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Female Workers’ General Knowledge Regarding Breast Cancer: an Educational Program

Sahar Gamal Mohamed, Fatma Saber Nady, Hanan Elzeblawy Hassan*

Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt

Abstract: Background: Breast tissue density is higher in younger women with lower body mass indexes, especially during pregnancy, nursing, or hormone therapy. Increased obesity raises breast cancer risk, linked to more aggressive tumor characteristics. Physical exercise can reduce this risk, particularly for women with a family history of the disease, by lowering exposure to endogenous sex hormones and modifying immune responses, even in those without such a history. Aim: Evaluate the effect of an educational program on female workers’ general knowledge regarding breast cancer. Subjects and Methods: Design: A quasi-experimental design was utilized in conducting the study. Sample & Settings: A purposeful sample of 323 working women from Beni-Suef University aged 18-60 years. Tools: A structured interviewing questionnaire sheet, women's general knowledge about breast cancer, and supportive material (Arabic booklet). Results: 45.8% have a university education, 75.9% are married, and 69.0% are urban residents. A statistically significant improvement in female workers’ knowledge regarding total general information about breast cancer during the posttest as p≤0.05 was found. The 1.5% of females who had university education had good knowledge before the program, which increased to 30.4% after the program. Conclusion: Based on the findings of the present study, it can be concluded that there was a statistically significant improvement in female workers’ knowledge regarding general information about breast cancer during the posttest, as noticed in the present effect of the program. Recommendations: During significant events like Breast Cancer Awareness Month, workplace awareness programs are expanded to promote breast cancer prevention.

Keywords: General Knowledge, Breast Cancer, Educational Program

Received February 07, 2026; Revised March 08, 2026; Accepted March 15, 2026

Citation: Sahar Gamal Mohamed, Fatma Saber Nady, Hanan Elzeblawy Hassan, Female Workers’ General Knowledge Regarding Breast Cancer: an Educational Program. Journal of Cancer Research and Treatment, 14 (1). 1-8. January 2026. doi:10.12691/jcrt-14-1-1

1. Introduction

Breast tissue density changes over a lifetime and is categorized into low-density, high-density, and fatty breasts [1,2,3,4]. Younger women with lower body mass index exhibiting pregnancy, lactation, or hormone replacement therapy have higher breast density. Increased breast tissue density is generally associated with a higher risk of breast cancer in both premenopausal and postmenopausal women [5,6,7,8,9,10].

Research shows that obesity heightens breast cancer risk, particularly in post-menopausal women, with higher Body Mass Index (BMI) linked to more aggressive tumor characteristics [11,12,13,14,15]. Regular exercise appears to reduce breast cancer risk for postmenopausal women, regardless of family history, potentially due to lower exposure to endogenous sex hormones, altered immune responses, or increased levels of insulin-like growth factor-1 [16,17,18,19,20].

Insufficient vitamin supplementation may impede breast cancer prevention, with ongoing research into vitamins C, E, B-group, folic acid, and multivitamins. High levels of 25-hydroxyvitamin D correlate with reduced breast cancer incidence [21,22,23,24] [25,26,27] [28,29,30]. The WHO classifies processed beef and saturated fats as Group 1 carcinogens, associated with increased breast cancer risk, while ultra-processed foods contribute to obesity and an 11% rise in breast cancer risk per 10% consumption increase [31]. A diet rich in fruits, vegetables, whole grains, and lean protein is linked to lower risk, with protective foods including those high in n-3 polyunsaturated fatty acids, vitamin D, fiber, folate, and phytoestrogens, along with recommendations to reduce saturated fats and n-6 polyunsaturated fatty acids. Green tea may also offer anti-cancer properties [32].

Tobacco carcinogens heighten breast tissue vulnerability to genetic alterations, increasing cancer risk for smokers. Women with a family history of breast cancer often smoke more, starting before their first pregnancy [33]. Alcohol consumption further raises estrogen levels, contributing to hormonal imbalances and the risk of estrogen-positive breast tumors, especially when consumed before the first pregnancy, resulting in harmful changes in breast tissue [34].

A variety of breast cancer treatment options include hormone therapy, chemotherapy, radiation therapy, and surgery [35,36]. Breast cancer surgeries vary in extent and invasiveness. A lumpectomy removes the tumor and a small margin of surrounding tissue while preserving the breast [37,38,39,40,41,42]. A partial mastectomy involves removing a larger section, potentially including some chest muscle linings. Skin-sparing mastectomies retain breast skin but remove the areola, nipple, and lymph nodes, often chosen for future reconstruction [36]. A simple mastectomy deletes the entire breast and associated lymph nodes, while a modified radical mastectomy also removes axillary lymph nodes but preserves the chest wall [43]. Chemotherapy employs a combination of drugs to kill or inhibit the growth of cancer cells, with medication selection based on tumor characteristics and the extent of cancer spread [44].

Nurses play a frontline role in assessing risk and implementing preventive measures and are crucial to minimizing cancer prevention, management, and education; moreover, they understand women’s knowledge, attitudes, and practices concerning risk factors and preventive measures. Maternity nurses play a crucial role in improving women’s knowledge about Body Mass Index, diet, vitamin supplementation, exercise, and various breast cancer treatments, which provides women with education and support. At the same time, the nurse can provide health promotion and psychosocial services, including assessment, health education, counseling, and appropriate referrals [45,46,47]. Hence, the current study was conducted to evaluate the effect of an educational program on female workers’ general knowledge regarding breast cancer.

2. Subject and Method

Research design:

The study employed an interventional, quasi-experimental research design with a pretest and a posttest to achieve its objectives.

Subjects and Settings:

As a purposeful sample, 323 working women between the ages of 18 and 60 who were not suffering from cancer, chemotherapy, radiation, or psychological disorders were selected from Beni-Suef University.

Tools of data collection:

Tool I: A Structured Interviewing Questionnaire Sheet

The researcher created it after reviewing pertinent literature. It focused on the age and educational attainment of the female subjects, among other personal information.

Tool II: women's general knowledge about breast cancer

The study aimed to evaluate women's general information about breast cancer, such as the definition of breast cancer, a woman's risk of developing breast cancer, warning signs, the primary treatment for early-stage breast cancer, the purpose of chemotherapy in breast cancer treatment, the purpose of radiation therapy in breast cancer treatment, the most common site of breast cancer metastasis, screening procedures for early detection, and the importance of screening for breast cancer treatments (14 Questions). System of scoring: All questions received a total score of degrees, with correct responses earning points and incorrect ones gaining zero points, with categories including good, average, average, and poor scores.

Tool III: Supportive material (Arabic booklet):

Supportive material in the form of an Arabic booklet provides essential information on breast cancer, including its definition, signs, symptoms, risk factors, types, stages, diagnosis, and treatments in Part I. Part II discusses preventive measures such as maintaining a healthy weight, diet, and exercise, along with recommendations to limit hormone therapy, encourage early childbearing, pregnancy, and breastfeeding, and avoid tobacco, alcohol, and environmental toxins, while promoting breast self-examination.

Fieldwork

Preparatory phase:

The researcher utilized a review to develop data collection tools, which were then evaluated by an expert jury to ensure content, knowledge, accuracy, and relevance.

Phase (I): Assessment phase:

The pretest assessment aims to evaluate the general knowledge of females about breast cancer through interviews, collecting personal characteristics data and establishing a baseline for comparison and evaluation of the educational program's effectiveness.

Phase (II): Planning phase:

The researcher developed an instructional program based on pre-test data to improve females' knowledge about breast cancer, tailored to their needs based on their pre-test scores.

Phase (III): Implementation phase:

Program implementation included a theoretical session aimed to acquire women with general knowledge regarding breast cancer through an explanation of the definition of breast cancer, the most commonly gender-affected, risk factor for breast cancer, the primary treatment for early-stage, the purpose of chemotherapy in treatment, definition of metastatic breast cancer, hormone is associated with growth of types, purpose of radiation therapy in treatment, the symptom of advanced breast cancer, purpose of hormone therapy in treatment, the most common site of breast cancer metastasis, the symptom of inflammatory breast cancer, not a common risk factor for breast cancer, modern methods used for early detection of breast cancer.

Phase (IV): Evaluation phase:

Post-tests assessed female participants' knowledge and practices of preventive behaviors, with abnormal signs referred to maternal healthcare centers for further investigation.

Statistical Design:

The data was analyzed using SPSS version 20 to compare women's understanding and practice of preventative behaviors before and after implementation, with p-values 0.05 indicating statistical significance.

3. Results

Table 1 shows that, at the age of 21.7% of the studied female workers, the age more than 40 years. The study reveals that 45.8% of female workers have a university degree, 75.9% are married, 69.0% are urban residents, and 84.2% have sufficient monthly income.

Table 1. Percentage distribution of the studied female workers regarding to their socio-demographic data (n=323)

Table 2 shows that there was a statistically significant improvement in female workers’ knowledge regarding general information about breast cancer during the posttest as p ≤ 0.05 in all items compared to the pretest, as noticed that more than one third (35.0%, 36.2%, 36.5%, & 37.2%) of females had correct answers in the pretest, which improved to nearly three quarters and more (73.7%, 79.9%, 71.5%, & 72.8%) of them had correct answers after the intervention, respectively.

Table 2. Percentage distribution of the studied female workers’ knowledge regarding general information about breast cancer (n=323)

Figure 1 shows that there was a statistically significant improvement in female workers’ knowledge regarding total general information about breast cancer during the posttest as p ≤ 0.05. It is noticed that 72.1% & 13% of females had poor & good knowledge at pretest which improved to 10% & 72.4% after the intervention, respectively.

Figure 2 reveals the relation between age of the studied female workers and their total knowledge about breast cancer. It clarifies that there is no statistically significant relationship between age and total knowledge score pre & post-test. 2.8% of females aged 30 to less than 40 years had good knowledge pretest, which improved to 31.3% during the posttest.

Figure 3 presents relationship between the studied female workers' total knowledge score with their educational level. The 1.5% of females who had university education had good knowledge before the program, which increased to 30.4% after the program.

Figure 1. Total General Information about breast cancer per and post implementation of the educational program, (p value = 0.05*)

Figure 2. Relation between the studied female workers’ age and their total knowledge about breast cancer

Figure 3. Relation between the studied female workers’ educational level and their total knowledge about breast cancer

4. Discussion

Breast cancer treatment options include hormone therapy, chemotherapy, radiation therapy, surgery, and targeted therapy. Surgery, including lumpectomy and mastectomy, is popular for removing tumor and surrounding tissue. Chemotherapy, a medication-based treatment, targets cancer cell growth based on factors like tumor size, stage, and spread risk. The aim of the study was evaluating effect of an educational program on female workers’ general knowledge regarding breast cancer.

Concerning general knowledge of breast cancer, the current study revealed that there was a statistically significant effect of the health education program on improvement in the female workers’ total general knowledge level about breast cancer, as prior to the health education program, only one-tenth of them had a good level of knowledge, whereas, after one month, the percentage improved to nearly three-quarters. This finding demonstrates that the program was effective in increasing women's knowledge about breast cancer, as it provided women with sufficient knowledge regarding breast cancer risk factors, signs and symptoms, and treatment.

The finding was in the same line with Rakhshani et al. (2022), who studied “the effect of educational intervention on knowledge, attitude, and practice of women towards breast cancer screening in Iran” and showed that there was a significant difference observed after the intervention, with the experimental group obtaining significantly higher mean scores of knowledges [48]. Also, this finding agrees with Mahmoud et al. (2020), who proved that there were improvements in the studied women's knowledge scores regarding breast cancer post-model implementation [49]. Also, this finding is supported by Eittah et al. (2014), who investigated the “effect of health education on raising female students’ awareness' regarding breast cancer in Saudi Arabia” and clarified that there was a statistically significant difference regarding posttest knowledge about breast cancer [50].

Regarding the relationship between the studied female’s total knowledge score and their age (pre- & post-program), the current study revealed that there was an improvement in women’s total knowledge for all age categories. However, more progression was observed among women aged 30-40 years, in which the minority of females their age, from 30 to less than 40 years, had a good knowledge pretest, which improved to around one-third during the posttest. This finding is supported by Ahmed et al. (2019), but conversely, this finding is in contrast with Kumarasamy et al., (2017) [51,52]. This may be due to increased age, and women are overburdened with their work and domestic responsibilities. Additionally, as the incidence of breast cancer increases by age, this may be explaining the improvement of knowledge among this age group after implementation of the program.

Also, there was an improvement in the studied female workers’ total knowledge score and their educational level during the posttest. This reflects the effect of the program on whatever women’s educational level. The minority of females who had university education had good knowledge before the program, which increased to nearly one-third after the program. This finding is similar to other research that showed that there was a significant positive relationship between the total knowledge scores of the studied group and their level of education [53,54,55,56] [57,58,59,60] [61,62,63,64]. This result was expected, as level of education, surely, affects level of understanding, awareness, cooperation, and interaction with the educational program.

The results of the current study declare the women’s total knowledge was improved after the implementation of the program sessions; the results indicated that there is a significant increase in women’s knowledge. Moreover, the progression of good women’s grading and regression of poor women’s grading after the implementation of sessions compared to before. This improvement could be attributed to the attending of the sessions and the lecture and positive reinforcement or the long-term retention of knowledge, as well as a wide variety of educational methods used [65,66,67,68] [69,70,71] [72,73].Additionally, the distributed Arabic booklets also played a crucial role in attaining and retaining knowledge. Booklets are best used when they are brief, written in plain language, and full of good pictures and when they are used to back up other forms of education. This is in accordance with Edgar Dale’s or the NTL’s Pyramid of Learning as cited by Masters, as the pyramid illustrated that individuals can retain 10.0% of what they read and 20.0% of what they see and hear (audiovisual). The same author added that one can retain 50.0% of what he learned by a discussion [74,75,76,77] [78,79,80,81] [82,83,84,85] [86,87,88,89] [90,91,92]. From the researcher's point of view, females who had intermediate education didn’t have enough information and knowledge before the program, but after the end of the educational program, they had enough information, which indicates the success of the educational guidance program.

Conclusion and Recommendations

Based on the findings of the present study, it can be concluded that there was a statistically significant improvement in female workers’ knowledge regarding general information about breast cancer during the posttest as noticed that presents effect of the program. During significant events like breast cancer awareness month, workplace awareness programs are expanded to promote breast cancer prevention.

Ethics Approval

Ethical approval for the study was obtained from the Research Ethics Committee at the Faculty of Medicine, Beni-Suef University.

Ethical Concern and Informed Consent

Consents were obtained from all females participating in the study after a brief explanation of the study's aim, and they were reassured that the information obtained was private and used only for the study, with the right to withdraw at any time without any consequence. The subject of this study did not address religious, ethical, moral, or cultural issues among women.

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[56]   | Nady F., Zaki S., Hassan H. Assess Health Belief Model of Breast Cancer and Its Preventive Measures among Beni-Suef University Female Workers. International Journal of Clinical Research and Reports, 2025; 4(1).
[57]   | Zaki S., HassanH., Nady F. Breast Self-Examination Practices: An Educational Program for Female Workers’ at Beni-Suef University. Journal of Community Medicine and Public Health Reports, 2025; 6(2).
[58]   | Hassan H., Zaki S., Nady F. Effect of an Educational Program on Female Workers’ Knowledge about Breast Cancer Preventive Measures at Beni-Suef University. American Journal of Nursing Research. 2025; 13(1):1-10.
[59]   | Zaki S., Nady S., Hassan H. Preventive Measures of Breast Cancer Female Workers’ Knowledge, Journal of Clinical and Laboratory Research, 2025; 8(2): 1-6.
[60]   | Hassan H., Zaki S., Nady F. Female Workers’ Socio-demographic characteristics and Their Total Knowledge about Breast Cancer: Effect of an Educational program at Beni-Suef University, International Journal of Nursing Science, 2025; 15(1): 1-8.
[61]   | Zaki S., Hassan H., Nady F. Female Workers’ Knowledge about Breast Cancer at Beni-Suef University: Effect Socio-demographic Characteristics. American Journal of Public Health Research, 2025; 13(3):140-144.
[62]   | Hassan H., Nady F., Zaki S. Northern Upper Egyptian Female Workers’ Beliefs Regarding Breast Cancer according to Health Belief Model: Effect of an Educational Program. Public Health Open Access, 2025; 9(1): 1-12.
[63]   | Zaki S., Nady F., Hassan H. Female Workers’ Total Practices Regarding Breast Self-Examination at Beni-Suef University. Journal of Clinical and Laboratory Research, 2025; 8(2): 1-12.
[64]   | Nady F., Zaki S., Hassan H. Study Relation between Female Workers’ History and Their Knowledge about Breast Cancer, Breast-Self-Examination and Preventive Measures. Journal of Pediatric Advance Research, 2025; 4(1):1-9.
[65]   | Hassan H., Abd-ELhakam F., Kasem E. Androgen-related Alopecia and Infertility: Impact of Lifestyle Modifications. International Journal of Clinical Research and Reports, 2025; 4(2): 1-6.
[66]   | Hassan H., Abd-ELhakam F., Ali E. Effect of Life Style Modification Implemented Program Among Infertile Women with Poly Cystic Ovary Syndrome on Obesity and Menstrual Regulation. Journal of Clinical and Laboratory Research, 2025; 8(2): 1-7.
[67]   | Abd-Elfattah N., Mohamed A., Hassan H. Study women's attitude regarding Oocyte Cryopreservation: The Impact of an Educational Initiative. American Journal of Public Health Research, 2025; 13(5).
[68]   | Hassan H., Nady F., Zaki S. Female’ Knowledge about Breast-Self-Examination: Effect of an Educational Program. ARC Journal of Nursing and Healthcare. 2025; 11(1):14-22.
[69]   | Hassan H., Abd-ELhakam F., Ali E. Poly Cystic Ovary Syndrome: Impact of lifestyle modifications among overweight and obese infertile women. ARC Journal of Nursing and Healthcare. 2025; 11(1):1-13.
[70]   | Hassan H., Abd-ELhakam F., Ali E. Infertility and Obesity: Impact of Lifestyle Modification. American Journal of Nursing Research, 2025; 13(3): 59-67.
[71]   | Abd-Elhakam F., Ali E., Hassan H. Effect of Lifestyle Modifications on Fertility and Menstrual Regularity among Infertile Obese Women with Polycystic Ovarian Syndrome. Menoufia Nursing Journal, 2025; 10(2):187-205.
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[73]   | Hassan H., Abd-ELhakam F., Kasem E. Knowledge about Preventive Measures of Breast Cancer: Educational Program. Journal of New Medical Innovations and Research, 2025; 6(5): 1-8.
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[75]   | Hassan H., Abd-ELhakam F., Kasem E. Hirsutism among Infertile Women: Impact of Lifestyle Modifications. Journal of New Medical Innovations and Research, 2025; 6(5); 1-7.
[76]   | Hassan H., Abd-ELhakam F., Kasem E. Effect of Dietary Habit Modification on Ovulatory Features and Symptoms Experienced among Studied Infertile Overweight and Polycystic Ovary Syndrome. Journal of New Medical Innovations and Research, 2025; 6(7): 1-8.
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[78]   | Hassan H., Gooda W., Nashed N. Correlation between Women’s Knowledge, Life Style and Impact Level of Social Networking Sites on Women After Abortion Using Counseling Based On PLISSIT Model. American Journal of Public Health Research, 2025; 13(5): 199-207.
[79]   | Hassan H., Gooda W., Nashed N. Post Abortion Women's Life Style: Impact of Counseling Based on PLISSIT Model. American Journal of Nursing Research, 2025; 13 (4): 89-96.
[80]   | Nashed N., Hassan H., Gooda W. Impact of Post Abortion Counseling Based on PLISSIT Model on Women's Life Style. Egyptian Journal of Health Care, 2025; 16 (2): 1009-1028.
[81]   | Hassan H., Mohamed A. Elfattah N. Working Females’ Knowledge, Attitude, and Intention at Beni-Suef University regarding Oocyte Cryopreservation: Effect of an Educational Program. American Journal of Nursing Research. 2025; 13(4):97-102.
[82]   | Hassan H., Abd-ELhakam F., Kasem E. Relationship between Infertile Overweight and Polycystic Ovary Syndrome Women’s Characteristics and Lifestyle Habits: An Interventional Study. Journal of General medicine and Clinical Practice, 2025; 8(8): 1-7.
[83]   | Masoud H., Mohamed H., Hassan H. Effect of An Educational Program on Pregnant Women’s Knowledge Regarding Possible Side Effects of Drugs Used During Pregnancy on Fetus and Mother. American Journal of Pharmacological Sciences, 2026; 14(1): 1-6.
[84]   | Abd-ELghafar F., Hassan H., Ali E. Lifestyle modifications among infertile women with poly cystic ovary syndrome. Nursing & Care Open Access Journal, 2026; 12(1):1‒10.
[85]   | Mohamed A., Hassan H., Mohamed N. Oocyte Cryopreservation Knowledge, Attitude, and Intention Effect of an Educational Program on Working Females at Beni-Suef University. Journal of Health Care Research, 2026; 3(1): 199-221.
[86]   | Hassan H., Nashed N., Gooda W. Impact of Counseling Based on PLISSIT Model on Women’s Knowledge Regarding Modern Educational Information about Abortion. Nursing & Care Open Access Journal, 2026; 12(1): 15‒22.
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[89]   | Gaafr H., Saad H., Hassan H., Omran A. (2026). Maternity Nurses’ Knowledge Regarding Nursing Care of First Stage of Normal Labor and Partogram Through Instructional Package. Journal of Women Health Care and Issues, 9(1): 1-8. DOI:10.31579/2642-9756/256
[90]   | Nady F., Zaki S., Hassan H. (2026). Beni-Suef University Female Workers’ Breast Self-Examination Practices. International Journal of Family & Community Medicine, 10(1): 42-47. DOI: 10.15406/ijfcm.2026.10.00410
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[92]   | Abd-ELhakam F., Kasem E., Hassan H. (2026). Effect of Physical Activity Habit Modifications on Gynecological Features among Studied Infertile Overweight and Polycystic Ovary Syndrome. American Journal of Nursing Research, 14(1)1: 1-7. doi: 10.12691/ajnr-14-1-1.