Background: Breast cancer remains the most commonly diagnosed cancer and one of the leading causes of cancer-related mortality among women worldwide. Mammography is the cornerstone of early breast cancer detection and has been shown to substantially reduce disease-specific mortality. As future healthcare providers, medical students are expected to possess adequate knowledge of evidence-based breast cancer screening recommendations to effectively educate patients and promote screening uptake. This study aimed to assess the knowledge and awareness of mammography screening among medical students at Taif University, Saudi Arabia.

Methods: A cross-sectional study was conducted among 305 medical students at Taif University between August and October 2024. Data were collected using a validated, self-administered online questionnaire assessing sociodemographic characteristics, awareness of mammography screening, knowledge of breast cancer risk factors and symptoms, recommended screening practices, and sources of information. Descriptive and inferential statistical analyses were performed to examine factors associated with awareness.

Results: Overall, 73.8% of participants reported being aware of mammography screening. Awareness increased significantly with academic progression, ranging from 28.6% among first-year students to 97.1% among interns. Female students demonstrated significantly higher awareness than males (84.4% vs. 66.1%).

Although 46.9% correctly identified 40 years as the recommended age to initiate screening, only 19.7% correctly recognized the recommended biennial screening interval. Nearly half of the participants (47.9%) incorrectly considered breast self-examination and clinical breast examination to be effective breast cancer screening modalities.

Conclusions: Although awareness of mammography screening was generally high, substantial deficiencies remain in students' knowledge of current evidence-based screening recommendations. These findings highlight the need to strengthen undergraduate medical curricula through guideline-based and practice-oriented education to improve future physicians' competency in breast cancer prevention and early detection.

Keywords: Breast cancer; Mammography; Screening; Knowledge; Awareness; Medical students; Saudi Arabia