Abstract
Despite current recommendations for women to be screened for breast cancer with mammography every 1 to 2 years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom. In a population-based study of breast cancer, we examined factors potentially associated with patient delay in seeking health care for a breast symptom among 436 symptomatic urban breast cancer patients (146 white, 197 black, and 95 Hispanic). Race/ethnicity, socioeconomic status, health care access and utilization, and misconceptions about the meaning of breast lumps were the key independent variables. Sixteen percent of patients reported delaying more than 3 months before seeking medical advice about breast symptoms. Misconceptions about breast lumps and lacking a regular provider, health insurance, and recent preventive care were all associated with prolonged patient delay (P < 0.005 for all). Misconceptions were much more common among ethnic minorities and women of lower socioeconomic status. Reducing patient delay and disparities in delay will require educating women about the importance of getting breast lumps evaluated in a timely manner and providing greater access to regular health care.
Highlights
Screening for breast cancer with mammography is the only widely accepted method for the early detection of breast cancer, and secular increases in mammography screening utilization have been linked to a shift toward earlier stage at diagnosis [1]
Statistical Analyses First, we examined the percentage of women with prolonged patient delay within categories of demographic, health care access, and attitudinal variables and the corresponding P values from χ2 tests for homogeneity
Half of patients in this study who reported symptomatic discovery of their breast cancer were African American; two thirds of Hispanic patients reported Spanish as their primary language
Summary
Screening for breast cancer with mammography is the only widely accepted method for the early detection of breast cancer, and secular increases in mammography screening utilization have been linked to a shift toward earlier stage at diagnosis [1]. Despite current recommendations for women to get screened every 1 to 2 years, many women are not screened and some women who are screened develop symptoms of breast cancer despite a recent screen. Less than half of all newly diagnosed breast cancers are initially detected through screening mammography [2,3,4,5]. Despite current recommendations for women to be screened for breast cancer with mammography every 1 to 2 years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom
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