, Allison CJ, Chen FL, Porter P, Hu YW, Zhao GL, Pan LD, Li W, Wu C, Coriaty Z, Evans I, Lin MG, Stalsberg H, Self SG (2002) Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst 94(19):1445–1457CrossRefGoogle Scholar
  19. 19.
    Corbelli J, Borrero S, Bonnema R, McNamara M, Kraemer K, Rubio D, Karpov I, McNeil M (2014) Physician adherence to U.S. Preventive Services Task Force mammography guidelines. Womens Health Issues 24(3):e313-9CrossRefGoogle Scholar
  20. 20.
    Yasmeen S, Romano PS, Tancredi DJ, Saito NH, Rainwater J, Kravitz RL (2012) Screening mammography beliefs and recommendations: a web-based survey of primary care physicians. BMC Health Serv Res 6(12):32CrossRefGoogle Scholar
  21. 21.
    American Cancer Society. Breast Cancer Facts & Figures 2015–2016. Atlanta: American Cancer Society, Inc. 2015. [cited 30 Jan 2018]
  22. 22.
    Barfar E, Rashidian A, Hosseini H, Nosratnejad S, Barooti E, Zendehdel K (2014) Cost-effectiveness of mammography screening for breast cancer in a low socioeconomic group of Iranian women. Arch Iran Med 17(4):241–245Google Scholar
  23. 23.
    Akinyemiju TF (2012) Socio-economic and health access determinants of breast and cervical cancer screening in low-income countries: analysis of the World Health Survey. PLoS ONE 7(11):e48834CrossRefGoogle Scholar
  24. 24.
    Agarwal S, Pappas L, Neumayer L, Kokeny K, Agarwal J (2014) Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer. JAMA Surg 149(3):267–274CrossRefGoogle Scholar
  25. 25.
    Litière S, Werutsky G, Fentiman IS, Rutgers E, Christiaens MR, Van Limbergen E, Baaijens MH, Bogaerts J, Bartelink H (2012) Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol 13(4):412–419CrossRefGoogle Scholar
  26. 26.
    Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, Liedke PE, Pramesh CS, Badovinac-Crnjevic T, Sheikine Y, Chen Z, Qiao YL, Shao Z, Wu YL, Fan D, Chow LW, Wang J, Zhang Q, Yu S, Shen G, He J, Purushotham A, Sullivan R, Badwe R, Banavali SD, Nair R, Kumar L, Parikh P, Subramanian S, Chaturvedi P, Iyer S, Shastri SS, Digumarti R, Soto-Perez-de-Celis E, Adilbay D, Semiglazov V, Orlov S, Kaidarova D, Tsimafeyeu I, Tatishchev S, Danishevskiy KD, Hurlbert M, Vail C, St Louis J, Chan A (2014) Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 15(5):489–538CrossRefGoogle Scholar
  27. 27.
    Rao M, Rao KD, Kumar AK, Chatterjee M, Sundararaman T (2011) Human resources for health in India. Lancet 377:587–598CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Gitika N. Singh
    • 1
    Email author
  • Aastha Agarwal
    • 1
  • Vinod Jain
    • 1
  • Priti Kumar
    • 2
  1. 1.Department of SurgeryKing George’s Medical UniversityLucknowIndia
  2. 2.Department of Obstetrics and GynecologySunflower Medical CentreLucknowIndia

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