Awareness and Attitude towards Breast Self-Examination (BSE) among Female Private Pharmacy College Students in Telangana, India

Abstract

Background: Breast cancer is the leading female malignancy globally and across India, where late-stage clinical presentation severely compromises clinical outcomes. Breast self-examination (BSE) serves as an accessible, cost-effective screening approach to foster breast health awareness. As future healthcare providers, female pharmacy students occupy a critical position in public health screening advocacy.

Objectives: To assess baseline awareness and multidimensional attitudes toward BSE among female pharmacy students in Telangana, India, and to identify independent sociodemographic and attitudinal determinants of favourable screening status.

Methods: A descriptive cross-sectional study was conducted among 129 female pharmacy undergraduates (B. Pharm, Pharm. D) using a pre-validated, structured instrument. Bivariate correlations between total awareness (TAWsS) and attitude domains - Beliefs & Screening Value (TBSVS), Perceived Barriers & Stigma (TPBPSS), and Behavioural Intent & Advocacy (TPIAS) were analysed using Spearman’s rho (ρ) and Kendall’s tau-b (τ_b). Independent predictors of outcome status were evaluated using multivariable binary logistic regression.

Results: High superficial familiarity with breast cancer existence (98%) and global prevalence (95%) contrasted sharply with substantial deficits in screening prognosis (only 29% recognized that early detection improves survival). Overall, 69% exhibited insufficient awareness. Although 90% endorsed the necessity of BSE education, 89% held negative or hesitant aggregate attitudes, driven by fear of diagnosis (60%), modesty taboos (60%), and procedural insecurity (40%, not knowing proper technique). Non-parametric correlations revealed complete statistical independence between awareness and attitude dimensions (τ_b range: - .002 to .066, p > .05: ☧ range: -.002 to .080, p > .05). Conversely, attitude domains exhibited strong mutual associations: TBSVS correlated positively with TPIAS (τ_b = .39, ☧ = .466, p < .001) and inversely with TPBPSS (τ_b = -.341, ☧ = -.415, p < .001). Multivariable logistic regression identified Beliefs & Screening Value as the sole independent predictor of favourable status (“aOR” = 8.332, 95%” CI: “2.080” – “33.371, p = .003), whereas baseline awareness, perceived barriers, and demographic covariates showed no significant adjusted predictive value (p > .05).

Conclusion: Cognitive knowledge alone is insufficient to cultivate screening behaviours. Pharmacy education must transition from didactic instruction to practical simulation training, addressing emotional stigma and reinforcing the clinical utility of BSE.