Background and Aim: Breast cancer is the most common cancer worldwide and the cause of about 18% of all malignancies in females. By breast self-examination (BSE) it is possible to diagnose a breast tumor in the preliminary stages and treat it. Basic changes in the knowledge, attitude and practice of women as regards regular BES and follow-up will lead to considerable success in campaigns against breast cancer. Considering the role and responsibilities of community health workers (CHWs) in the health services delivery system in the Islamic Republic of Iran, this study aimed at determining the knowledge, attitude and practice of female CHWs as regards BSE in 2006.

Methods and Materials: This was a cross-sectional study conducted on 89 female CHWs in the Iranian Mako township health houses. The data was collected through interviews using a questionnaire consisting of 4 sections, the first section containing 10 demographic questions, and the second to fourth sections containing 33 questions on knowledge, attitude, and practice. The validity and reliability of the questionnaire were confirmed using the repeat testing with r=85%. The data were analyzed using the SPSS software (version 11).

Results: The data showed that the BSE knowledge of 50.6% and 49.4% of the subjects was good and moderate, respectively; 76.4% of them had a positive attitude towards BSE. The reasons for not self-examination were as follows: inability to do it alone (12.4%); fear of a positive result, i.e., existence of a tumor (1.1%); having no time (2.2%); fear of increased anxiety (5.6%); not believing in BSE, even if it was likely to have a tumor (11.2%). Further analysis of the data showed the practice of the subjects to be good, moderate, and weak in 9%, 61.8%, and 29.2% of the cases, respectively.
There were significant associations between knowledge and a positive attitude (p=0.038), between attitude of the unmarried subjects towards performing BSE as compared to the married subjects (p=0.00), and between attitude and practice (p=0.045).

Conclusion: This study showed a moderate to good knowledge, a relatively good attitude, and a moderate practice among female CHWs in the Makoo Township, Iran, with regard to BSE. Considering the role of CHWs, improving their knowledge, attitude , and practice of BSE is essential.