Abstract :

Background: Breast cancer remains the most common cancer and a leading cause of cancer-related mortality among women worldwide, including women of reproductive age. Early detection through Breast Self-Examination (BSE), locally known as SADARI, is a simple and cost-effective method, particularly relevant in low-resource settings. Knowledge about breast cancer is considered a key cognitive factor influencing women’s engagement in early detection behaviors.

Objective: This study aimed to determine the relationship between the level of knowledge about breast cancer and Breast Self-Examination behavior among women of reproductive age in Kupang City, Indonesia.

Methods: This study employed an observational analytic design with a cross-sectional approach. The research was conducted in six districts of Kupang City from August to October 2025. The study population consisted of women aged 15–49 years. A total of 100 respondents were selected using proportional random sampling. Data were collected using a validated structured questionnaire measuring breast cancer knowledge and BSE behavior. Data analysis included univariate analysis and bivariate analysis using the Chi-square test, with a significance level set at α = 0.05.

Results: Most respondents demonstrated a moderate level of breast cancer knowledge (68.0%), followed by good (27.0%) and poor knowledge (5.0%). The majority of participants reported supportive BSE behavior (70.0%). Statistical analysis revealed a significant association between breast cancer knowledge and BSE behavior (Chi-square test, p = 0.031).

Conclusion: There is a statistically significant relationship between breast cancer knowledge and Breast Self-Examination behavior among women of reproductive age in Kupang City. Higher levels of knowledge are associated with a greater likelihood of engaging in early detection practices through BSE. Strengthening educational interventions may improve early detection behaviors and contribute to breast cancer prevention efforts.

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Keywords :

breast cancer, Breast self-examination, Knowledge, Kupang City, Women of reproductive age

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References :

1. American Cancer Society. Cancer Facts & Figures 2024. Atlanta (GA): American Cancer Society; 2024.
2. World Health Organization. Breast cancer. Geneva: World Health Organization; 2023.
3. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(1):1–35.
4. Ministry of Health of the Republic of Indonesia. Indonesia Health Profile 2021. Jakarta: Ministry of Health RI; 2022.
5. Kupang City Health Office. Kupang City Health Profile 2023. Kupang: Kupang City Health Office; 2024.
6. Sari DP, Lubis NL, Siregar KN. Prevalence and determinants of breast self-examination practice among Indonesian women: a systematic review and meta-analysis. BMC Public Health. 2022;22:2104.
7. Ministry of Health of the Republic of Indonesia. East Nusa Tenggara Province Health Profile 2021. Jakarta: Ministry of Health RI; 2022.
8. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. Version 4.2023. Plymouth Meeting (PA): NCCN; 2023.
9. Oeffinger KC, Fontham ETH, Etzioni R, Herzig A, Michaelson JS, Shih YT, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. CA Cancer J Clin. 2015;65(5):343–368.
10. Anderson BO, Ilbawi AM, Fidarova E, Weiderpass E, Stevens L, Abdulrahman GO Jr, et al. The global breast cancer initiative: a strategic collaboration to improve breast cancer outcomes. Lancet Oncol. 2021;22(5):578–581.
11. Delita F. Association between breast cancer knowledge and breast self-examination behavior among adolescent girls. Journal of Community Health. 2018;13(2):98–105.
12. Wulandari F. Knowledge level and breast self-examination practice among female university students. Journal of Nursing Science. 2017;9(1):45–52.
13. Rosenstock IM. Historical origins of the Health Belief Model. Health Education Monographs. 1974;2(4):328–335.
14. Glanz K, Rimer BK, Viswanath K. Health Behavior: Theory, Research, and Practice. 5th ed. San Francisco (CA): Jossey-Bass; 2015.
15. McCready T, Littlewood D, Jenkinson J. Breast self-examination and breast awareness: a literature review. Journal of Clinical Nursing. 2005;14(5):570–578.
16. Harirchi I, Kolahdoozan S, Karbakhsh M, Chegini N, Mohseni SM, Montazeri A. Twenty years of breast cancer in Iran: downstaging without a formal screening program. Annals of Oncology. 2011;22(1):93–97.
17. Montazeri A, Vahdaninia M, Harirchi I, Harirchi AM, Sajadian A, Khaleghi F, et al. Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods. Asia-Pacific Family Medicine. 2008;7:6.
18. Jones CE, Maben J, Jack RH, Davies EA, Forbes LJ. A systematic review of barriers to early presentation and diagnosis of breast cancer among Black women. BMJ Open. 2014;4:e004076.
19. Haber G, Ahmed NU, Pekovic V. Family history of cancer and its association with breast cancer risk perception and repeat mammography. American Journal of Public Health. 2012;102(12):2322–2329.
20. Parsa P, Kandiah M, Mohd Nasir MT, Hejar AR, Nor Afiah MZ. Reliability and validity of Champion’s Health Belief Model Scale for breast cancer screening among Malaysian women. Asian Pacific Journal of Cancer Prevention. 2008;9(2):321–325.
21. Dundar PE, Ozmen D, Ozturk B, Haspolat G, Akyildiz F, Cakiroglu G. Knowledge and attitudes regarding breast self-examination and mammography among women in a rural area of western Turkey. BMC Cancer. 2006;6:43.
22. Lauby-Secretan B, Scoccianti C, Loomis D, Benbrahim-Tallaa L, Bouvard V, Bianchini F, et al. Breast cancer screening—viewpoint of the IARC Working Group. New England Journal of Medicine. 2015;372(24):2353–2358.
23. Sankaranarayanan R, Ramadas K, Thara S, Muwonge R, Prabhakar J, Augustine P, et al. Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. Journal of the National Cancer Institute. 2011;103(19):1476–1480.
24. Kösters JP, Gøtzsche PC. Regular self-examination or clinical examination for early detection of breast cancer. Cochrane Database of Systematic Reviews. 2003;(2):CD003373.
25. Sedighi Z, Besharat MA, Shafaie FS. Psychological determinants of adherence to breast cancer screening behaviors. Journal of Health Psychology. 2019;24(9):1191–1201.