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The breast self-examination (BSE) behavior of 142 women referred to a large cancer center with malignant or benign breast disease was investigated. The women were interviewed about their BSE practices and variables that may have influenced their BSE behavior. Those reporting prior BSE practice were asked to demonstrate their breast examination to a trained nurse, who rated their performance against a set of standard criteria. Although it might be assumed that these women have had more opportunity to become educated about BSE, results showed the ratings of the women's performances were uniformly poor. Less than half reported having formal instruction by a medical professional. This is of particular consequence considering that those women taught by a doctor or nurse performed significantly more BSE steps than did those taught in other ways. Women who were encouraged to do BSE by friends or relatives also performed significantly more steps. Based on the study findings, specific recommendations are made, which can be applied to the improvement of BSE educational programs.