Exploring the planned behavior of breast self-examination and its predictors among women in Northern Iran.

Background: Breast cancer (BC) is the most commonly diagnosed cancer among women worldwide. This study aimed to explore the planned behavior of breast self-examination (BSE) and its predictors among women in Northern Iran.

Methods: A cross-sectional study was conducted among 240 women in Babol, Iran, from 2020 to 2022. Data were collected using BSE barriers, knowledge and practice of BSE, and the Theory of Planned Behavior (TPB) questionnaires. Data were analyzed using a linear regression model and Pearson's correlation coefficient.

Results: The mean TPB construct score was 53.2 ± 3.9. The majority of women did not perform the BSE correctly (91.2%), and over half of the women lacked knowledge about BC and timely detection methods (54.6%). There was a significant positive correlation between attitude and "Do not know how to do it" (r = 0.160, P = 0.01), and a negative correlation with the marriage age (r = -0.210, P = 0.001), while a significant negative correlation was found between behavioral intention and ''fear of biopsy'' as a barrier (r = -0.130, P = 0.05). Additionally, there was a significant positive correlation between the perceived behavioral control and ''Fear of feeling pain during examination'' as a barrier (r = 0.130, P = 0.04). Multiple linear regression analysis revealed that the lack of training by health care providers (β = 0.16, P = 0.02) and being afraid of finding a lump in the breast (β = 0.13, P = 0.04) were positive predictors of TPB. Conversely, marriage age (β = -0.13, P = 0.049) and attitude toward BSE (β = -0.19, P = 0.005) were negative predictors of TPB construct. Additionally, "fear of feeling pain during examination" positively predicted perceived behavioral control (β = 0.13, P = 0.05). Notably, the results showed BSE practice was able to positively predict behavior (β = 0.94, P = 0.0001). Knowledge was positively associated with "afraid of finding a lump in the breast" (β = 0.13, P = 0.04).

Conclusions: Low levels of knowledge about BC, BSE, symptoms, and risk factors point to the need for targeted planned behavior-based interventions.