Background <p>Breast self-examination (BSE) is a simple, low-cost method for promoting breast awareness and early detection of breast abnormalities, particularly among young women. However, lack of confidence and perceived barriers often limit regular BSE practice. Educational interventions that combine theoretical knowledge with hands-on training may enhance self-efficacy and support sustainable behavioral change.</p> Objective <p>This study aimed to compare the effects of theoretical education alone versus theoretical plus hands-on BSE training on breast cancer knowledge, health beliefs, and BSE practice among female university students.</p> Methods <p>This randomized controlled study was conducted among 40 female university students residing in university dormitories. Participants were stratified based on pretest scores and randomly assigned to either a theoretical education–only group (<i>n</i> = 20) or a theoretical plus hands-on training group (<i>n</i> = 20). The primary outcomes were breast cancer knowledge, health beliefs, and BSE practice. Breast cancer knowledge was assessed at baseline, immediately after training, and at a 3-month follow-up using the Breast Cancer Knowledge Test (BCKT). Health beliefs were assessed at baseline and at the 3-month follow-up using the Champion Health Belief Model Scale. BSE practice frequency and perceived barriers were also recorded. Repeated-measures and mixed-design ANOVA and chi-square tests were used for data analysis.</p> Results <p>Breast cancer knowledge increased significantly in all participants from pretest to posttest (<i>p</i> &lt; 0.001) and remained significantly higher than baseline at the 3-month follow-up, although a slight decline was observed. No significant Time × Group interaction was found for knowledge scores. </p> <p>In contrast, significant Time × Group interactions were observed for health motivation (<i>p</i> = 0.001), perceived barriers to BSE (<i>p</i> &lt; 0.001), and self-efficacy (<i>p</i> = 0.005), all favoring the theoretical plus hands-on training group. Regular BSE practice increased from 0% at baseline to 60% at follow-up across the cohort, with a significantly greater increase in the hands-on training group compared with the theoretical-only group (75% vs. 45%, <i>p</i> = 0.038).</p> Conclusion <p>While theoretical education effectively improves breast cancer knowledge, the addition of hands-on BSE training is critical for reducing perceived barriers, enhancing self-efficacy, and promoting regular BSE practice. Incorporating hands-on training into breast health education programs may substantially improve behavioral outcomes among young women.</p>