Background: Recognition of breast changes and timely clinical assessment are important components of breast health education. Physical breast simulators provide opportunities for hands-on practice and assessment of visual recognition and palpation skills. This study evaluated changes in breast warning sign recognition, simulated mass detection, and intended help-seeking responses following physical simulator–based training among female university employees of reproductive age.

Methods: This quasi-experimental study used a one-group pretest–posttest design involving 40 female employees aged 15–45 years recruited through convenience sampling at the central administrative building of Kerman University of Medical Sciences, Iran. Participants received individual, simulator-based training using a researcher-developed breast simulator featuring six visible warning signs and eight concealed, three-dimensionally printed masses. The assessment instruments demonstrated content validity (CVR = 0.85; CVI = 0.92) and inter-rater reliability (Cohen’s κ = 0.88; ICC = 0.91). Warning sign recognition, simulated mass detection, and intended help-seeking responses were assessed before and immediately after training. Data were analyzed using McNemar’s test and paired-samples t-tests in IBM SPSS Statistics, version 26.

Results: Recognition of selected visible warning signs, including peau d’orange, dilated superficial veins, and abnormal nipple discharge, improved significantly after training (all reported p < 0.05). The proportion of participants selecting the designated referral response increased from 82.5% before training to 100% after training (p = 0.008). The mean number of correctly detected simulated masses increased from 3.38 to 4.83 out of eight masses (p < 0.001).

Conclusion: Simulator-based training was associated with improved breast warning sign recognition, simulated mass detection, and intended help-seeking. Controlled studies with longer follow-up are needed to assess skill retention, real-world applicability, and cost-effectiveness.