Practice of breast self-examination and its associated factors among women of reproductive age in seven public health facilities in Addis Ababa,Ethiopia: A multi-centre cross-sectional study

Abstract

Background

Breast cancer is the leading cause of cancer-related deaths worldwide and the second most common cancer among women globally. Breast self-examination is a highly cost-effective method for the early detection of breast cancer in asymptomatic women. Despite this, the practice of breast self-examination remains low in Ethiopia.

Objectives

This study aimed to evaluate the practice of Breast Self-Examination and Its Associated Factors among Women of reproductive age in Seven Public Health Facilities in Addis Ababa, Ethiopia.

Design

This study employed a quantitative, multicenter, institution-based, cross-sectional, analytical design.

Methods

The study was conducted among women of reproductive age receiving medical care at designated public health facilities in Addis Ababa, Ethiopia. The study participants were selected using a simple random sampling technique from the study population. The data were reviewed, coded, and entered into Epi Info version 7.0, then transferred to SPSS version 27 for analysis. A P-value of less than 0.05 was considered statistically significant. Results were reported by using texts and frequency distribution tables.

Result

A total of 553 respondents participated in the study; of these, only 96 (17.3%) participants ever practiced breast self-examination. Education and Occupational status were found to have a significant association with the practice of breast self-examination. There is a strong association between knowledge and the practice of breast self-examination (BSE). Women of reproductive age who were knowledgeable about BSE were 4.75 times more likely to perform it compared to those with poor knowledge [AOR = 4.75, 95% CI (3.85, 7.45)].

Conclusion

The practice of breast self-examination among the study participants was low. Therefore, we recommend that the Ministry of Health and other relevant organizations promote community awareness about breast cancer and the importance of breast self-examination.

Plain Language Summary

This study explores how women of reproductive age in Addis Ababa, Ethiopia, practice breast self-examination (BSE) and the factors that influence their behavior. Breast self-examination is a simple method women can use to check their own breasts for any changes or abnormalities, which can help in early detection of breast cancer. The research was conducted across seven public health facilities and involved surveying a diverse group of women. The study aimed to identify how many women perform BSE regularly, what knowledge they have about it, and what factors encourage or discourage them from doing so. Key findings revealed that many women were unaware of the importance of BSE or did not know how to perform it correctly. Factors such as education level, access to health information, and support from healthcare providers were significant influences on whether women practiced BSE. Women who received education about breast health and BSE were more likely to engage in regular self-examinations. The study highlights the need for improved education and awareness campaigns about breast health among women in Addis Ababa. By providing better access to information and resources, healthcare facilities can empower women to take charge of their breast health, potentially leading to earlier detection of breast cancer and better health outcomes. Overall, increasing awareness and knowledge about BSE is crucial for improving women's health in the region.

Keywords

breast cancer breast self-examination practice perceived barriers Ethiopia

Introduction

Breast cancer is a disease characterized by the uncontrolled growth of abnormal cells within the breast tissue.^1,2 It is a type of malignant tumor that starts in the breast cells. It can be found in both males and females, but the rate of occurrence is higher in females.^3,4 It is a diverse disease with numerous morphological and molecular subgroups.⁵ The types of breast cancer depend on which cells in the breast turn into cancer.^5,6 Most breast cancer begins in the lobules (milk glands) or in the ducts that connect the lobules to the nipple.⁷ It can spread outside the breast through blood vessels and lymph vessels.^8,9

Breast cancer is one of the most frequently diagnosed cancers in developing countries compared to developed countries among women of reproductive age (15–49 years),¹⁰ and it is the leading cause of cancer deaths in women worldwide.^11,12 The International Agency for Research on Cancer (IARC) estimates there were more than 2.26 million new cases of breast cancer and 685,000 deaths worldwide in 2020.^13,14 In Africa, it is the most commonly diagnosed cancer and the second leading cause of death among women in 2020.¹⁵ The incidence of mortality rates for breast cancer in East Africa is 17.9 per 100,000 women per year.¹⁶ In Ethiopia, it is the leading cause of cancer mortality and morbidity among women of reproductive age.¹⁷ It accounts for one-third of all cancer cases among women and one in five of all cancer cases.^18,19

Lack of human resources and service delivery were the principal health system factors that influenced the diagnosis and treatment of women with breast cancer.^20,21 reproductive age group is one of the main risk factors for breast cancer in women, and the other risk factors of breast cancer are personal or family history of breast cancer; high breast tissue densities; high dose radiations to the chest resulting from medical procedures; long periods of menstruation histories; being overweight or obese after menopause; prolonged use of oral contraceptives; postmenopausal hormone therapy, ethnicity; level of education and women’s perception and knowledge towards breast cancer and breast self-examination, and regular alcohol intake are the main contributed factors for breast cancer.^22–24

The American Cancer Society (ACS) states that mammography, clinical breast examination (CBE), and breast self-examination (BSE) are the three essential methods for detection that are advised for the early identification of breast cancer.^15,25 The frequent utilization of mammography is not possible in low-resource nations such as Ethiopia because of the scarcity of educated experts and equipment, the high cost of the procedure, and limited health service resources. The clinical breast examination (CBE), which requires a visit to a healthcare facility, also depends on the expertise of professionals.²⁶

Breast self-examination (BSE) is a simple, quick, non-harmful, and cost-free procedure for early detection of breast cancer among women.^27,28In developing countries, breast self-examination is the recommended method because it is easy, convenient, private, safe, and doesn’t require any advanced equipment.²⁹ Despite its importance as an early detection strategy, poor knowledge among women has been a major obstacle. So, amplifying women’s knowledge, attitude, and practice towards BSE through creating a breast cancer awareness campaign^30,31

Since there are limited studies conducted regarding breast self-examination practice among women, the findings of this study will provide more information to governmental and non-governmental organizations to plan important interventions to improve women’s practice of breast self-examination. Therefore, this study aimed to assess breast self-examination practices and their associated factors among women of reproductive age across seven public health facilities in Addis Ababa, Ethiopia.

Method

Study setting, design, and period

A multicenter, institution-based cross-sectional study was conducted from April 1 to June 30, 2025, in Addis Ababa, Ethiopia. The city is divided into 10 sub-cities and 116 woredas. The total area of the city is 54,000 hectares. According to the 2013 population estimation, the total population of Addis Ababa is more than 6 million. At the time of this study, there were 13 public hospitals, 40 health centers, 122 health stations, 37 health posts, and 382 modern private clinics in Addis Ababa.³² The study was done in selected governmental hospitals in the city. The study has followed the STROBE guidelines for reporting observational studies.³³

Source population

All women aged between 20 and 49 years were considered a source population.

Study population

Selected women aged between 20 and 49 years old who attended the health service during the time of data collection in selected hospitals who fulfilled the Inclusion criteria.

Inclusion and exclusion criteria

All selected women aged between 20 and 49 years were included in the study, and women who were seriously ill during the period of data collection, females who were diagnosed with breast cancer, those who had a mastectomy procedure, and those not willing to participate in the study were excluded.

Study variables

Dependent variables

Practice of breast self-examination

Independent variables

Socio-demographic characteristics of

➢ Age in years,

➢ marital status

➢ The educational level of women

➢ Occupational status

➢ income and residency

Breast cancer history

➢ Family history of breast cancer

➢ Personal history of breast cancer

Knowledge of breast self-examination

Perception

➢ Susceptibility,

➢ Seriousness,

➢ Benefit,

➢ Barriers and Confidence

Source of information

➢ Radio

➢ Television

➢ Social media

➢ Friends and families

Sample size determination

The sample size was determined using a single population proportion formula with the assumption of a marginal error of 5%, a 10% non-response rate, a 95% confidence level, a design effect of 1,5, and the prevalence of the breast self-examination practice was 66.1%.³⁴ Then the calculated sample size was 568.

Sampling technique

A multistage sampling technique was used to select study areas, and by using the lottery method, seven hospitals were selected: St. Peter Hospital (SPH), Alert Hospital (AH), Saint Paul Hospital (SPH), Minilik Hospital (MH), Trunesh Beijing Hospital (TBH), Ras Desta Hospital (RDH), and Torhailochi Hospital (TH). The sample size in each public hospital was allocated proportionally to the patient flow. Finally, a systematic random sampling method was used to select individuals for the study participants.

Data collection tools and procedures

Data was collected using a structured questionnaire-guided interview, which was adopted and prepared after a literature review, and the local situation of the study area and the purpose of the study were considered in preparing the questionnaire. The questionnaire was developed in the English language after reviewing and extracting from different pieces of literature developed for the same purpose. It has four sections, including sociodemographic characteristics, family and personal history of BC, knowledge of BSE, perception towards BSE practice, and BC. The questionnaire was prepared in English and translated into the local language, Amharic, for better understanding by both data collectors and respondents, and translated back to the English version to verify consistency. Data were collected by using face-to-face interview methods with seven bachelor’s degree Science nurse collectors recruited. To assess the internal consistency of the items, Cronbach’s alpha was assessed, and it was 0.86, indicating good internal consistency of the items.

Data quality control

The questionnaire was pre-tested outside my study area at Black Lion Hospital on 52 mothers (10% of the total sample size) before conducting the actual data collection. A pre-tested result helps determine the accuracy of the tool based on the required information from study participants. If the drafted tool was devoid of this capacity, the questionnaire was adjusted accordingly.

Training was given to data collectors and supervisors for two days by the principal investigator on the purpose of the study, methods of interviewing, maintaining confidentiality of information, and other basic principles related to data collection. The data collection instrument was prepared in English, translated into Amharic, and then returned to English by different language translators to check its consistency. The completeness of the questionnaire was checked by supervisors at the end of each day and double-checked by the researcher/principal investigator.

Statistical analysis

The collected data were coded, entered into the EpiData software (version 7) for cleaning errors, and analysed by SPSS version 26. Descriptive statistics were used to show frequency, mean, median, standard deviation, and percentage. The presentation of data was done by using tables and figures. Frequencies and percentages were calculated for categorical variables to measure central tendencies and variation.

Then, the socio-demographic characteristics of study participants were presented using tables. Besides, knowledge, attitude, and practice levels have been presented using tables and figures as necessary. The overall associations between the different covariates and breast self-examination were tested with a chi-square test. The odds ratio with a 95% confidence interval was used to assess the presence and degree of association between the dependent and independent variables.

A logistic regression model with a p-value <0.05 was considered to identify predictors of BSE practice. Significant factors were determined using crude and adjusted odds ratios with 95% confidence intervals. To assess the association between the different predictor variables and the dependent variables, first, bivariate relationships between each independent variable and the outcome variables were investigated using a binary logistic regression model. Those independent variables with a p-value < 0.02 by the Hosmer-Lemeshow rules at the bivariate level were included in a multivariate logistic regression model to control potential confounding factors. After adjusting their effect on the outcome variables, those variables with a p-value < 0.05 and a 95% confidence interval were regarded as significant determinant factors.

Operational definition

Breast self-examination is an examination done by women of their breasts to check for lumps or other changes. According to this study, breast self-examination is described as women in a community who use their hands to inspect and palpate their breasts and the surrounding areas for any abnormality.

Practice = The self-examination of the breasts is done to identify any changes in the breasts.³⁵

Good practice of breast self-examination: Those who performed breast self-examination practiced a week after each menses by their palm and middle three fingers, otherwise called poor practice.³⁶

Participants who scored a mean and/or above the value of the provided 11 questions were categorized as knowledgeable, while those who scored below the mean value were considered not knowledgeable.³⁷

Serious illness, defined as a condition where death is possible or the situation is permanent/life-altering, requires immediate professional attention if emergency symptoms are present. Emergency signs include severe breathing problems, chest pain, stroke symptoms, uncontrolled bleeding, or a non-fading rash (sepsis).

Result

Socio-demographic characteristics

Among the total, 568 respondents were expected, but 553 (97.35%) were the respondents. According to these studies, five hundred and fifty-three (553) mothers were interviewed. The participants were between 20 and 49 years old, with a mean age of 29 and a standard deviation of 6.4 years. The respondents predominantly were between the ages of 20 and 29, with 65.5% (362), next to 28.9% (160) between 30-39 years, and 5.6%³¹ above 40 years. According to this study, 30.2% of participants (167) do not have formal education, 24.95% (138) received primary education, 31.65% (175) have secondary education, and 13.2% (73) have a diploma or above. Regarding the marital status of participants, 20.7% (114) are single, 49.5% (274) are married, 18.9% (104) are divorced, and 11% (61) are widowed (Table 1).

Table 1.

Shows the Socio-demographic characteristics of women attending breast self-examination and associated factors among women aged between 20 and 49 years in selected hospitals in Addis Ababa, Ethiopia, 2025 (N=553).

Variables	Category	Frequency (n=553)	Percentage
Age	20-29	362	65.5%
	30-39	160	28.9%
	>40	31	5.6%
Educational status	Not educated	167	30.2%
	Primary education	138	24.95%
	Secondary education	175	31.65%
	Diploma and above	73	13.2%
Occupational status	Student	46	8.4%
	Daily laborer	44	7.9%
	Housewife	257	46.5%
	Govt. employee	92	16.6%
	Merchant	28	5.1%
	Private employee	86	15.1%
Economic status	Poor	168	30.7%
	Medium	265	47.8%
	high	120	21.6%
Marital status	Single	114	20.7%
	Married	274	49.5%
	Divorced	104	18.9%
	Widowed	61	11%

Family and personal history of breast cancer

Around 87.4% (483) reported that they did not have a family member diseased or diagnosed with breast cancer. Only 12.6% of the respondents whose family or sick with breast cancer, and 61.2% have ever used FP as shown (Table 2).

Table 2.

Shows the Family and Personal history of Breast cancer women attending breast self-examination and associated factors among women aged between 20 and 49 years in selected hospitals in Addis Ababa, Ethiopia, 2025 (N=553).

Variables	Category	Frequency (n=553)	Percentage
Family history of breast cancer	Yes	70	12.6%
Family history of breast cancer	No	483	87.4%
Who is the affected family?	Mother	35	50%
	Sister	28	40%
	Aunt	7	10%
Do you have a personal history of breast cancer	Yes	63	12%
Do you have a personal history of breast cancer	No	490	88%
Ever breastfeed	Yes	336	60.8%
Ever breastfeed	no	217	39.2%
Ever use Family planning (FP)	Yes	338	61.2%
Ever use Family planning (FP)	no	215	38.8%

The practice of breast self-examination

This study shows that only 96 (17.3%) of the study participants ever practiced breast self-examination; of those, 24 (6%) reported having practiced BSE regularly. The reason why they practiced BSE was that 21.7²⁰ of them had previous breast problems. 36%³⁴ once a month had a frequency of practicing BSE. Only 45%³⁸ of the participants practiced BSE on the regular day of each month. Only 9 (9.8%) of the participants practiced BSE 10–12 times in the last 12 months, and the reason not to practice 10–12 times in the last 12 months was predominantly 60% (58) forgetfulness, and 8%⁸ of them said they were not convinced about its effectiveness, as shown in Table 3.

Table 3.

Practice of women attending breast self-examination and associated factors among women aged between 20 and 49 years in selected hospitals in Addis Ababa, Ethiopia, 2025. (N=553).

Variables	Category	Frequency (n=553)	Percentage
Why do you perform breast self-examination	had a previous breast problem	20	21.7%
Why do you perform breast self-examination	No previous breast problem	76	78.3%
Frequency of practicing BSE	Once a week	12	13%
	Once a month	34	36%
	Once every 3 months	17	18%
	Once every 6 months	22	23%
	Once every 12 months	11	10%
Have you ever had a breast examination by a doctor?	Yes	199	36%
Have you ever had a breast examination by a doctor?	No	353	74%
The time BSE did	2 to 3 days after the menstrual sensation	10	10%
	When it comes to mind	29	30%
	The regular day of each month	43	45%
	Any time during menses	14	15
BSE in the last 12 months	10 -12 times	9	9.8%
	7 - 9 times	7	7.2 %
	4 – 6 times	15	16
	1- 3 times	35	36.4%
	I didn’t perform in the last 12 months	29	30.6%
Reason not to do 10 – 12 in the last 12 months	Not convinced about its effectiveness	8	8
	Performing causes discomfort	18	19
	Forgetfulness	58	60
	Fear of finding something or having BC	12	13

BSE: Breast Self-Examination.

Multivariate analysis of the practice of BSE with independent variables

In the multivariate logistic regression model, level of education, occupation, and knowledge were significantly associated with breast self-examination (< 0.05). The result of multivariate analysis revealed that respondents or women of reproductive age who had completed secondary school were 1.57 times more likely to be knowledgeable about the practice of BSE than the other groups with secondary education. They were shown to have a statistically significant association with those who know BSE practice [AOR = 1.57, 95%CI (1.283–3.14)]. Those women of reproductive age who were government-employed are about 2.65 times more likely to practice breast self-examination than those who are non-governmental employees. [AOR=2.65,95%CI (1.59,4.03)),]. There is a strong association between knowledge and the practice of breast self-examination. Regarding knowledge of BSE, those women in the reproductive age group who knew BSE were 4.75 times more likely to practice BSE than those who had poor knowledge [AOR = 4.75, 95% CI (3.85, 7.45)](Table 4).

Table 4.

Shows a Multivariate analysis of practice BSE with independent variables among women aged between 20 and 49 years in selected hospitals in Addis Ababa, Ethiopia, 2025 (N=553).

variables	BSE practice	No BSE practice	COR(95%CI)	AOR(95%CI)	P-value
Educational status
Not educated	26	141	0.24(0.23,1.64)	0.19(0.11-25.72)	0.705
Primary education	40	98	1.74 (1.03,2.93)	0.72(0.07-7.67)	0.789
Secondary education	67	109	2.75 (1.67,4.53)	1.57(1.283-3.14)	0.001**
College and above	45	24	1	1
Occupation
Student	15	31	0.87 (0.62,1.85)	0.71 (0.62,1.85)	0.66
Daily laborer	14	30	0.96 (0.58,1.98)	0.83 (0.58,1.98)	0.52
Housewife	89	168	0.83 (0.52,1.63)	0.73 (0.52,1.63)	0.32
Govt. employee	35	57	3.23 (1.59,4.3)	2.65 (1.59,4.03)	0.000**
Merchant	9	19	0.76 (0.42,1.57)	0.66 (0.42,1.57)	0.45
Private employee	16	70	1	1
Knowledge
Knowledgeable	105	142	5.26(4.65,8.05)	4.75(3.85,7.45)	0.000**
Non-knowledgeable	73	233	1	1

1 = Reference Group, COR = Crudes Odds Ratio. CI = confidence interval, AOR = adjusted odds ratio, ** = statically significant p<0.05.

Discussion

The ever-present practice of breast self-examination was low, and the practice of regular breast self-examination was considered poor in this study area because only a limited number of respondents knew how to do breast self-examination. Our findings showed that only 96 (17.3%) ever practiced breast self-examination. This study was consistent with the study conducted in Cameroon (15%)³⁹ and Jimma (15%).³⁶ It might be due to the nature of the population used for the study; both studies used similar study designs, or the reason could be a similar setup in the prevalence of breast self-examination.

This study result is also greater than or higher than the prevalence of studies conducted in North Ethiopia, Adwa town. Of the total study participants, only 26 (6.5%) had ever practiced breast self-examination,²⁶ in Indonesia(12.5%),⁴⁰ in Yemen(11%),⁴¹ in Saudi Arabia(4.0%),⁴² and in the Bale zone(13.2%).³⁸ The difference is due to the study setting, study period, intervention, and baseline differences in community awareness, access to health facilities, and exposure to media.

This study is also less than compared to other studies when we compared the study conducted in ILORIN, NIGERIA, Fifty-six (29.9%),⁴³ Uganda Kampala 58%,⁴⁴ in Ghana (37.6%),⁴⁵ and in Adama (51.4%).⁴⁶ The variation is due to different setups in which there is not enough infrastructure, or similar community awareness. This difference might be due to different socio-economic statuses and designs, explained by the fact that there is a low level of knowledge on the benefits of breast self-examination and the prevention of breast cancer. In addition to this, it is not addressed as a major public health problem at any level of the health care system.

According to this study respondents or women of the reproductive age group who had completed secondary school were 1.57 times more likely to implement towards practice of breast self-examination than the other groups or secondary education were shown to have a statistically significant association with those who have a piece of knowledge about BSE practice [AOR=1.57, 95%CI (1.283-3.14) In a similar study carried out in Uganda, ILORIN, NIGERIA(44).

According to this study, women of reproductive age who were government employees. Employees are about 2.65 times more likely to practice breast self-examination than non-governmental employees.[AOR=2.65,95%CI (1.59,4.03))]. This study is Similar to a study conducted in rural Ghana, Knowledge about breast cancer among government employees (AOR = 0.22, 95% CI = 0.071–0.683).⁴⁷

The practice of breast self-examination can help women know the structure and composition of their normal breasts, thereby enhancing their sensitivity to detect any abnormality at the earliest possible time. Knowing the barriers to breast self-examination practice among study participants through these studies and addressing them is crucial. There is a strong association between knowledge and the practice of breast self-examination. Regarding knowledge of breast self-examination, those women in the reproductive age group who knew breast self-examination were 4.75 times more likely to practice breast self-examination than those who had poor knowledge [AOR = 4.75, 95% CI (3.85, 7.45)]. Women should know that irregularities in the size of the breasts are common and normal. They should look for a new abnormality in appearance, such as asymmetry, flattening, or dimpling. Any new change in the nipple, including ulceration, is noted.⁴⁸

A similar study was carried out in rural Ghana. Knowledge about breast cancer among participants who received the program was better than among those who did not. Participants who attended the program were significantly more likely to obtain higher knowledge scores or showed that a higher level of education was significantly associated with the practice of breast self-examination (odds ratio (OR) 5 2.10, 95% confidence interval (CI) 5 1.14–3.86) and to state practicing breast self-examination (OR 5 12.29, 95% CI 5 5.31–28.48.⁴⁹

Education and occupation significantly influence the practice of biosimilar erythropoietin (BSE) due to the varying levels of knowledge and familiarity with biosimilars among healthcare professionals. Clinicians with advanced education and specialized training in pharmacology or hematology are more likely to understand the nuances of biosimilars, including their safety, efficacy, and regulatory approval processes. Additionally, healthcare providers in academic or research-oriented settings may have greater exposure to emerging data on biosimilars, fostering a more favorable attitude toward their use. Conversely, those in less specialized roles or with limited continuing education opportunities may harbor misconceptions or uncertainty about biosimilars, leading to hesitancy in prescribing them. Consequently, enhancing education and training for healthcare professionals is crucial to improving the adoption of BSE and ensuring that patients receive the most effective and cost-efficient therapies available.⁵⁰

Cultural barriers significantly impact the practice of breast self-examination (BSE) among women, often influencing their willingness to engage in this potentially life-saving behavior. In many cultures, discussions about breast health and sexuality are considered taboo, leading to a lack of awareness and education regarding BSE. Women may feel uncomfortable discussing their bodies or seeking information about breast health due to societal norms that discourage open conversations about reproductive health. This cultural stigma can result in misinformation or a lack of knowledge about the importance of early detection of breast cancer, making women less likely to perform regular self-examinations.

Additionally, cultural beliefs about health and illness can further complicate the acceptance of BSE. In some communities, traditional healing practices may take precedence over modern medical advice, leading women to prioritize alternative methods of health care over preventive measures like BSE. Furthermore, there may be a perception that breast cancer is a fate that cannot be avoided, which can diminish the perceived importance of proactive health behaviors. These cultural attitudes can create significant barriers to education and awareness campaigns aimed at promoting BSE, ultimately affecting women’s health outcomes and their ability to detect breast cancer early. Addressing these barriers requires culturally sensitive approaches that respect local beliefs while providing accurate information about the benefits of breast self-examination.

Strengths and limitations of the study

Strength of the study

The sampling method and procedure decreased selection bias for the study population because we used a probability systematic sampling method, so that it was possible to generalize to the general population.

Limitations of the study

The self-reported information is subject to bias, specifically to social desirability bias. There was no internationally recognized standardized tool to assess BSE. The use of a cross-sectional design has limited the degree of cause-and-effect associations among variables of interest.

The behavioral study outcomes are based on self-reported information, which is subject to bias since the study raised personal issues, and the possibility of underestimation cannot be ruled out. The behavioral outcome is based on self-reported information.

Therefore, the possibility of under- or over-estimation may not be ruled out. Social desirability and recall biases may not be eliminated. It was also not triangulated with a qualitative method.

Recommendation

Based on the findings of this study, the following recommendations were forwarded to the concerned bodies:

Develop practical strategies to reduce the risk of developing breast cancer by promoting BSE and other screening methods. Considering the source of information access to women about BSE in this study, provide effective training for health professionals to enhance the practice of BSE.

Integration of education campaigns and screening services into existing programs like Family planning and reproductive health services, VCT (voluntary counseling and treatment), and so on.

The results show that the practice of BSE and knowledge among women in these reproductive age groups were inadequate. Efforts should be made to strengthen community-based health education to increase knowledge related to breast cancer, as well as the practice of breast self-examination. So, the Federal Ministry of Health, Addis Ababa Health Bureau, and the Ethiopian Cancer Association were responsible bodies for promoting awareness creation at the community level on breast cancer and breast self-examination.

Conclusion

The result of this study revealed that 17.3% of participants practiced breast self-examination (BSE), highlighting a need for increased awareness and education on this important health practice. While factors such as educational status, occupation, and knowledge of BSE were significantly associated with the likelihood of engaging in BSE, age, marital status, and monthly income showed no significant correlation. Regular BSE is recommended for women over 20, as it can be a life-saving exercise. To improve participation rates, the Ministry of Health and the Addis Ababa Health Bureau should implement various awareness campaigns to encourage communities to adopt BSE practices.

Footnotes

Acknowledgments

Our heartfelt gratitude goes to the study participants for their willingness and cooperation during data collection, as well as to the data collectors. Additionally, we express our appreciation to our colleagues for their invaluable support and assistance in providing the necessary data, which was made possible with their generous help.

ORCID iDs

Abdurehman Seid Mohammed

Mustofa Hassen

Getachew Mekete Deress

Ethical considerations

Ethical clearance and ethical approval were obtained from the Institutional Review Committee of Addis Ababa Medical and Business College. Whose ethical reference number was 111/10/06/2025.

Consent to participate

Written informed consent and oral consent were obtained from each study participant according to the principles of the Helsinki Declaration. The Declaration of Helsinki was considered, and principles and recommendations have been used.

Consent for publication

“Written informed consent was obtained from the patient for publication of this study and accompanying images”.

Authors’ Contributions

Abdurehman Seid Mohammed, Tsehaynesh Tafese, Mathewos Sileshi Menberu, Yared Nigussie, and Mustofa Hassen have contributed to the Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing -review & editing. Getachew Mekete Diress and Zewudu Minda have contributed to the Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing -review & editing.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Declaration of conflicting interests

The authors declare that there is no conflict of interest.

Data Availability Statement

The data of this study will be available from the corresponding author upon reasonable request.*

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