Delayed presentation in breast cancer: relationship to tumour stage and survival

Abstract

During 1976–1985, 20% of new breast cancer patients ( 109 548 ) delayed presentation by 6 months or more. This study investigated the relationship between delay and outcome in symptomatic (as opposed to screen detected) women. Delay was associated with greater age (median 68 v 65 years, p=0.042) and progesterone receptor positivity (p=0.017, U-test) and advanced disease stage (p<0.0001, U-test). For those who delayed 6 months or more, 5-year survival was not impaired (53% v 56%). With 18 months or more delay, 5-year survival was worse (42% v 57%, p=0.030). When survival was recalculated from date of first symptom, those delaying 6 months or more lived longer (68% v 54%, p=0.014). This retrospective study provides no evidence that delay before presentation to hospital prejudices survival in symptomatic women. Instead, a prolonged preconsultation delay was associated with increased overall survival. The high incidence of associated advanced disease is, however, a cause for concern.