The American Cancer Society and other leading cancer agencies recommended monthly practice of BSE [11, 17]. However, this study indicated that a quarter participants have ever performed BSE, nonetheless as little as 47(13.1%) females implemented regular BSE. This finding supports the other researches done in Ethiopia which described a small number of the participants had performed BSE [12, 13, 18, 19]. In addition, a study conducted in Malaysia, Tamil Nadu, Cameroon, Iran and Nigeria indicated comparable findings [14, 20-24]. On the other hand, the study conducted in Northern and southern Ethiopia found that 37% and 45.6% of the participants had practiced BSE respectively, which is slightly higher than the current study and the reason could be due to the health workers were the study population in the previous studies [25, 26]. Furthermore, another studies conducted in Iraq and Ghana reported 48.3% and 80% respondents practiced BSE respectively, which is in contrary to the present study [27, 28].
The study revealed that half of the participants had heard about BSE. This is in line with studies done in Ethiopia and Nigeria that showed nearly similar findings [19, 21, 29]. An analysis done on BSE among women in developing countries reported also nearly three quarters of participants had previously heard about BSE [30]. In contrast, the study done on predictors of BSE among female teachers in Ethiopia revealed only 16.5 % participants ever heard about BSE [13]. Moreover, the finding is also in contrary with the studies done in Iraq and Ghana which indicated that the very large number of participants had heard of BSE [27, 28].
This study revealed that only 5.9% of the participants had a family history of breast cancer. The figure is in line with the study done in central Ethiopia [29]. On the other hand, the studies done in Malaysia, Iraq, United Arab Emirates and Saudi showed slightly higher breast cancer family history, which indicated 15%, 14%, 9.2%, 11% respectively [20, 31-33].
Regarding the sources of information about BSE, the majority mentioned mass media was the commonest source of information in the current study. This confirmed the other study done in the country which revealed the main source of information was mass media [29], additionally research conducted in Ghana, Iraq and Saudi also found out the main source of information being mass media [27, 28, 33].
As stated by literatures, the best time to do a monthly self-breast exam is about 3 to 5 days after period starts [11]. In the current study, as many as 38.1% of the females practiced BSE when it comes to their mind, and a third of them two to three days after session of menstruation. Contrarily, slightly improved result from Ghana described that when respondents were asked on the appropriate time for performing BSE, more than half stated that the appropriate time to perform BSW is some days after menstruation, and a quarter stated that there is no particular time to perform BSE [28]. Furthermore, a study done in Cameroon indicated as little as 10 (7%) participants knew the appropriate time to perform a BSE is few days after menstruation [24].
The majority stated the reason for performing BSE was for the purpose of early detection and treatment, followed by health provider recommendation, fear of developing breast cancer, family history, and the previous breast problem. Likewise, the finding from Malaysia is closely in agreement with this study as the majority identified the reason was to check their breast regularly, accompanied by family and personal history [20]. Moreover, the greatest reason for not practicing BSE was lack of knowledge of how to perform the technique correctly, then forgetfulness and didn’t have any breast problem. This is in agreement with the studies done in Ethiopia, Iran and Iraq, [12, 23, 25, 27, 29].
Significant knowledge insufficiencies can have a detrimental effect on the education of women on screening and early detection practices [34]. In the current study, knowledge about BSE was found to be the major predictor for practice of BSE, after confounding factors being controlled for. This outcome maintenances the investigation conducted by Birhane, Mamo [13] on predictors of breast self – examination among female teachers in Ethiopia. In addition, this finding is in consistent with the study done in Iran [23].
Besides, the present study showed that age was statistically associated with the practice of BSE. A study done on barriers to BSE practice among Malaysian female students reported consistent result with this study [20]. Likewise, a study done in Iran on need for greater women awareness of warning signs and effective breast screening methods revealed matching result [23]. However, there was no significant association between practice of BSE and selected variables, which is parallel with other study finding [32].
With regarding to the associated factors of knowledge about BSE, acquaintance to someone suffering with breast cancer, had heard about BSE, and advanced study year were statistically associated to BSE knowledge. This finding confirmed the study done in Ethiopia which indicated as the year of stay in the University increases the knowledge about cancer increases [12]. Moreover, a significant association were found between academic levels with knowledge of students regarding breast cancer self-examination. This is in line with the study done by Kumarasamy, Veerakumar [22] in Tamil Nadu which was found to be significantly associated with educational attainment.