Although it is acknowledged that appropriate breast support during exercise is important, no published literature has assessed breast support usage in a cohort of female marathon runners. This study aimed to identify sport bra use and perceived importance of sports bra use in female marathon runners. Bra satisfaction, incidence of bra related issues and factors that influence the appropriateness of sports bras were also investigated. A 4-part, 30-question survey was administered to 1397 female runners at the 2012 London marathon registration and via an online survey. In total 1285 surveys were completed. Sports bra use and its perceived importance was high, however was lower in moderate compared to vigorous activity, and lower in participants with smaller breasts. Seventy-five per cent of participants reported bra fit issues. The most common issues were chaffing and shoulder straps digging in, with a higher incidence of issues reported by participants with larger breasts. Use of professional bra fitting was low, and perceived knowledge of breast health was poor. Engagement with sports bra use is high although sports bra design could be improved to alleviate bra fit issues experienced by female runners. Educational initiatives are needed to ensure females are informed regarding the importance of breast support and appropriate bra fit during activity.

Mastalgia was experienced by a third of marathon runners and was found to be related to breast size which has previously been unreported. The link between exercise and mastalgia has yet to be established; however, this study identified that exercise was the most prevalent factor in mastalgia occurrence which may have implications for its management. The number of participants who took no measures to relieve their mastalgia, or resorted to pain medication, highlights the importance and significance of research into exercise-related mastalgia.

As most of the breast concerns raised in this survey could be addressed via education and 87% of girls wanted to know more about breasts, this study demonstrates a need for breast education for school girls, which may reduce the influence of the breast on sport and exercise participation.

Schools are fundamental settings for health education and adolescent females are an important group for promoting positive breast habits. We surveyed 2089 schoolgirls (11-18 years) to provide evidence for, and guidance on, breast education for schoolgirls. 26% reported negative feelings about their breasts and 87% reported ≥ one breast concern. 72% wanted to know more about breast cancer (69% rating this extremely important). >50% wanted to know more about breast sag and breast pain. Preferred delivery format was age eleven (50%), girls only taught sessions (41%) with female teachers (43%). A need for breast education and delivery preferences was identified.

Adolescent girls are an important target group for breast cancer education and promoting breast awareness. However, research has not established schoolgirls' perceived importance of breast cancer education or explored factors that may impact engagement. This study aimed to identify schoolgirls' concerns about breast cancer, desire to know more and perceived importance of breast cancer education, and explored associations with demographic factors. Of 2089 schoolgirls (11-18 years) surveyed, 1958 completed all relevant breast cancer questions and demographic factors (ethnicity, school type, breast size, physical activity level and age). χ-Tests assessed associations between demographics, desire to know more and perceived importance of breast cancer. Overall, 44% of schoolgirls reported concerns about breast cancer, 72% wanted to know more and 77% rated the topic as extremely important. Breast size was not associated with wanting to know more about breast cancer. Schoolgirls who wanted to know more about breast cancer were White, from single-sex schools with boys at sixth form, more physically active and older. However, among other ethnic groups, school types and physical activity levels, the proportion of girls who wanted to know more about breast cancer was still high (≥61%). This study provides evidence of the need for breast cancer education for schoolgirls across all school types, irrespective of breast size or physical activity levels. The results highlight the need to be inclusive and engage schoolgirls from all ethnic groups and to promote breast awareness at a young age to ensure effective breast cancer education.