Community perspectives on breast cancer: a thematic analysis of community members’ perceptions, beliefs, and attitudes towards breast cancer

Breast cancer is the most frequently diagnosed cancer and a leading cause of cancer-related deaths among women in sub-Saharan Africa. In Ghana, many cases are found at advanced stages, and there is a high rate of treatment abandonment. Cultural, religious, and social beliefs significantly influence how communities perceive and react to breast cancer, affecting their health-seeking behaviours. This study examined community views, beliefs, and attitudes towards breast cancer in five regions of Ghana to identify cultural and social barriers that hinder effective breast cancer care. A qualitative approach using focus group discussions was used to gather community insights. Nine focus groups were held at five regional hospitals in Accra, Cape Coast, Kumasi, Ho, and Tamale. Eighty-eight participants aged 18 and older were purposively chosen. Discussions took place in English or local languages, were recorded, transcribed, and translated into English. Thematic analysis was performed to find common patterns and themes. The analysis showed widespread misconceptions about breast cancer causes, such as the belief that brassieres store toxins, along with myths related to sexual practices, poor hygiene, tattoos, and breastfeeding. Spiritual explanations like witchcraft and ancestral punishment were also prevalent. While some participants acknowledged real causes like aging and genetics, their medical knowledge was often limited. Pain and noticeable changes in the breast were commonly cited as symptoms. Participants expressed strong emotional and psychological responses to breast cancer, including fear, hopelessness, embarrassment, and suicidal thoughts. They focused mainly on the surgery as a physical consequence of breast cancer, but also highlighted other concerns like persistent pain and job loss. The disease was seen as a threat to family relationships and social status, leading to stigma and isolation. Community beliefs about breast cancer combine biomedical knowledge with physical, spiritual and cultural misconceptions and evoke fear, hopelessness, and for some, suicidal ideation. Public health initiatives should include culturally aware education that addresses misunderstandings while honouring traditional values. Engaging community leaders and incorporating psychosocial support into awareness and care initiatives could help lessen stigma, encourage early detection, and enhance treatment compliance and results for women impacted by breast cancer.