Knowledge Level towards Breast Cancer and Breast Self-Examination among Medical Students of Indonesia

Andri Rezano, Marhendra Satria Utama, Hesti Lina Wiraswati, Savira Ekawardhani, Melia Juwita Adha, Nurul Mufliha Patahuddin, Veronica Oladitha Siagian, Siti Silvia Nur Shofa Shamantri, Erlangga Ing Geni Bisma Pratama, Liana Awalia Lutfunnisa, Asep Wiryasa, Hansen Wangsa Herman


Breast cancer is a life-threatening disease among Indonesian women. The etiology of breast cancer is still uncertain, and therefore adequate primary prevention is difficult. Early diagnosis improves cancer prognosis while also reducing medical costs, substantially reducing mortality rates. Knowledge and awareness of breast cancer risk factors and their screening may help women take preventive measures. The community service program aimed to assess the level of understanding of undergraduate medical students on breast cancer and breast self-examination (BSE). It was a one-group pretest-postest quasi-experimental study to measure the level of knowledge of 100 medical students in Indonesia from August 20th, 2020, to February 27th, 2021. The participants were asked 36 questions, which was an adaptation of previous questionnaires. A mini-lecture managed the program that focuses on risk factors and early detection. Furthermore, pretest and post-test were conducted to analyze the knowledge level before and after the dissemination. The participants included in this study were mostly 20 years and above (62%). The average recognition of breast cancer and its early detection was not high. The knowledge of breast cancer among medical students was found to be moderate. The efficacy of dissemination among medical students was apparent in knowledge change. However, good cancer awareness, especially breast cancer, needs to be established and integrated through effective cancer educational programs in the medical curricula. Hence, modification of the medical curriculum through extensive training on breast cancer preventive measures and early diagnosis is required.


Cancer awareness; cancer education; dissemination; early detection; screening

Full Text:



Angrainy R. Hubungan pengetahuan, sikap tentang SADARI dalam mendeteksi dini kanker payudara pada remaja. J Endurance. 2017;2(2):232–8.

Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer (Dove Med Press). 2019;11:151–64.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

Hortobagyi GN, de la Garza Salazar J, Pritchard K, Amadori D, Haidinger R, Hudis CA, et al.; ABREAST Investigators. The global breast cancer burden: variations in epidemiology and survival. Clin Breast Cancer. 2005;6(5):391–401.

Wang L. Early diagnosis of breast cancer. Sensors (Basel). 2017;17(7):1572.

Thompson PA, Ambrosone C. Molecular epidemiology of genetic polymorphisms in estrogen metabolizing enzymes in human breast cancer. J Natl Cancer Inst Monogr. 2000;(27):125–34.

Kwong A, Shin VY, Ho JC, Kang E, Nakamura S, Teo SH, et al. Comprehensive spectrum of BRCA1 and BRCA2 deleterious mutations in breast cancer in Asian countries. J Med Genet. 2016;53(1):15–23.

Lakhani SR, Reis-Filho JS, Fulford L, Penault-Llorca F, van der Vijver M, Parry S, et al. Prediction of BRCA1 status in patients with breast cancer using estrogen receptor and basal phenotype. Clin Cancer Res. 2005;11(14):5175–80.

Rezano A, Kuwahara K, Yamamoto-Ibusuki M, Kitabatake M, Moolthiya P, Phimsen S, et al. Breast cancers with a high DSS1 expression that potentially maintains BRCA2 stability have poor prognosis in the relapse-free survival. BMC Cancer. 2013;13:562.

Shalini, Varghese D, Nayak M. Awareness and impact of education on breast self examination among college going girls. Indian J Palliat Care. 2011;17(2):150–4.

Rahman SA, Al-Marzouki A, Otim M, Khalil Khayat NEH, Yousuf R, Rahman P. Awareness about breast cancer and breast self-examination among female students at the University of Sharjah: a cross-sectional study. Asian Pac J Cancer Prev. 2019;20(6):1901–8.

Koc G, Gulen-Savas H, Ergol S, Yildirim-Cetinkaya M, Aydin N. Female university students' knowledge and practice of breast self-examination in Turkey. Niger J Clin Pract. 2019;22(3):410–5.

Dewi TK, Massar K, Ruiter RAC, Leonardi T. Determinants of breast self-examination practice among women in Surabaya, Indonesia: an application of the health belief model. BMC Public Health. 2019;19(1):1581.

Rızalar S, Avcı İA, Żołądkiewicz P, Altay B, Moraczewska I. University students' awareness of breast and cervical cancers: a comparison of two countries and two different cultures. J Breast Health. 2017;13(2):77–82.

Linsell L, Forbes LJ, Burgess C, Kapari M, Thurnham A, Ramirez AJ. Validation of a measurement tool to assess awareness of breast cancer. Eur J Cancer. 2010;46(8):1374–81.

Grunfeld EA, Ramirez AJ, Hunter MS, Richards MA. Women's knowledge and beliefs regarding breast cancer. Br J Cancer. 2002;86(9):1373–8.

Nurdiawan W, Odillia C, Priyas MR, Radinda YR, Ahmad NA, Ningsih NA, et al. Knowledge level towards cervical cancer among students of Baabul Kamil Vocational High School. GMHC. 2020;8(3):226–32.

Camiz S. The Guttman effect: its interpretation and a new redressing method. Data Anal Bull. 2005;5:7–34.

International Agency for Research on Cancer. GLOBOCAN 2020: estimated cancer incidence, mortality, and prevalence in Indonesia in 2018 [Internet]. Lyon: International Agency for Research on Cancer; 2020 [cited 2021 November 20]. Available from:

Ng CH, Pathy NB, Taib NA, Teh YC, Mun KS, Amiruddin A, et al. Comparison of breast cancer in Indonesia and Malaysia – a clinico-pathological study between Dharmais Cancer Center Jakarta and University Malaya Medical Centre, Kuala Lumpur. Asian Pac J Cancer Prev. 2011;12(11):2943–6.

McPherson K, Steel CM, Dixon JM. ABC of breast disease. Breast cancer epidemiology, risk factors, and genetics. BMJ. 2000;321(7261):624–8.

Lauver D. Theoretical perspectives relevant to breast self-examination. Adv Nursing Sci. 1987;9(4):16–24.

Kementerian Kesehatan Republik Indonesia. Panduan program nasional gerakan pencegahan dan deteksi dini kanker leher rahim dan kanker payudara [Internet]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2015 April 21 [cited 2021 December 2]. Available from:

Anderson BO, Yip CH, Smith RA, Shyyan R, Sener SF, Eniu A, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the breast health global initiative global summit. Cancer. 2008;113(8 Suppl):2221–43.

Erdem Ö, Toktaş İ. Knowledge, attitudes, and behaviors about breast self-examination and mammography among female primary healthcare workers in Diyarbakir, Turkey. Biomed Res Int. 2016;2016:6490156.

Erkoç A, Oran F, Yorulmaz H. The effect of training on nursing students’ knowledge about the breast self-examination (BSE). J Breast Health. 2011;7(2):101–5.

Alpteker H, Avci A. Determine the knowledge of the women about breast cancer and their practice about breast self examination. J Breast Health. 2010;6(2):74–9.

Jones ME, Schoemaker MK, Wright LB, Ashworth A, Swedlow AJ. Smoking and Risk of Breast Cancer in Generation Study Cohort. Breast Cancer Res. 2017;19:118.

Güner İC, Tetik A, Gönener HD. Determination of women’s knowledge, attitude and behaviours about the self examination of breast. Gaziantep Med J. 2007;13(2):55–60.

Heena H, Durrani S, Riaz M, AlFayyad I, Tabasim R, Parvez G, et al. Knowledge, attitudes, and practices related to breast cancer screening among female health care professionals: a cross sectional study. BMC Womens Health. 2019;19(1):122.

Chee H, Rashidah S, Shamsuddin K, Intan O. Factors related to the practice of breast self examination (BSE) and Pap smear screening among Malaysian women workers in selected electronics factories. BMC Womens Health. 2003;3(1):3.


pISSN 2301-9123 | eISSN 2460-5441

Visitor since 19 October 2016: 

View My Stats

Free counters!

Global Medical and Health Communication is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.