Abstract:
Background: Breast cancer is the most common cancer among females and a leading cause of
death worldwide. Breast self-examination (BSE) is a cost-effective method for self-assessment
and for potential early detection of breast cancer in low-resource settings.
Objective: To assess the level of knowledge and practice on breast self-examination among
female university students in Western Province, Sri Lanka
Methods: A descriptive cross-sectional study was conducted among conveniently selected female
students aged >18 years from two public and two private universities in Western Province. An
adopted semi-structured, self-administered questionnaire was distributed online for data collection
and was analyzed by SPSS version 26.0. Knowledge and attitude scores were categorized based
on pre-defined cut-off values from Bloom’s cut-off categories, high (80-100%,) moderate (60-
79%) and low (<60%) level, respectively. Practice of the participants was assessed according to
their inclusion of breast self-examination on routine basis.
Results: A total of 420 students participated from two private and two public universities (105
from each university). Among them, 71.0% had poor knowledge and have never performed BSE
before, while 12.1% and 16.9% had moderate and high level of knowledge and have performed
BSE infrequently. Of the sample, 52.5% recognized the need for regular check-ups. A majority of
73.6% of students understood that BSE can detect various breast problems. The recommended age
to start BSE was chosen as 20 years by 21.2% and 30 years by 49.6% of participants. About
43.2% suggested performing BSE as a lifelong practice, out of which, 35.7% believed it should be
done on a monthly basis. Sixty eight percent preferred performing BSE in front of a mirror. Key
aspects such as changes in breast size and shape (65.9%), nipple discharge (38.5%), and palpation
techniques (62.0%) were recognized by students. The majority (72.4%) performed BSE on both
breasts, and 61.8% acknowledged the importance of examining the entire breast area.
Conclusions: The findings suggested that the knowledge on BSE among the participants is not
satisfactory and their BSE practices are not up to the standards: therefore, there is a gap in the
knowledge and practice of BSE amongst female university students.
