Sys Rev Pharm 2021;12(03):800-808 A multifaceted review journal in the field of pharmacy 800 Systematic Reviews in Pharmacy Vol 12, Issue 3, Mar-April 2021 Knowledge Assessment on Breast Cancer and Breast Self-Examination Practice among Female University Students in Kedah, Malaysia Sireesha Paruchuri 1* , Sharon Sim 2 , Ganesh Pandian Balasubramanian 1 , Sam Aaseer Thamby 1 , Ng Yen Ping 1 . 1 Unit of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, AIMST University, Malaysia 2 Faculty of Pharmacy, AIMST University, Malaysia ABSTRACT Objective: To review the knowledge on breast cancer (BC), breast self- examination (BSE) and clinical breast examination (CBE) practices among female university students in a private University, Malaysia. Methodology: This is a cross-sectional study conducted in a private university teaching medical and healthcare courses in Malaysia. Simple random sampling method was used. A structured questionnaire consisting of 4 sections was used for data collection. Data obtained were coded and SPSS Statistics (version 25) was used for analysis. Categorical data were presented as frequency and percentage whereas chi-square test was used to find the association between two different categorical variables. Results: A total of n=309 responses were collected from female students in a private university in Malaysia. The mean age of the respondents was 20.58 years (SD = 1.479, range = 19 - 30). One tenth of the respondents had family history of breast cancer [32 (10.4%)]. 304 students (98.4%) have heard of breast cancer. The study revealed media as the major source of information on breast cancer. 276 respondents (89.3%) have heard of BSE. 72.5% of respondents did not practice BSE. 291 (94.2%) respondents think that BSE is a useful tool to detect breast cancer. 85.8% of the respondents knew that BSE is performed by the individual. More than half of the students [193 (62.5%)] have not been taught on how to do BSE. Only [116 (37.5%)] of the respondents correctly stated that BSE should be performed monthly. 194 respondents (62.8%) have heard of CBE. Majority wrongly identified that CBE is done by using mammography [209 (67.6%)] and ultrasound [125 (40.5%)]. Only 13.6% of respondents identified that CBE is done by hand. There was significant association between education field and awareness of CBE. Conclusion: Most of the respondents are mindful of the existence of breast cancer and BSE but majority did not practice BSE as a routine. besides, they have lack of awareness and practice of CBE. Keywords: Breast Cancer, Breast Self-Examination, Clinical Breast Examination, Malaysia, screening Correspondence: Sireesha Paruchuri Unit of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, AIMST University, Malaysia Email: siree.paruchuri@gmail.com INTRODUCTION Breast cancer is the most typical cancer among women in today’s world. It ranks 2nd among cancer diseases and ranks 5th in terms of cancer mortality among women 1 . It is a malignant tumor that occurs primarily in the cells of the breast. Malaysian women have greater prevalence of breast cancer at the age of 40- 49 years as compared to women of 50 - 59 years of age in West. The Age Standardized Rate (ASR) of female breast cancer among Malaysian women was 47.4 per 100,000 populations 2,3 . The Chinese ethnic group had ASR of 59.7 per 100,000 population (highest rate), followed by Indian: 55.8 and Malay: 33.9 per 100,000 population in 2003 3-7 . However, most women do not routinely check their breasts for abnormalities or go for annual screenings after the age of 40. Delay in diagnosis and treatment of this disease decreases the survival rates 2 . When breast cancer is detected early (stage 1), the survival rate is approximately 90%. At stage 2, the survival rate drops to about 70% 8 . At stages 3 and 4, the outcome is even less positive, and treatment is more complex. In Malaysia, about half of the newly diagnosed breast cancer cases are in stages 3 and 4. There are 3 main activities for breast cancer screening in Malaysia, which are Breast Self- Examination (BSE), Clinical Breast Examination (CBE) and mammography screening 7,9-11 . Breast self- examination (BSE) is a screening method employed monthly in an attempt to detect breast cancer earlier. One of the main determinants of survival from breast cancer is early detection, which is dependent on disease awareness and uptake of screenings 8 . Monthly breast self-examination (BSE) plays an extremely crucial role in the health care of all women in every stages of life. It’s an easy, simple, safe, feasible and free of charge method without any need for specific screening tools. If properly performed, BSE enables one to detect the palpable masses in early stages. The method involves the women herself looking at and feeling each breast for possible lumps, distortions or swelling. Early detection is key when it comes to surviving breast cancer 6 . BSE should be done by all women, usually monthly, to be mindful of how the breasts appear and feel normally. Few days after the period ends is the best time to perform breast self-examination because the breasts are less likely to be swollen. In 2014, a study by Universiti Putra Malaysia researchers revealed that 70.5% of respondents (female undergraduates) did not perform regular breast self-examinations (BSE) and they did not know how to do it 12 . Their knowledge of breast cancer and BSE was inadequate. CBE is an action of inspecting and palpating the entire breast area of an individual by a well-trained health care professional or doctor. It also includes the lymph nodes located around the collarbone as well as under the armpits area 13 . From previous research, addition of CBE to screening mammography could increase the detection rate of breast cancer 14 . CBE could detect about 60% of cancers detected by mammography