Breast Cancer Risk Prevention Model (RICANDRA) to Determine the Risk Factors Associated with the Incidence of Breast Cancer in Women of Childbearing Age in Lampung Province

Breast cancer in Indonesia is at the top of the list that occurs in women. Most breast
cancer conditions are known to be in an advanced stage. Detection at this advanced
stage has a very poor prognosis, because at this stage cancer cells have spread more
widely and faster than when cells were detected in an early stage. Objectives of this
study to determine the risk factors associated with the incidence of breast cancer
in women of childbearing age in Lampung Province and to develop a breast cancer
risk prevention model (RICANDRA). This type of research is quantitative with a
cross sectional design. This research was conducted from March to December 2019
in Lampung Province. The target of this study were all women of childbearing age,
a sample of 458 women of childbearing age with purposive sampling. The objects
taken are advanced age, first child born at the age of > 30 years, close family
ties/hereditary, history of breast tumor, previous diagnosis, early menstruation, late
menopause, use of hormones for menopausal symptoms, exposure to radiation,
history of cancer, use of contraceptives hormones, obesity and stress. Collecting
data using checklist sheets and questionnaires. Data analysis was univariate,
bivariate (chi square) and multivariate. A total of 150 (32.8%) respondents were in
the high-risk category and as many as 308 (67.2%) respondents were in the alert
category. The results showed that the risk factors that influence breast cancer based
on bivariate analysis were advanced age (OR = 5.869; 95% CI: 3.831-8.991; p =
0.000), the first child was born at the age of > 30 years (OR = 2.756; 95% CI : 1.841-
4.125; p = 0.000), close family ties/hereditary (OR = 3.932; 95% CI : 2.607-5.932; p
= 0.000), history of breast tumors (OR = 1.629; 95% CI : 1.100-2.413; p = 0.019), Prior
diagnosis (OR = 1.672; 95% CI: 1.086-2.576; p = 0.025), Early menstruation (OR =
4.174; 95% CI: 2.761-6.309; p = 0.000), Menopause (OR = 4.696; 95% CI : 3.091-
7.133; p = 0.000), Hormone use in menopausal symptoms (OR = 2.478; 95% CI:
1.661-3.698; p = 0.000), Exposure to radiation (OR = 7.213; 95% CI: 4.661-11.162 ;
p = 0.000), had a history of cancer (OR = 2.226; 95% CI: 1.495-3.315; p = 0.000), used
hormonal contraception (OR = 2.264; 95% CI: 1.384-3.705; p = 0.001), obesity ( OR
= 1.825; 95% CI: 1.223-2.725; p = 0.000), stress (OR = 3.126; 95% CI: 2,086-4,685; p
= 0.00), smoking (OR = 1.611; 95% CI: 1.040-2.495; p = 0.042), breastfeeding (OR =
2.385; 95% CI: 1.601-3.552; p = 0.000), and alcohol consumption (OR = 1.711; 95%
CI: 1.053-2.778; p = 0.040). The magnitude of the risk of breast cancer based on the
probability of the logistic function is obtained by the magnitude of the risk of 98.5%
wus experiencing breast cancer and if the risk can be avoided then only 1.5% will
experience breast cancer. The Ministry of Health can facilitate regulation on efforts
to accelerate efforts to reduce the incidence of breast cancer through making
referral designs by strengthening human resources, infrastructure, procedures, or
operational methods that can be easily applied to all health workers at the primary
level. For women of childbearing age, they must increase their knowledge by
participating in activities that can increase knowledge such as mother class
activities, reading or viewing pictures in books, so that WUS knows the risks that
may occur in women of childbearing age.