Screening is a key component of breast cancer early detection programs that can
considerably reduce relevant mortality rates. The purpose of this study was to determine
the breast cancer screening behavioral patterns and associated factors in women over
40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of age
women visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling.
The data were collected using the sociodemographic characteristics questionnaire, breast
cancer perception scale, health literacy for Iranian adults scale, and the Breast Cancer
Screening Behavior Checklist. The obtained data were analyzed in SPSS version 16 using
descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential
statistics (univariate and multivariate logistic regression analyses). In total, 68.3% of all
participants performed breast self‑examination (BSE) (9.9% regularly, once per month),
60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year),
51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwent
sonography (3.8% regularly, twice per year). The findings also showed that women with
benign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21;
P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography
(OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderate
breast cancer perception scores were more likely to perform BSE than women with high
breast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women who
had a history of benign breast disease were more likely to perform screening behaviors than
others (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 were
more likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE
(OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participation
of women in regular breast cancer screening, it is suggested that health care providers
highlight the need for screening at the specified intervals in their training programs. In
addition, health authorities are recommended to use reminder systems to remind women,
especially those over 40 years of age, of the best time for breast screening. Moreover, health
care providers must seek to improve breast cancer knowledge, attitudes, and perceptions
of women who visit health centers, which are the first level of contact with the healthcare
system for the general population.