P-ISSN: 2808-0467

E-ISSN: 2808-5051

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1721

BREAST CANCER PREVENTION THROUGH SADARI

INTERVENTION IN WOMEN OF REPRODUCTIVE AGE IN LOA

BAKUNG

Evy Nurachma

, Samsiah, Fara Imelda

Department of Midwifery, East Kalimantan Health Polytechnic, Samarinda, East Kalimantan, Indonesia

hjevynurachma@yahoo.co.id

PAPER INFO ABSTRACT

Received:

December 2022

Revised:

December 2022

Approved:

December 2022

Background: Cancer is a non-communicable illness brought on by the

unnatural and unchecked proliferation of bodily tissue cells. A malignant

tumor of the breast or one of the breasts is breast cancer in and of itself.

Aim: The purpose of this activity is to educate through BSE (Breast Self-

Examination, SADARI) socialization as the first step in preventing breast

cancer and increasing the participation of the community, especially women

of reproductive age, in carrying out early detection of breast cancer

prevention.

Method: To delve further into this subject, the researchers adopted a

qualitative technique. The researchers sought to learn more about residents'

awareness about breast cancer and its prevention, particularly SADARI, by

initial observation and interviews. The researchers analyzed and organized

the data they had gathered in order to come up with a reliable conclusion.

Findings: In terms of knowledge, before being given health education by

Posyandu (Integrated Healthcare Center, Pos Pelayanan Terpadu) cadres

most of the knowledge of women of reproductive age about SADARI was in

the sufficient category as many as 18 respondents (45.%) and after being

given health education there was an increase where most of the women of

reproductive age’s knowledge (80%) became good. Meanwhile, for the

attitude before being given health education by Posyandu cadres, some of

women of reproductive age had a negative attitude towards SADARI (12.5%),

and after being given There was an increase in health education by cadres,

namely the majority of respondents 39 respondents (97%) had a positive

attitude towards SADARI.

KEYWORDS

breast cancer, BSE, SADARI, cancer prevention

Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0)

INTRODUCTION

Health transition is now a challenge in Indonesian. The incidence of non-communicable

diseases continues to grow, while the incidence of infectious diseases still remains high. The

health transition is caused by two things, namely the demographic transition and the

epidemiological transition (Marthias et al., 2021). The demographic transition is caused by

changes such as urbanization, industrialization, increasing incomes and education levels, as

well as the development of health and medical technology in society (Stolnitz, 2018).

Meanwhile, the epidemiological transition arises due to changes in mortality patterns,

especially infections, total fertility rates, increasingly high life expectancy of the population,

and an increase in non-communicable diseases or also known as chronic diseases (Adogu et

al., 2015; Corbett et al., 2018; Gómez-Dantés et al., 2016; Özdemir et al., 2014).

Cancer is a non-communicable disease caused by abnormal and uncontrolled growth of

body tissue cells (Geto et al., 2020; Kerry et al., 2021). Breast cancer is a malignant tumor of

Breast Cancer Prevention through SADARI Intervention in Women of Reproductive Age in Loa Bakung

1722 Interdisciplinary Social Studies, 2(3), Dec 2022

the two breasts or one of them (Drukker et al., 2014). It is also a lump or single mass that is

often present in the outer upper quadrant area (Famá et al., 2016; Kojima & Tsunoda, 2011); it

is hard and irregular in shape and immobile (Fisher et al., 2018). Breast cancer occurs due to

damage to genes that regulate cell growth and differentiation so that cells grow and multiply

uncontrollably. Breast cancer is a cancer that generally affects women (Santrock, 2007).

According to Oladimeji et al. (2015), the importance of health promotion in increasing

awareness and willingness to do breast self-examination in an effort to early detect breast

cancer so as to improve preventive strategies in breast cancer patients. Based on Nurachma's

research at SMAN XI Sambutan Samarinda on the Benefits of Providing Health Education

about SADARI shows that there is a significant influence of health education about SADARI

on respondents' knowledge, with p value (0.0001) <α (0.05) and there is a significant influence

of health education about SADARI on respondents' attitudes with p value (0.002) <α (0.05)

(Nurachma & Hendriani, 2020). However, the aforementioned research have not discussed

further on how SADARI applies in rural society.

The purpose of this activity is to conduct health education through SADARI socialization

as the first step in preventing breast cancer and increasing participation from the community,

especially women of Reproductive age in carrying out early detection of breast cancer

prevention.

METHOD

The implementation of solutions to overcome partner problems consists of observation

steps to Loa Bakung Village, identification of partner problems, literature studies,

determination of solutions, coordination with the Loa Bakung Public Health Center regarding

the implementation of solutions, SADARI training, and evaluation of activities. The

implementation of SADARI training includes providing material and video screenings about

breast cancer and SADARI, SADARI simulations, as well as providing SADARI modules and

leaflets. The direct target is the Loa Bakung community, especially women of Reproductive

age who are in the work area of the Loa Bakung Public Health Center.

Picture 1. Locals at Loa Bakung Public Health Center

Evaluation Design

Evaluation During the Process and at the End of Educational Activities

Health by giving questions orally as follows:

1) Re-explain the notion of breast cancer;

2) Describe the cause of breast cancer;

Breast Cancer Prevention through SADARI Intervention in Women of Reproductive Age in Loa Bakung

1723 Interdisciplinary Social Studies, 2(3), Dec 2022

3) Mention the signs and symptoms of breast cancer;

4) Mention risk factors for developing breast cancer;

5) Mentioning ways of prevention and treatment of breast cancer; and

6) Mentions the SADARI stage.

Evaluation Criteria

Structure Evaluation

1) Setting up an SAP;

2) Prepare materials and media;

3) Time contracts with goals;

4) Setting up the premises; and

5) Prepare questions.

Process Evaluation

1) The goal of paying attention and listening during health education;

2) The active goal asks if there is something that is not yet understood;

3) The goal gives an answer to the question of the material giver;

4) The target does not leave the premises while health education is taking place; and

5) The Q&A went well.

Evaluation of Results

1) Health education is said to be successful if the goal is able to answer 80% more

questions correctly;

2) Health education is said to be quite successful/good enough if the goal is able to answer

questions between 50–80% correctly; and

3) Health education is said to be less successful/not good if the target is only able to answer

less than 50% correctly.

Picture 2. Locals at Loa Bakung Public Health Center

RESULTS AND DISCUSSION

The researchers used qualitative approach to dig deeper into this topic. Through an initial

observation and interviews, the researchers tried to unveil locals’ knowledge regarding breast

cancer along with its prevention, especially SADARI. The data collected then analysed and

arranged by the researchers to generate a valid result.

Breast Cancer Prevention through SADARI Intervention in Women of Reproductive Age in Loa Bakung

1724 Interdisciplinary Social Studies, 2(3), Dec 2022

SADARI training activities for women of Reproductive age aim to improve WUS (Women

of Reproductive Age) knowledge about breast cancer and WUS (Women of Reproductive Age)

skills in SADARI as an effort to prevent breast cancer. Through this counseling activity, it is

hoped that it can empower WUS (Women of Reproductive Age) to be able to find out the

condition of her breasts and if any abnormalities are found, they can take appropriate action.

In addition, it is hoped that counseling participants can disseminate information to families by

utilizing leaflets that have been given during counseling. The community service team also

compiles scientific publications, publications in international journals, modules, so that

information about SADARI can be accessed by the wider community.

External Targets

Table 1. External Targets

External Type

Indicators

Increased Knowledge of Women of Reproductive Age

Present

International Journal Publications

Draft

Teaching Book

Draft

Leaflet

Present

The location of partners in this community service program is located in the Loa Bakung

Public Health Center. In the picture below, it is shown that the location of the implementation

of this community service program is approximately 9.8 KM from Campus B of the Politeknik

Kesehatan Samarinda, East Kalimantan.

Picture 3. The Location of Loa Bakung Public Health Center

Be aware of only early detection of breast cancer, not to prevent breast cancer. With early

detection, breast cancer can be detected at an early stage so that early treatment will extend the

life expectancy of breast cancer sufferers (Oemiati et al., 2011). Early detection is a very

important first step to know early the presence of tumors or lumps in the breast so as to reduce

the mortality rate due to the cancer. The advantage of early detection is beneficial for increasing

the likelihood of life expectancy in women with breast cancer. Almost 85% of disorders or

lumps are discovered by the sufferers themselves through proper examination.

Breast Cancer Prevention through SADARI Intervention in Women of Reproductive Age in Loa Bakung

1725 Interdisciplinary Social Studies, 2(3), Dec 2022

Picture 4. Doctor Obgyn Gives SADARI Material

Picture 5. Doctor Obgyn Explains the Signs and Symptoms of Breast Cancer

Examination on the 7

to 10

day includes the first day of menstruation, when the breasts

are loosening and noticeably softer (Birhane et al., 2017; Marni, 2014).

Table 2. Frequency Distribution of Respondents Based on Knowledge of Women of

Reproductive Age about SADARI Before and After Being Given Health Education by Cadres

Variable

Category

Before

Health Education

After

Health Education

Percentage (%)

Attitude

Positive

87,5

97,5

Negative

12,5

2,5

Total

100

Based on table 1, it shows that in the knowledge variable, before being given health

education by Posyandu (Integrated Healthcare Center, Pos Pelayanan Terpadu) cadres, most

of the knowledge of women of reproductive age about SADARI in the category is sufficient as

many as 18 respondents (45%) and after being given health education there is an increase where

most of the knowledge of women of reproductive age becomes good as many as 32 respondents

(80%), and in table 2 shows the attitude variable before being given health education by

Posyandu (Integrated Healthcare Center, Pos Pelayanan Terpadu) cadres a small percentage

of attitudes of women of Reproductive age who are negative towards SADARI, namely 5

respondents (12.5%), and after being given health education by cadres there is an increase,

namely most of the respondents 39 respondents (97%) are positive towards SADARI.

The results of the SADARI assessment were that from 7 women of reproductive age who

were well informed. There was one woman of reproductive age who was detected with a lump

in the breast and was advised to go to the Puskesmas (Public Health Center) to be referred to

the hospital for Marography examination for BRCA 1 and BRCA 2 examination.

Of the 18 women of Reproductive age who are knowledgeable, there are 2 people who

already have breast cancer and are on medication. Of the 15 women of reproductive age who

have less knowledge, one person has entered stage IV because they are late in the

Marmographic examination.

CONCLUSION

Risk factors for breast cancer are women who get their first menstruation at the age of less

than 12 years, women who menopouse over the age of 50 years, have never given birth, never

breastfeed, give birth to their first child at the age of more than 35 years, a history of benign

tumor disease, a history of cancer in other family members, and both active and passive

smokers.

Early detection of breast cancer can be done by SADARI (Breast Self-Examination),

SADANIS (Clinical Breast Examination), and Mammography. A woman who finds an

abnormality during SADARI can check herself at a health facility for SADANIS.

The challenges of breast cancer include low public knowledge and awareness about early

detection, not all Puskesmas (Public Health Centers) have trained health workers, and the

cancer referral system from FKTP to FKRTL has not been running effectively. Therefore, the

authors suggests that the implementation of these three aspects be improved and research on

early detection of breast cancer can reappear with a more detailed and in-depth discussion.

Breast Cancer Prevention through SADARI Intervention in Women of Reproductive Age in Loa Bakung

1727 Interdisciplinary Social Studies, 2(3), Dec 2022

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