title: Breast cancer in Iran: need for greater women awareness of warning signs and effective screening methods.
abstract: BACKGROUND
  Breast cancer remains an important public health problem. This study aimed to investigate about female knowledge of breast cancer and self-reported practice of breast self-examination in Iran.
  
  
  METHODS
  This was a population-based survey carried out in Tehran, Iran. Data were collected via a structured questionnaire containing 15 questions on demographic status, history of personal and family breast problems, subjective knowledge about breast cancer covering its symptoms, the screening methods and practice of breast self-examination (BSE). A trained female nurse interviewed each respondent. Analysis included descriptive statistics and the Chi-squared test where necessary.
  
  
  RESULTS
  A total of 1402 women were interviewed. The mean age of respondents was 43.4 (SD = 14.4) years; most were married (85%), and without any personal (94%) and family history (90%) of breast problems. It was found that 64% of the respondents were familiar with breast cancer and 61% (n = 851) believed that 'the disease is relatively common among women in Iran'. Most women (44%) perceived a painless mass as a breast cancer symptom. Overall, 61% of the respondents stated that they knew about breast cancer screening programs and most indicated that electronic media (television 34% and radio 14%) were their source of information. Only 17% of women said that 'they were conducting regular breast self-examination'. The main reason for women not doing breast self-examination was due to the fact that they did not know how to do it (64%). The findings indicated that performing breast self-examination is significantly related to: age, marital status, education, knowledge of breast cancer and knowledge about breast cancer screening programs (p < 0.05), but not to personal (P = 0.2) and family (P = 0.7) history of breast problems.
  
  
  CONCLUSIONS
  This descriptive study provides useful information that could be utilized by both researchers and those involved in public health programmes. The findings indicated that the women awareness of breast cancer warning signs (painless lump, retraction of nipple, and bloody discharge) and effective screening methods i.e. clinical examination, and mammography were very inadequate. Thus, health education programmes to rectify the lack of women awareness is urgently needed. Indeed the focus of primary health care providers should be to raise awareness about breast care among women and to encourage them to report any unusual changes in their breasts to their family or care physicians.
authors.affiliation: Iranian Institute for Health Sciences Research (IHSR), ACECR, Tehran, Iran. montazeri@acecr.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
authors.forename: Mariam
authors.initials: M
authors.lastname: Vahdaninia
authors.forename: Iraj
authors.initials: I
authors.lastname: Harirchi
authors.forename: Amir Mahmood
authors.initials: AM
authors.lastname: Harirchi
authors.forename: Akram
authors.initials: A
authors.lastname: Sajadian
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Khaleghi
authors.forename: Mandana
authors.initials: M
authors.lastname: Ebrahimi
authors.forename: Shahpar
authors.initials: S
authors.lastname: Haghighat
authors.forename: Soghra
authors.initials: S
authors.lastname: Jarvandi