Breast and able to identify symptoms of

cancer is the second highest malignancy that lead of death among women (Gwanzo,
Sabitu & Idris, 2009) with estimated 40, 610 deceased in 2017 (American
Cancer Society, 2017). According to WHO (2015), it is estimated that 1.5
million of new cases are detected globally and 570, 000 died from breast cancer
in each year. In Malaysia, breast cancer is the first killer among women with
its incidence rate recorded at 32.1% in 2015 (Low, Papapreponis & Yong,
2015). The Cancer Research Malaysia (2017) reported that approximately 5000
Malaysia women aged between 30 to 60 years are diagnosed with cancer each year.
Akhtari-Zavare, Juni, Ismail, Said & Latiff (2015) stated that one in
nineteen Malaysian women have the chance in developing breast cancer in their
lifetime. Studies also have found that the disease may occur at tender age
(Taib, Yip, Ibrahim, Ng & Farizah, 2007) with low survival rate as the
benign tumor is metastasize to other parts of the body more aggressive in
younger women (Nde, Assob, Kwenti, Njunda & Tainenbe, 2015). 


is important that women especially younger generation increase their knowledge,
attitude, and practice in preventing breast cancer. Al-Azmy, Alkhabbaz,
Almutawa, Ismaiel, Makboul and El-Shazly (2013) reported that limited information
and knowledge about breast cancer are main reasons why women miss the early
detection and thus, present with advanced stages to the hospital. Women
especially younger generation need to be “breast aware” and able to identify
symptoms of breast cancer through a routine practice to avoid being diagnosed
at late stages of breast cancer, (Nwaneri, Emesowum, Osuala, Okoronkwo, Okpala
& Adeyemo, 2016). Preventive practices that are proved to be effective in
detecting early sign of breast cancer are breast self-examination (BSE),
clinical breast examination (CBE) and mammography (Rosmawati, 2010). Although
this lifesaving method can help in detecting breast cancer (Akhigbe &
Omuemu, 2009), poor knowledge and misconception about breast cancer prevention
among women are responsible for a negative perception of the curability of a
cancer detected and the efficacy of the screening tests (Dandash &
Al-Mohaimeed, 2007).

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practice is common in women and nurses are responsible to educate the women
regarding screening practices. Nurses need to be trained from the grass root to
give a better guidance to the women. According to Erdem and Toktas (2016),
emphasis should be laid on BSE in undergraduate and postgraduate nursing
students as they are involved in the patient education. Another study by
Akhigbe and Omuemu (2009) emphasized the importance of BSE from the nursing
school to ensure the nursing students are well prepared to give a health care
in future. Hence, it is importance to look into nursing student knowledge about
BSE before they become real nurses. However, some studies shows knowledge,
attitude, and practice are differs among nursing students and it will affects
the screening practice (Nemenqani et al., 2014; Sujindra and Elamurugan, 2015;
Ayed et al., 2015). Although the nursing students have the knowledge of the
clinical sign of breast cancer and the examination technique (Alsaif, 2004),
yet the nursing students overlook this important lifesaving practice.
Therefore, it is imperative to look at the nursing student knowledge, attitude,
and practice of BSE because they are the future nurses that become an educator
to correctly guide the women on correct methods of BSE. It also can help to
improve the breast cancer screening through nursing students.


Statement of Problem


basically compose of 90% females. They are the educator in teaching and guiding
women to practice correct BSE technique in order to prevent late diagnosed of
breast cancer among women. This is because nurses are the forefront lines in
helping people through public advocacy, care giving and support (Akhigbe &
Omuemu, 2009). Therefore, it is necessary for the nurses especially students
nurses to have BSE educational programs to increase their knowledge, attitude,
and practice of BSE.


studies have explored this research matter. Nemenqani et al., (2014); Sujindra
and Elamurugan, (2015); and Ayed et al., (2015) find out that, there were low
level of knowledge, attitude, and practice towards BSE among nursing students.
The same study carried out by Umbreen, Jabeen, and Riaz (2017), also stated low
percentage of knowledge in nursing students due to did not know the correct
time and correct method in performing BSE. This might cause wrong information
and technique given to the women during the health education in the future. In
addition, Segni, Tadesse, Amdemichael and Demissie (2016) indicate that low
knowledge is due to the roles played by the formal and non-formal education in
health related issue. This portrays the lack of awareness about BSE that lead
to ignorance concerning breast cancer. Moreover, it explains the late diagnosed
of breast cancer and poor practice of BSE that cause increase in numbers of
death in women.


reported that women especially nursing students did not practice BSE regularly
(Erbil & Bolukbas, 2014; Rosmawati, 2010). A study conducted by Nemenqani,
Abdelmaqsoud, Al-Malki, Oraija and Al-Otaibi (2014) reported that nursing
students have low level of BSE practice despite the nursing curriculum has
taught on BSE education and practice. It is due to that fact that the nursing
students think that they are still young to be diagnosed with breast cancer.
This shows the student did not received yet in-depth breast cancer curriculum
that lead to low BSE practice. It also shows the nursing students still do not
prepared to be a qualified nurse to give health education to the women
regarding BSE when they are working later.


such, a study to assess the knowledge, attitude, and practice of BSE will be
conducted among nursing students in Universiti Malaysia Sarawak. The findings
will provide useful information on the current knowledge, attitude, and
practice of BSE among nursing students. Moreover, the results will also provide
data on the efficiency of the current efforts.