The Relationship Between Knowledge And Attitudes Of Young Women Towards Self-Breast Examination (Sadari)

Breast cancer can attack anyone, especially women, women's attitudes and awareness regarding breast health are still not well developed so that most cancer cases are found at an advanced stage, when early stage healing is very easy, and can be done at home. Just a few minutes, once a month, to do a breast self-examination. The research aims to determine the relationship between knowledge and attitudes of young women towards breast self-examination (BSE) at SMA Negeri 14 Medan City, North Sumatra Province in 2023. The conceptual framework used is based on dependent and independent variables. The research design is correlational. The research was conducted February 23-25 on 88 respondents. The research data were analyzed manually and using frequency distribution tables. Based on attitudes, out of 35 (100%), the majority of young women have negative attitudes and do not carry out conscious examinations. namely 35 (67.3%) people and a minority of young women who have negative attitudes and have carried out self-breast examinations. 17 (32.7%) P value = 1.000. It can be concluded that there is no relationship between young women's attitudes towards breast self-examination (BSE). For young women, it is hoped that every young woman will be responsive to changes, or the presence of lumps and pain that are felt or arise in the breasts. For health institutions, it is hoped that they can provide counseling and information so that young women are motivated to be able to routinely carry out self-examination of their breasts and teach the techniques and appropriate time to do it


INTRODUCTION
Adolescence is a very critical vulnerable period of human life because it is a transition stage from childhood to adulthood.At this stage, teenagers often do not realize that a stage of development has begun, but what is certain is that every teenager will experience changes, both physical, emotional and social (Dianawati, 2003).
Breast cancer cases in developing countries have reached more than 580,000 cases each year and approximately 372,000 patients or 64% of these cases die from this disease.WHO (Word Health Organization) data shows that 78% of breast cancer occurs in women aged 50 years and over, while 6% of them are less than 40 years old.However, many women in their 30s also suffer from this disease As you get older, it becomes more important to pay attention to breast health.Breast cancer is a disease that attacked more than a million women throughout the world in 2000.
One third of these sufferers were in Europe.Around 60% of breast cancer occurs in women over 60 years of age and the risk of developing this disease is highest after the age of 75 years (Ariavita, 2005).
The American Cancer Society recommends that from the age of 20 women have their breasts checked every three years until the age of 40.After that, inspections can be carried The Relationship Between Knowledge And Attitudes Of Young Women Towards Self-Breast Examination (Sadari) out once a year.Although lumps in the breast can be found before the age of 20, the potential for malignancy is very small (Setiati, 2009).
In advanced industrial countries, the most common cause of death is women over 50 years of age.The incidence of breast cancer increases 1-2% per year.In Germany the incidence is approximately 45,000 per year and deaths 19,000/year, equivalent to 45 deaths per 100,000 women.The incidence increases with increasing age.Women with genetic changes are found to have breast cancer as much as 70-90% (Bazied, 2003) In Indonesia, breast cancer is the second most common cancer suffered by women after oral/cervical cancer.Breast cancer generally attacks women who are over 40 years old.
However, even young women can get this cancer.More than 1 million new cases occur every year throughout the world, placing breast cancer as the most common malignancy found in women.One in 8 women will be diagnosed with breast cancer by the age of 80 years (Schorgen, 2007).
Breast cancer is the second most common cancer in women, and affects 1 in 14 Another fact shows that around 85% of women find lumps in their own breasts by feeling (Schorgen, 2007).
For women over 20 years of age or those who are at high risk, it is recommended that they take an active role in detecting breast cancer early or not, namely that they are advised to routinely carry out breast self-examination (BSE) because in research it turns out that 75% to 85% of breast cancers are discovered during breast self-examination.Based on the description of the problem above, teenagers are at high risk of breast cancer and tumors, so it is very important for young women to know, understand and be encouraged to take an active role in early detection of the presence or absence of breast cancer, namely that they are routinely advised to perform breast self-examination (BSE).Based on Table 2. above it can be seen that the majority of young women with sufficient knowledge are 51 people (58%) and the minority of young women with insufficient knowledge is 5 people (5.7%).

METHODS
Table 3.Frequency Distribution of Young Women's Attitudes Regarding Self-Breast Examination (BSE) in SMA Negeri 14 Medan City, North Sumatra Province in 2023 Based on Table 3 above, it can be seen that the majority of Young Women had a negative attitude as many as 52 people (59.1%) in the awareness examination.(84.3%), and the minority of young women who have sufficient knowledge and carry out conscious examinations are 8 people (15.7%).With P value = 0.000

Breast Self-Examination (BSE)
Based on table 1, it can be seen that the majority of young women do not carry out breast self-examination, namely 60 people (68.2%), and 28 people (31.8%) do it, so it can be seen that there are more young women who have never done breast self-examination.
compared to those who perform breast self-examination.Breast Self-Examination (BSE) is an inseparable part of every woman's breast examination.Breast self-examination is carried out once a month and can be an effective screening instrument to detect breast lesions (Varney, 2007).Another research conducted by Kardinah ( 2005), shows that in Indonesia very few women want to do breast self-examination because it can create frightening images, and they may find something they don't understand what it means.

Knowledge
Based on table 2. Based on the table above, it can be seen that the majority of young women with sufficient knowledge are 51 people (58%) and the minority of young women with insufficient knowledge is 5 people (5.7%).Knowledge is the result of knowing, and this occurs after people sense a particular object.Most human knowledge is acquired through the eyes and ears.Knowledge or cognitive is a very important domain in shaping a person's actions.A person's level of knowledge is systematically very difficult to measure.So, to measure the respondent's knowledge, it is seen from their ability to express their opinion to answer the questions asked.Based on these answers, the level of knowledge of respondents can be divided into three categories, namely; Good, Fair, Poor (Notoatmodjo, 2003).
From table 4, it can be seen that of the 51 (100%), the majority of young women who have sufficient knowledge and do not carry out conscious examinations are 43 (84.3%), and the minority of young women who have sufficient knowledge and have carried out conscious examinations are 8 people (8 people).15.7%).With P value = 0.000.
Nursalam ( 2003) also stated the results of bivariate analysis, namely the decision to accept the Ha hypothesis if the P value (P value) is smaller than α (alpha) or (p<0.05),then the decision is to accept the Ha hypothesis.Conversely, if the P value is greater than alpha The Relationship Between Knowledge And Attitudes Of Young Women Towards Self-Breast Examination (Sadari) (p>0.05) then the hypothesis is rejected It can be concluded that there is a relationship between adolescent girls' knowledge of breast self-examination (BSE).Based on the data above, researchers can conclude that respondents or young women have sufficient knowledge about breast self-examination.Where young women don't know the importance of awareness checks and the benefits of awareness, so they know but don't want to have an examination.It is necessary to educate young women from health workers to detect the possibility of tumors or cancer early.
In another study, Kardinah (2005) argued that due to the lack of knowledge and minimal information among adult women about breast self-examination, they often ignore the ability and willingness to carry out early detection, resulting in higher rates of breast cancer being found in women in advanced stages.Information and publication efforts regarding early anticipation of breast cancer attacks and how to refer sufferers from the lowest health services to special hospitals that treat cancer have not been well managed.The results of this study show that the majority of respondents are categorized as having sufficient knowledge regarding breast self-examination in young women, namely 43 respondents (58.9%) out of 73 respondents, this is due to the lack of students getting information from both mass and electronic media, and the lack of active students.looking for information about breast self-examination.So, it is hoped that young women can increase their knowledge about how to self-examine their breasts through counseling carried out by schools in collaboration with health workers, as well as ways to increase awareness of young women about reading health books.

Attitude
Based on table 3, it was found that the majority of young women had negative attitudes as many as 52 people (59.1%) in the awareness examination.
For women over 20 years of age or those who are at high risk, it is recommended that they take an active role in detecting breast cancer early or not, namely that they are advised to Instilling awareness in young women to be able to maintain cleanliness and self-care, so that young women can be aware of the changes that occur to them.In general, this disease is discovered in sufferers late in life, so treatment becomes more difficult and expensive.
With this condition, it is hoped that all health cadres can help the community and themselves to be able to carry out prevention by implementing a clean, healthy and balanced lifestyle and carrying out early detection by one way of doing breast self-examination (awareness).

CONCLUSION
1.The majority of young women did not undergo awareness checks, namely 60 people (68.2%).
2. The majority of young women with sufficient knowledge were 51 people (58%) and the minority of young women with insufficient knowledge was 5 people (5.7%).
3. The majority of Young Women had a negative attitude, 52 people (59.1%) in the awareness examination.
4. There is a relationship between the attitude of young women towards breast selfexamination (BSE).
5. There is no relationship between young women's attitudes towards breast self-examination (BSE).

SUGGESTION
1.For Young Women, it is hoped that every young woman will be responsive to changes, or the presence of lumps and pain that are felt or arise in the breasts 2. It is hoped that health institutions, especially midwives, can motivate young women to routinely carry out breast examinations themselves and teach them the techniques and the appropriate time to do so.
3. Educational institutions can create students who are reliable and can play a good role in society The Relationship Between Knowledge And Attitudes Of Young Women Towards Self-Breast Examination (Sadari)

E
-ISSN: 29621178-P-ISSN: 2962-0880, Page 29-36 Data obtained at Idi Rayeuk Hospital in 2009-2010 saw the number of sufferers diagnosed with breast cancer, namely 10 people aged 15-20, 3 people aged 21-35, while 2 people aged >35-50.women and those diagnosed with benign tumors or mammary fibrioadenoma, namely 32, aged 10-20 years, namely 15 people, aged 21-35 years, namely 12 people and aged >35-50 years, namely 5 women (Registration RSU Idi, 2010).Based on data obtained at schoolSMA Negeri 14 Medan City, North Sumatra Province in 2023 with a total of 70 class I and II female students.Initial research on 10 female students, it was found that 80% of students did not know about the technique and the right time to self-examine their breasts as an early detection of tumors or breast cancer.Kurnia's research (2012) on the level of knowledge of young women regarding breast self-examination (BSE) at Madrasah Aliyah Negri I Surakarta, resulted in the level of knowledge of young women being in the sufficient category, namely 87 respondents (72.5%).These results show that young women at MAN 1 Surakarta know BSE well enough According to the results of research by Niatilina (2006) regarding breast selfexamination at SENIOR HIGH SCHOOL Harapan Hamparan Perak class II, the majority of respondents who knew about BSE were 22 people (62.9%) who had less knowledge, while class I was a minority of 13 people (37, 1%) who have sufficient knowledge.

Table 1 .
Research design is correlational.This research used a cross sectional design.This research was conducted SMA Negeri 14 Medan City, North Sumatra Province in 2023.The population in this study isAll female students in class I and II at SMA Negeri 14 Medan City, Data collection has been carried out by researchers from date February 23-25 2023,on 88 respondents inSMA Negeri 14 Medan City, North Sumatra Province in 2023 with the following results: Frequency Distribution of Self-Breast Examination (BSE) by Young Women in SMA Negeri 14 Medan City, North Sumatra Province in 2023Based on Table1above, it can be seen thatthe majority of young women did not undergo awareness checks, namely 60 people (68.2%).Table 2. Frequency Distribution of Respondents' Knowledge of Providing Supplementary Food to Babies Aged 0-6 Months at SMA Negeri 14 Medan City, North Sumatra Province, 2023

Table 4 .
Frequency Distribution of the Relationship between Young Women's Knowledge of Breast Self-Examination (BSE) in SMA Negeri 14 Medan City, North Sumatra Province in 2023 Based on Table 4 above can be seen that out of 51 (100%), the majority of young women have sufficient knowledge and do not carry out conscious examinations are 43 E-ISSN: 29621178-P-ISSN: 2962-0880, Page 29-36 This condition makes it quite difficult to treat quickly and discover early stage cancer cases.According to the results of research by Niatilina (2006) regarding breast selfexamination at Senior High School Harapan Hamparan Perak class II, the majority of