Reviewer ’s report  
 
Title: Knowledge of symptoms and risk factors of breast cancer among women: A 
community  based study in a low socio -economic area of Mumbai,  India  
 
Version: 0 Date: 25 Jan 2020  
 
Reviewer: Lindsay Forbes  
 
Reviewer's report:  
 
This is an interesting paper. I have some recommendations for improving it.  
 
I am not sure I agree with the statment that the high death rates in India are due to lack of 
alertness of signs and symptoms of malignancy and I do not think the two references given 
provide sufficient evidences. It may be true, but I suspect there are other factors contributing 
- I suggest acknowledge this.  
 
I am sceptical of the idea that early marriage is in itself a risk factor for breast cancer. Any 
study showing this is likely to be highly confounded by other factors. The paper also suggests 
that spontaneous abortion is  risk factor for breast cancer - I believe the evidence does not 
suggest that this is the case in other countries of the world.  
 
I think the authors need to revise the sample size calculation as I am not sure I understand 
how they have reached their conclusions.  
 
Sampling frame - I think the authors need to provide more data on how they went about 
identifying the sampling frame and the total number of households that were included.  
 
More detail is needed about the data collection tool - this is crucially important for being able 
to interp ret the findings.  
 
The authors will need to set out more clearly how they defined a woman as being aware of 
breast cancer.  
The results section needs to set out more clearly that the analyses of symptom and risk factor 
knowledge are based only on the half  of women who were aware of breast cancer.  
 
In the discussion, the authors need to set out what the limitations of their study are.  
 
The English needs significant revision.  
 
 
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Not suitable for publication unless extensively edited  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, fund ing, or salary from 
an organisation that may in any way gain or lose financially from the publication of 
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3. Do you hold or are you currently applying for any patents relating to the content of 
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4. Have you received reimbursements, fees, funding, or salary from an organization that  
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
 
 
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below.  If your reply is yes to any, please give details below.  
 
I declare I have no competing interests  
 
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