Knowledge of and attitudes toward breast self-examination in Iranian women: a multi-center study.

BACKGROUND In Iran, breast cancer is the second most common malignancy among women and diagnosed in advanced stages almost a decade earlier than women living in western countries. OBJECTIVE To determine the level of knowledge and attitudes toward breast self-examination (BSE) among Iranian women. METHODS In a cross-sectional multi-center study, 3,060 women aged between 25 and 54 years attending between July and October 2009 to 11 general health care centers located in 11 cities of Iran, were interviewed to assess their knowledge and attitudes toward BSE. RESULTS Of the total, the data of 3,030 were found eligible for analyses. The median (interquartile range [IQR]) age of participants was 40 (14) years; 2,687 (88.7%) were married; 1496 (49.4%) women performed BSE, 290 of whom (19.4% of performers and 9.6% of all studied women) did it using a correct method and at an appropriate time. More than three-quarters of performers (n=1141) learned about BSE from a health care provider; 248 (16.6%, 95% confidence interval [CI]: 14.7% to 18.5%) had abnormal findings, 11 (0.7% , 95% CI: 0.3% to 1.2%) of which were malignant. Of 1,534 (50.6%) non-performers, 474 (30.9%) did not know how to do BSE; the remaining women did not do BSE for fear of being found positive for cancer or did not care about it. Being a health care provider, married, educated, and knowing of a person with breast cancer was associated with performing BSE. CONCLUSIONS The level of BSE practice and knowledge among Iranian women is unsatisfactory. We should emphasize appropriate education of women.