Critical Knowledge Gaps in Breast Cancer Awareness and Early Breast Cancer Detection among Nursing Professionals: A Cross-Sectional Survey Revealing the Need for an Innovative, Partner-Supported, Lifestyle-Integrated Strategy for Early Breast Cancer Screening—The Brahams Protocol

Abstract

Background: Breast cancer remains the most frequently diagnosed cancer and a leading cause of cancer-related mortality among women worldwide. Nursing professionals play a pivotal role in breast cancer awareness, patient education, and early diagnosis; however, baseline knowledge gaps within this workforce remain inadequately characterised. This study evaluated breast cancer awareness and early detection knowledge among nursing professionals and provides the scientific rationale for the Brahams Protocol (BP), a lifestyle-integrated, partner-supported, shared-responsibility complementary breast cancer screening modality.
Methods: A questionnaire-based cross-sectional survey was conducted among 273 nursing professionals from Sarvodaya Hospital, Faridabad, and Sarvodaya Hospital, Noida, between April and June 2026. Participants completed a structured anonymous questionnaire immediately before educational sessions. Twenty-one knowledge items covering general awareness, risk/protective factors, screening, and warning symptoms were analysed. Comparisons between female and male participants were performed using chi-square or Fisher's exact tests where appropriate.
Results: General breast cancer awareness was relatively satisfactory (60.2%), whereas knowledge of risk and protective factors was poor (19.2%). Awareness of mammography as a screening tool was high (96.7%), but none of the participants knew that routine mammographic screening is generally not recommended for average-risk women younger than 40 years or that WHO recommends breast self-awareness rather than breast self-examination. Only 2.2% practised breast self-examination, and no participant reported clinical breast examination or breast cancer screening. Significant sex-based differences were observed for several knowledge domains (p<0.05).
Conclusions: Substantial evidence-based knowledge and behavioural gaps exist among nursing professionals despite satisfactory general awareness. These findings support the need for targeted educational interventions and provide the scientific rationale for prospective evaluation of the Brahams Protocol as a complementary breast cancer screening modality designed to strengthen continuous breast health vigilance, particularly in women younger than 40 years while complementing existing evidence-based screening pathways.