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Background Breast cancer (BC) is the most prevalent cancer among women in both developed and developing countries. Breast self-examination (BSE) is crucial for the early detection of BC. This study aimed to assess the effectiveness of face-to-face and virtual education on BSE, based on the theory of planned behavior (TPB). Methods This randomized controlled trial was conducted on 240 women aged 30–55 in northern Iran from 2020 to 2022. Participants were selected using a random sampling method and were randomly assigned to three groups of 80 each (face to face, virtual, and control). The face to face educational intervention consisted of four consecutive weekly sessions (50 min each), with 20 participants per session. In the virtual training group, all teaching materials were delivered once a week via WhatsApp messenger. The control group did not receive any intervention. All participants completed questionnaires assessing demographic and fertility characteristics, BSE barriers, knowledge, and practice regarding BSE, as well as TPB constructs (attitude, subjective norm, perceived behavioral control, behavioral intention, and behavior) before, one month, and three months after the intervention. Data analysis was performed using SPSS version 23.0. Statistical tests included the chi-square test, t-test, analysis of variance, repeated measures RMANOVA, and Pearson’s correlation coefficient. The significance level was set at P  < 0.05. Results The study results indicated that the mean BSE and TPB constructs increased in both the face to face and virtual education groups one and three months after the intervention ( P  < 0.001). In the face-to-face group, knowledge one month after the education was correlated with practice at both one and three months post-education ( r  = 0.304, P  = 0.006, and r  = 0.232, P  = 0.038, respectively). Similarly, in the virtual group, knowledge and practice one month after the education was correlated with knowledge and practice three months post-education ( r  = 0.814, P  = 0.001, and r = 0.722, P  = 0.001, respectively). Conclusions The results of this study demonstrated that TPB is an effective theory for promoting BSE. Both face to face and virtual education interventions proved to be successful, with no significant difference between them. Trial registration IRCT20230130057274N4 Date of registration: 2024-04-29 Retrospectively registered

Though early intervention saves many lives worldwide, breast cancer remains a leading cause of cancer among women in Ethiopia. This study, therefore, aimed to evaluate community-based interventions promoting breast self-examination using the Health Belief Model. A cluster randomized controlled trial followed by a cross-sectional study lasting six months was used to evaluate the effectiveness of the community-based educational intervention on breast self-examination among reproductive-aged women in Ethiopia. A total of 810 participants were randomly assigned in a 1:1 ratio and assessed at baseline, three months, and six months post-intervention. A general linear model for repeated measures was used to examine the mean differences in study variables across time points. Non-parametric tests (Cochran's Q) were employed to analyze dichotomous variables related to breast self-examination practices. Path analysis was conducted to examine the interactions among the constructs of the Health Belief Model. A total of 810 reproductive-aged women participated in the study, yielding a 100% response rate at baseline. The mean age of participants was 33.2 ± 7.7 years in the intervention group and 33.5 ± 8.1 years in the control group. The proportion of women performing breast self-examinations increased from 33.3% at baseline to 59.9% at the end of the intervention. And the Comprehensive knowledge about breast self-examination rose from 11.7% to 69.1% over the same period. Perceived susceptibility, perceived severity, knowledge, and health motivations had a statistically significant mean difference between the intervention and control groups (p < 0.0001). We registered PACTR database (https://pactr.samrc.ac.za/): \"PACTR201802002902886\". The study found that there is a strong interplay between the likelihood of performing breast self-examination and perceived susceptibility, perceived severity, knowledge, and health motivations. Field specialists should figure out the problem related to perception and awareness through intensive health promotion interventions. Registered in the Pan African Clinical Trial Registry (www.pactr.org) database, and the unique identification number for the registry is PACTR201802002902886.

Background Breast cancer (BC) is the most prevalent cancer among women. Teachers play a crucial role in promoting healthy behaviors, including breast cancer screening (BCS). This study aimed to assess the impact of an Health Belief Model (HBM)-based educational intervention on BCS uptake, knowledge, and beliefs among female Yemeni teachers in Klang Valley, Malaysia. Methods A cluster-randomized controlled trial was conducted with 180 participants from 12 schools, randomly assigned to intervention or control groups. The intervention group participated in a 90-minute educational session, with follow-up assessments at baseline, and at 1, 3, and 6 months’ post-intervention, using validated Arabic questionnaires. Data analysis was performed using SPSS version 22.0, with Generalized Estimating Equations (GEE) applied to assess differences within and between groups over time. Statistical significance was set at P  < 0.05. Results At baseline, there were no significant differences between groups. Post-intervention, the intervention group showed significantly higher rates of breast self-examination (BSE) and clinical breast examination (CBE) compared to the control group, with adjusted odds ratios (AOR) of 17.51 (CI: 8.22–37.29) for BSE and 2.75 (CI: 1.42–5.32) for CBE. Over six months, BSE performance in the intervention group increased, with AORs improving from 11.01 (CI: 5.05–24.04) to 18.55 (CI: 8.83–38.99). Similarly, CBE uptake rose from 1.60 (CI: 1.02–2.52) to 2.27 (CI: 1.44–3.58). Secondary outcomes revealed significant gains in knowledge and beliefs in the intervention group, including increased confidence in performing BSE and reduced perceived barriers. Conclusions The HBM-based educational intervention effectively enhanced BCS uptake, improved knowledge, and decreased barriers to BCS among Yemeni teachers in Malaysia, highlighting the potential of targeted educational programs to promote cancer screening behaviors in underserved populations. Clinical trial registration Retrospectively registered, ANZCTR (ACTRN12618000173291). Registered on February 02, 2018.

Background Breast cancer is the most common cancer and the second principal cause of cancer deaths in women worldwide as well as in Malaysia. Breast self-examination (BSE) has a role in raising breast cancer awareness among women and educational programs play an important role in breast cancer preventive behavior. The aim of this study is to develop, implement and evaluate the effectiveness of Breast Health Awareness program based on health belief model on knowledge of breast cancer and breast-selfexamination and BSE practice among female students in Malaysia. Methods A single-blind randomized controlled trial was carried out among 370 female undergraduate students from January 2011 to April 2012 in two selected public universities in Malaysia. Participants were randomized to either the intervention group or the control group. The educational program was delivered to the intervention group. The outcome measures were assessed at baseline, 6, and 12 months after implementing the health educational program. Chi-square, independent samples t-test and two-way repeated measures ANOVA (GLM) were conducted in the course of the data analyses. Results Mean scores of knowledge on breast cancer ( p <0.003), knowledge on breast self examination ( p <0.001), benefits of BSE ( p <0.00), barrier of BSE (0.01) and confidence of BSE practice ( p <0.00) in the intervention group had significant differences in comparison with those of the control group 6 and 12 months after the intervention. Also, among those who never practiced BSE at baseline, frequency of BSE practice increased 6 and 12 months after the intervention ( p <0.05). Conclusion The Breast Health Awareness program based on health the belief model had a positive effect on knowledge of breast cancer and breast self-examination and practice of BSE among females in Malaysia. Trial registration The ANZCTR clinical trial registry ( ACTRN12616000831482 ), retrospectively registered on Jun 23, 2016 in ANZCTR.org.au.

Background Correctly, performing breast self-examination (BSE) has an important role in the early diagnosis of breast cancer and prevention of women's mortality due to it. The present study aimed to investigate the effect of virtual education programs on breast self-examination, self-efficacy, and skills. Methods This quasi-experimental study was conducted on 146 women who were 18–59 years old (73 in each intervention, and control group) working in Fars Oil Industry. Data collection tools included the researcher-made knowledge questionnaire (10 items), the self-efficacy questionnaire of Champion and Scott (10 item), and Wood’s breast self-examination skill questionnaire (23 items). The participants were selected by systematic random sampling and divided into intervention and control groups through Permuted blocks randomization. A four-week virtual educational interventions were conducted for the intervention group through the WhatsApp messenger by sharing educational videos, booklets, and posters. The control group received no education. The questionnaires were completed by both groups, before and two months after the intervention. Data were analyzed in SPSS version 22 using frequency descriptive statistics, independent t-test, and paired t-test. Results The knowledge mean scores showed no significant differences in participants in the two groups before and after the intervention. The mean score of self-efficacy increased significantly, in both the intervention ( p  < 0.001) and control ( P  = 0.025) groups. After the intervention, the mean scores of BSE skills in the intervention group were significantly ( p  < 0.001) higher than the control group. Conclusion Virtual education using social networks alone is not able to increase and improve all aspects of BSE skills sufficiently.

Background Cancer screening awareness and participation may be lower in low- and middle-income countries that lack established national screening programmes compared with those that do. We evaluated potential determinants of awareness about and participation in breast and cervical cancer screening, and breast self-examination (BSE) in women using survey data from Indonesia. Methods From the fifth Indonesian Family Life Survey (2014–2015), a total of 5397 women aged 40 and older without any history of cancer who responded to questionnaires concerning Pap smears, mammography, and BSE were included. Multilevel modelling was used to assess potential determinants in relation to awareness about Pap smears and mammography, and participation in Pap smears and BSE practice. Multivariable analyses were performed to identify independent predictors of cancer screening. Results Of the 5397 respondents, 1058 (20%) women were aware of Pap smears, of which 297 had never had the procedure. Only 251 (5%) participants were aware of mammography. A total of 605 (12%) of women reported they performed BSE. Higher education and household expenditure were consistently associated with higher odds of awareness about Pap smears and mammography (e.g. odds ratio [OR] of being aware of Pap smear and mammography: 7.82 (95% CI: 6.30–9.70) and 7.70 (6.19–9.58), respectively, for high school graduates compared to women with less educational attainment in the multivariable models), and participation in Pap smears and BSE. We also identified enabling factors linked with greater cancer screening awareness and participation, including health insurance, shorter distance to health services, and social participation. Conclusion There are socioeconomic disparities in cancer screening awareness and participation among Indonesian women. Our findings may help inform targeted health promotion and screening for cancer in the presence of limited resources.

Background Breast cancer is a global health issue and a leading cause of death among women. Early detection through increased awareness and knowledge on breast cancer and breast cancer screening is thus crucial. The aim of the present study was to assess the effect of an educational intervention program on breast cancer knowledge and the practice of breast self-examination among young female students of a university in Bangladesh. Methods A quasi-experimental (pre-post) study design was conducted at Jahangirnagar University in Bangladesh. Educational information on breast cancer and breast self-examination (BSE), demonstration of BSE procedure and leaflets were distributed among 400 female students after obtaining written informed consent. The stepwise procedures of BSE performance were demonstrated with images. Pre-intervention and 15 days post-intervention assessments were conducted to assess the changes in knowledge on breast cancer and practices of BSE. Mc-Nemar’s tests and paired sampled t -tests were performed to investigate the differences between pre- and post-test stages. Results A total of 400 female university students aged 18-26 years were included in the sample. Significant changes were found in knowledge and awareness about breast cancer and BSE practices after the educational intervention. The significant differences were measured in the mean scores of pre-test vs. post-test: breast cancer symptoms (2.99 ± 1.05 vs. 6.35 ± 1.15; p  < 0.001), risk factors (3.35 ± 1.19 vs. 7.56 ± 1.04; p  < 0.001), treatment (1.79 ± 0.90 vs. 4.63 ± 0.84; p  < 0.001), prevention (3.82 ± 1.32 vs. 7.14 ± 1.03; p  < 0.001), screening of breast cancer (1.82 ± 0.55 vs. 3.98 ± 0.71; p  < 0.001) and process of BSE (1.57 ± 1.86 vs. 3.94 ± 0.93; p  < 0.001). Likewise, a significant percentage of change in BSE practices was obtained between pre-test and post-test (21.3% vs. 33.8%; p  < 0.001). Conclusions Study findings confirm that the study population had inadequate awareness and knowledge at baseline which was improved significantly after educational intervention. A nationwide roll-out with community-based interventions is recommended for the female population in both rural and urban areas.

Breast cancer is the primary cause of cancer death among women globally, responsible for about 425,000 deaths in 2010. This study assessed the awareness, knowledge and practices of breast self-examination as a method of prevention and early diagnosis of breast cancer among reproductive aged women in Akatsi South district in Volta region of Ghana. This study was a cross-sectional study involving 385 women between the ages of 15-49 years. Data were collected with a structured questionnaire and variables included socio-demographic characteristics, breast cancer knowledge, breast self-examination knowledge and practice. Descriptive statistics were used to analyze and present the data and chi square test of significance was used to determine association between socio-demographic variable and practice of breast self-examination. The mean age of the women was 24.54±7.19. Only 3.1% of women had no formal education and 58.9% were single. Although 88.3% of the respondents were aware of breast cancer, 64.9% of the respondents had good or sufficient knowledge of breast cancer and only 94(37.6%) practice BSE. Over 50% of the respondents did not know how to perform BSE. There was a significant association between knowledge on breast cancer and practice of BSE (χ2 = 36.218 p = 0.000). The higher the age of a participant, the lower practice of breast self-examination and this was significant (χ2 = 11.324, p = 0.003). Breast self-examination is a key strategy to early detection of breast cancer and subsequently critical for effective treatment and cure of the disease. The findings in this study have shown significant low levels of awareness and practice of breast self-examination among women in Akatsi South district of the Volta region. This pattern may be similar to other rural communities across the region. The need to create awareness and to educate women, especially rural women, on importance of breast self-examination as preventive measure for breast cancer is paramount.

Background Incidence of breast cancer in the Kingdom of Saudi Arabia (KSA) has increased in recent years. Screening helps in early detection of cancer and early diagnosis and timely treatment of breast cancer lead to a better prognosis. Women in the healthcare profession can have a positive impact on the attitudes, beliefs, and practices of general public. Therefore, it is important that the healthcare workers themselves have adequate knowledge and positive attitudes. We conducted a study to assess the knowledge, attitudes, and practices related to breast cancer screening among female healthcare professionals. Methods A cross-sectional study was conducted on female health professional of KFMC (King Fahad Medical City). Data was collected using a pre-designed, tested, self-administered questionnaire. The questionnaire included specific sections to test the participants’ knowledge, attitude, and practices related to cervical cancer and its screening. Data analysis was done using descriptive statistics. Results A total of 395 health care workers participated in this study. The mean age of the participants was 34.7 years. Participants included physicians ( n  = 63, 16.0%), nurses ( n  = 261, 66.1%), and allied health workers ( n  = 71, 18.0%). Only 6 (1.5%) participants had a good level of knowledge of breast cancer and 104 (26.8%) participants demonstrated a fair level of knowledge. Overall, 370 (93.7%), 339 (85.8%), and 368 (93.2%) participants had heard of breast self-examination, clinical breast examination, and mammography, respectively. A total of 295 (74.7%) participants reported practicing breast self-examination, 95 (24.1%) had undergone clinical breast examination, and 74 (18.7%) had ever undergone mammography. Conclusion The knowledge, attitudes, and practices related to breast cancer screening were found to be lower than expected. Active steps are required to develop educational programs for the health care staff, which might empower them to spread the knowledge and positively influence the attitudes of female patients in the hospital.

Breast cancer is the leading cause of cancer-related mortality among women worldwide, and it has poor prognosis if diagnosed at late stages. Common breast cancer detection methods include mammography, clinical breast exams (CBE), and breast self-examination (BSE). Breast self-examination is the most cost-effective strategy for early detection in low- and middle-income countries. To evaluate the knowledge and practice of breast self-examination, along with associated factors, among women with breast cancer visiting Ali Abad Teaching Hospital in Kabul, Afghanistan in 2025. This cross-sectional study was conducted among 290 Afghan women aged 20-80 who were either currently or previously admitted to the Oncology department of Ali Abad Teaching Hospital for regular follow-ups or treatment. Data was collected using an interviewer-administered questionnaire between January and February 2025. Chi-square tests were conducted to examine the associations between BSE knowledge, BSE practice, and potential explanatory factors. Those that showed significant associations in the bivariate analyses were considered potential confounders and included in multivariable logistics regression analysis. The mean age of participants was 42.9 ± 14.7. Majority of the participants were illiterate (83.8%) and unemployed (95.9%). Women with education of secondary level or higher were more likely to practice BSE than those who were illiterate (AOR: 3.65, 95% CI: 1.06-12.76). Participants with good knowledge level were more likely to practice BSE than those who had a poor knowledge of BSE (AOR: 5.28, 95% CI: 2.45-12.48). In addition, women who had heard of BSE were more likely to practice it compared to those who had not (AOR: 4.31, 95% CI: 1.37-19.25). In this study, education, knowledge score, and awareness of BSE (i.e., having heard of BSE) were selected as important predictors for practice of BSE via both bivariate and multivariate logistic regression analysis. While about 50% of participants demonstrated good knowledge of BSE, only 18% were practicing it, and among those who did, only about 30% were performing it at the right time and frequency. These findings highlight the importance of educational programs with an aim to increase breast cancer awareness among women in Afghanistan, and to promote breast self-examination as a low-cost, accessible tool for early detection - helping to alleviate cancer burden in the country.