Knowledge and Practice of Breast Self-Examination Among Female Non-Medical Students in Universiti Kebangsaan Malaysia (UKM) in Bangi

Authors: Mohd Rohaizat Hassan, Hasanain Faisal Ghazi, Ahlam S. Mohamed, Saladina Jaszle Jasmin

Affiliations: Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur; Community Medicine Unit, International Medical School, Management and Science University, Selangor; Endocrine and Breast Unit, Department of Surgery, UKM Medical Centre, Malaysia

Published: 2017  |  Malaysian Journal of Public Health Medicine, 2017; Volume 17 (1): 51-58

Last reviewed: March 2026

Background

Breast cancer is the most commonly diagnosed cancer among women worldwide and is the leading cause of cancer-related deaths in Malaysian women. According to the Malaysian National Cancer Registry, breast cancer accounts for approximately 31% of all cancers among women in the country, with age-standardised incidence rates showing a concerning upward trend over recent decades. While Malaysia has established mammographic screening programmes, access and utilisation remain inconsistent, particularly among younger women and those in rural areas.

Breast self-examination (BSE) is a simple, cost-free screening technique through which women regularly examine their breasts for abnormal lumps, swelling, skin changes, or nipple discharge. While BSE alone is not sufficient for definitive screening, it promotes breast health awareness and encourages women to seek timely medical attention when abnormalities are detected. In resource-limited settings where mammographic access is constrained, BSE serves as an important component of breast cancer awareness programmes.

University students represent a critical population for breast cancer prevention education. Knowledge and behaviours established during young adulthood can persist throughout life, and university settings provide efficient channels for health education delivery. This study investigated the knowledge and practice of BSE among female non-medical students at Universiti Kebangsaan Malaysia (UKM) in Bangi—students who, unlike their medical counterparts, do not receive formal health sciences education.

Study Design and Methods

A cross-sectional study was conducted among female non-medical students at UKM Bangi campus. A total of 364 students participated, completing a validated self-administered questionnaire that assessed knowledge about breast cancer and BSE, practice of BSE, sociodemographic characteristics, personal and family history of breast cancer, and sources of information about breast health.

Knowledge was assessed through questions covering risk factors for breast cancer, recommended screening methods, when to begin BSE, the correct timing during the menstrual cycle for performing BSE, and the proper technique. Students were classified as having ‘good’ or ‘poor’ knowledge based on their aggregate scores. BSE practice was assessed by asking whether students currently performed BSE and, if so, their frequency and technique.

Results

Knowledge Levels

Knowledge about BSE among the study population was suboptimal: only 45% of students were classified as having good knowledge. Many students were unfamiliar with the recommended frequency of BSE, the best time during the menstrual cycle for BSE, and the proper technique involving systematic palpation of all breast quadrants and the axillary region.

BSE Practice

The practice of BSE was even lower than knowledge levels, with only 37.1% of students reporting that they performed BSE. Among those who practised BSE, many did not do so at the recommended monthly frequency, and self-reported technique was often incomplete.

Factors Associated with Knowledge

Several factors were significantly associated with knowledge levels about BSE:

Factors Associated with BSE Practice

In multivariate analysis, BSE practice was more likely among students with a family history of breast cancer, those who used the internet and pamphlets as sources of health information, and those with good knowledge about BSE. Knowledge level emerged as the strongest modifiable predictor—students with good knowledge were significantly more likely to practise BSE than those with poor knowledge, suggesting that educational interventions could effectively increase BSE practice.

Discussion

The finding that fewer than half of female non-medical university students had good knowledge about BSE, and even fewer practised it, highlights a significant gap in breast health awareness among young Malaysian women. This gap is particularly concerning given that breast cancer is the most common female cancer in Malaysia and early detection significantly improves survival outcomes.

The association between information sources and both knowledge and practice provides actionable insights. The internet and health pamphlets were significant positive influences, suggesting that digital health education and accessible print materials are effective channels for reaching this demographic. Universities could leverage their existing communication infrastructure—student portals, social media channels, campus events—to deliver targeted breast health education.

The strong relationship between family history and both knowledge and practice likely reflects heightened awareness of breast cancer risk among women with affected family members. However, from a population health perspective, the goal should be to achieve similarly high awareness levels across all women, regardless of family history. The fact that knowledge was the strongest modifiable predictor of practice underscores the potential impact of well-designed educational interventions.

Public Health Implications

Malaysian universities should integrate breast health awareness programmes into student orientation activities and campus wellness initiatives. Given the effectiveness of internet-based information channels observed in this study, developing engaging, culturally appropriate digital content about breast cancer awareness and BSE technique would be a cost-effective strategy.

The Ministry of Health’s breast cancer awareness campaigns should specifically target non-medical students and young women in educational institutions, where receptivity to health education is generally high and peer-to-peer knowledge sharing can amplify programme reach. Training campus health staff to provide BSE instruction during routine health visits could further normalise breast self-examination as a regular health practice among young women.

Limitations

The study was conducted at a single university campus (UKM Bangi) among non-medical students, and findings may not be generalisable to students at other Malaysian universities or to non-student populations. The cross-sectional design cannot establish causal relationships between knowledge and practice. Self-reported BSE practice may be subject to social desirability bias, potentially inflating the reported prevalence. The study did not assess the correctness of BSE technique among those who reported practising it. Future studies should include assessment of actual BSE technique through observed demonstration and should evaluate the effectiveness of specific educational interventions in improving both knowledge and practice.