Background: Breast cancer is the most common cancer diagnosed among women in Sri Lanka. Early detection
can lead to reduction in morbidity and mortality. The objective here was to identify perceptions of public health
midwives (PHMs) on the importance of early detection of breast cancer and deficiencies of and suggestions on
improving existing breast cancer early detection services provided through Well Woman Clinics. Materials and
Methods: A qualitative study using four focus group discussions (FGDs) were conducted among 38 PHMs in the
Gampaha district in Sri Lanka and the meetings were audio-recorded, transcribed and analyzed using constant
comparison and identifying themes and categories. Results: All the PHMs had a firm realization on the need of
breast cancer early detection. The four FGDs among PHMs revealed non-availability of guidelines, inadequacy
of training, lack of skills and material to provide health education, inability to provide privacy during clinical
examination, shortage of stationery, lack of community awareness and motivation. The suggestions for the
improvements of the programme identified in FGDs were capacity building of PHMs, making availability of
guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination
between clinical and preventive sectors, and improving community awareness. Conclusions: Results of the FGDs
can provide useful information on components to be improved in breast cancer early detection services. Study
recommendations were training programmes at basic and post basic levels on a regular basis and supervision
for the sustainance of the breast cancer early detection program.