**1. Introduction**

The paper using information obtained through a survey examines the social and institutional support mechanisms in breast cancer management in Nigeria. Its main assumption is that despite what may be considered an alarming incidence of occurrence nowadays, breast cancer in management in Nigeria seems bedeviled by inadequate support. In other words, in spite of a significant incidence of breast cancer in Nigeria, the public health system has not responded commensurately, while social support has been affected by wrong notions of causes and stereotypes with severe implications for health of those affected and coping capacity of families [1]. In other words, the quality and access of women to reproductive health services are important in confronting these health problems. In spite of the above, women can only seek them out when the need arises if they are aware of their existence and where they can be received. In other words, awareness and access are critical in obtaining breast cancer services in Nigeria. Consequently, the extent to which

members of the society hold the informed perception about the nature and care of breast cancer is crucial in accessing health provisions and services targeted at the disease.

Given that reproductive health-care provisioning has to do with the availability of health-care services to individuals in the society with regard to their reproductive well-being, societal perception of the causes, nature and management of breast cancer can be seen as making a major difference in whether aged women afflicted by breast cancer survive or not [2]. Among women, older women, i.e. those beyond childbearing age, may be seen as particularly disadvantaged. This is especially the case of Nigeria where the health needs of elderly women are not totally covered given the lack of a clearly conceptualized social policy on health care of elderly members of the Nigerian population [3]. Therefore, the survival and meaningful existence of women may not only depend on the health-care services available but also on the conviction of elderly their families and the larger society of the need to spend both time and money on the reproductive health needs of these women even as they have passed the stages of conception and childbearing. Breast cancer is without doubt largely a reproduction health problem much like cervical cancer. In this sense, both ailments can be addressed through reproductive health provisioning in the public health sector. Irrespective of the attitude of family members to the reproductive health of elderly women, there is also a crucial need for women as they age to become sensitive of the likelihood of reproductive health challenges they may encounter especially breast cancer and adopt right attitudes to such issues. Actually, a general consensus which appears true is that early detection makes a big difference in both the treatment and management of breast cancer. Conceding to this opinion, [4] asserted that the high mortality associated with the disease has been ascribed to late detection, lack of knowledge and inadequate medical response. In other words, knowledge and awareness by these women and the society at large are crucial. Hence, the poor attitude of society to women's health including breast cancer may be the product of misconception or lack of awareness of the reproductive health-care challenges women face as they age.

Even though it is contended that 85–90% of cancer incidence is attributable to lifestyle choices as diet and smoking and environmental factors, culture is however seen as the single most influential determinant of these life choices [5]. Culture in this sense refers to factors which exist in a given social environment that influence or inform health-seeking behaviors as well as support system. Thus, such things as perception of nature of illnesses, early access to and availability of health services, beliefs about one's susceptibility to a given illness, etc. are critical elements of one's cultural environment in this case. Therefore, the effort to nib the incidence of breast cancer in the bud must start from a good awareness and knowledge of the sociocultural factors that influence both cancer risk behaviors and attitudes to its prevention and control. Scholars of reproductive health diseases have suggested that there is what may be conceived as an emerging breast cancer epidemic in Africa and some scholars see the increase in breast cancer as ironically related to such things as increasing life expectancy in the general population, improved control of infectious diseases and changing life styles including diet and obstetric practices [1]. As Oluwatosin and Oladepo [4] and Adebamowo and Ajayi [6] observed, breast cancer has become the number one or commonest form of cancer among women with an increasing mortality rate; unfortunately, the mortality associated with the disease has been ascribed to late detection, lack of knowledge and inadequate medical response. In view of the above, the focus of a study on breast cancer among elderly women as a core reproductive health challenge in Nigeria can be seen as really imperative.

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*Social and Institutional Support in Breast Cancer Management among Elderly Women in Nigeria*

Actually it has been established that breast cancer mortality can be reduced by 30% for women aged 50–69 years with routine screening and mammography followed by appropriate treatment [7]. In other words, improved awareness of breast cancer and its appropriate perception and consequent behaviour modification are essential for prevention and control of the disease. Interestingly quite a good number of authors have identified socio-economic factors, adequacy or otherwise of the health-care system and cultural factors as the barriers to the utilization of such preventive practices as mammography, clinical breast examination and breast

Perhaps, the challenges of the reproductive health care of the aged in Nigeria are underlined by the fact that nowadays, an increasing number of women are afflicted by diseases of the reproductive system long after ceasing childbearing. This problem is however not peculiar to Nigeria since there appears to be an observable steady increase in such diseases around the world [11]. But while a reproductive health disease like breast cancer may continue to affect elderly women, its early detection

This paper is therefore based on the study and findings from a study carried out in the Southeastern Nigeria which sought to reveal the dominant public perception and opinions regarding breast cancer among elderly women in Nigeria and how these affect social and institutional support in the management of the disease. The importance of the study is further enhanced by the fact that scholars are largely in agreement that breast cancer has been so far under-researched and dependence on small clinical and case studies has limited both social and medical responses to the disease [1].

According to Oluwatosin and Oladepo [4], Adebamowo and Ajayi [6], Okobia et al. [12] and Adotey and Jebbin [13], awareness and knowledge of breast cancer is critical to its early detection and management because its treatment and management are affected by social factors which according to Kagawa-Singer [5] and Levi [14] affect the treatment and management of breast cancer. These factors which the authors classified as lifestyle choices emanate from cultural beliefs, values and practices and may in fact be consistent with the fact that just like values and beliefs, awareness of the impact of breast cancer especially the likelihood of fatality differs

While acknowledging the tremendous progress made in the understanding of cell biology and the genetic changes involved in oncogenesis, a few authors have pointed out the relative lag in sociocultural and behaviour studies of cancer which has undermined the expected impact of these advances on cancer control. As Kagawa-Singer (5:2) asserted, positive change in prevention and control of cancer means that "first, greater resources must be directed towards social and behavioural research, and second, better strategies must be developed to study the effects of cultural differences on health behaviour". This sentiment is related to the earlier contention of DeVita et al. [15] in that currently only about 5–10% of cancer globally is known to be due to inherited genetic abnormalities, while the remaining 90% is attributable to lifestyle factors like smoking, diet and environmental factors which are largely determined or influenced by sociocultural contexts. Interestingly the above authors in spite of their medical backgrounds see studies of the social and behavioral factors impacting on awareness and knowledge of cancer as critical to its control and prevention.

*DOI: http://dx.doi.org/10.5772/intechopen.88748*

self-examination by women [8–10].

**2. Overview of literature**

among cultural and social groups globally.

has often made a crucial difference between life and death.

**2.1 Sociocultural factors in the management of breast cancer**

#### *Social and Institutional Support in Breast Cancer Management among Elderly Women in Nigeria DOI: http://dx.doi.org/10.5772/intechopen.88748*

Actually it has been established that breast cancer mortality can be reduced by 30% for women aged 50–69 years with routine screening and mammography followed by appropriate treatment [7]. In other words, improved awareness of breast cancer and its appropriate perception and consequent behaviour modification are essential for prevention and control of the disease. Interestingly quite a good number of authors have identified socio-economic factors, adequacy or otherwise of the health-care system and cultural factors as the barriers to the utilization of such preventive practices as mammography, clinical breast examination and breast self-examination by women [8–10].

Perhaps, the challenges of the reproductive health care of the aged in Nigeria are underlined by the fact that nowadays, an increasing number of women are afflicted by diseases of the reproductive system long after ceasing childbearing. This problem is however not peculiar to Nigeria since there appears to be an observable steady increase in such diseases around the world [11]. But while a reproductive health disease like breast cancer may continue to affect elderly women, its early detection has often made a crucial difference between life and death.

This paper is therefore based on the study and findings from a study carried out in the Southeastern Nigeria which sought to reveal the dominant public perception and opinions regarding breast cancer among elderly women in Nigeria and how these affect social and institutional support in the management of the disease. The importance of the study is further enhanced by the fact that scholars are largely in agreement that breast cancer has been so far under-researched and dependence on small clinical and case studies has limited both social and medical responses to the disease [1].
