Journal of Clinical and Diagnostic Research. 2023 Jul, Vol-17(7): LC01-LC06 1 1 DOI: 10.7860/JCDR/2023/62390.18134 Original Article Nursing Section The Relationship between Breast Cancer Prevention and Breast Cancer Screening Behaviours in Tehranian Women: A Structural Equation Modeling Analysis MAHLA RAJABZADEH 1 , ROYA NADERI 2 , SATTAR BAB 3 , MINA RIAHI 4 , FATEMEH BAHRAMI 5 , MOHAMMAD EGHBALI 6 , FATEME HASELI 7 INTRODUCTION Breast cancer is the most common cancer in women and one of the most important health issues in developing countries [1]. It is the second cause of death in women after cardiovascular diseases [2]. Further, it accounts for 23% of all cancer cases and 14% of all deaths in women [3]. More than two million new breast cancer cases were diagnosed worldwide in 2018, accounting for 11.6% of all cancer cases in that year [4]. About 2.09 million women are diagnosed with breast cancer annually, 627,000 of whom die [2]. The prevalence of breast cancer in Iran is 22.6 per 100,000 women [5]. Despite a decrease in breast cancer mortality worldwide, its mortality rate has increased from 19% to 21.4% in Iranian women from 2015-2020 [6]. Prevention of breast cancer and its early detection are among the essential factors in controlling mortality and increasing life expectancy [7]. Concerning breast cancer, primary and secondary preventions are fundamentally important because they allow the disease to be diagnosed in the early stages and prevent its progress [8]. Indeed, prevention and screening will decrease the incidence and mortality of breast cancer [9]. Experts believe that breast cancer in women is diagnosed at advanced stages in less developed countries [10]; as a result, its treatment and costs put great pressure on the healthcare system. Secondary prevention, which prevents breast cancer progression, is possible with regular screening. According to the recommendations of the American Cancer Society, breast self- examination, mammography, and clinical examination by an expert at different ages are three important and effective methods in the secondary prevention of breast cancer [11]. Self-breast examination, clinical breast examination, and mammography for breast cancer screening are the most effective methods to prevent breast cancer mortality and morbidity. Screening methods have been defned as activities facilitating the early screening and improvement of women’s health and are said to be good for the early detection of breast cancer [12-16]. Recent studies have recommended self-examination and clinical examination of the breast as important and vital criteria for early diagnosis [12-15,17]. American Cancer Society recommends a yearly clinical breast examination for 20-30-year-old, over 40-year-old, and low-risk women, as well as mammography once every two years for over 60-year-old women [11]. The effectiveness of common screening methods such as breast self-examination, clinical examination by a physician, and mammography has been confrmed in previous studies [12,16,18]. The high prevalence of breast cancer in women makes it necessary to encourage breast cancer screening behaviours in women. A society’s health beliefs and behaviours are formed based on the Keywords: Early detection, Female, Neoplasm, Unfavourable behaviours ABSTRACT Introduction: Breast cancer is the most commonly occurring cancer in women. It is also one of the most important health issues in many countries. Its high prevalence in women makes it necessary to encourage breast cancer screening behaviours. Aim: To investigate the relationship between breast cancer prevention behaviour and its screening behaviour in Tehranian women. Materials and Methods: This was cross-sectional study conducted on 859 women from November to December 2019 by the Iran University of Medical Sciences in Tehran, Iran. These women were selected by the multistage cluster method among five socio-economic classes living in different districts of Tehran. Structural Equation Modeling (SEM) was used to determine the relationship between breast cancer prevention behaviour and its screening behaviour. Data were analysed by Statistical Package for Social Sciences (SPSS) version 22.0 and Analysis of Moment Structures (AMOS) software. The level of significance was set at 0.05. Results: The mean age of the participants was 42±6.94 years. Also,137 (15.9%) of the participants were single, and 604 (70.3%) were married, 78 (9.08%) were divorced and rest widow. Among the studied subjects, 510 (57%) had unfavourable breast cancer screening behaviour. In Pearson’s correlation test, there was a direct and significant relationship between the mean score of breast cancer prevention behaviour and its subscales with breast cancer screening behaviour, except for the dimension of information-seeking (r=0.35, p=0.007). In other words, with the increased breast cancer prevention behaviour, breast cancer screening behaviour also increased. The results of SEM analysis showed that breast cancer prevention behaviour was positively correlated to breast cancer screening behaviour (p<0.001), and about 41% of changes in the breast cancer screening behaviour could be explained by the breast cancer prevention behaviour (β=0.41, p=0.01). Conclusion: Based on the results, it seems vital to take measures to inform and educate women about breast cancer and its complications, problems, prevention, screening, and diagnostic methods. The findings of this study can be used to increase motivation in the design of interventions in order to improve attitude, strengthen self-efficacy, reduce stress, and improve breast cancer screening behaviour.