Patient delay in initiating treatment after breast cancer diagnosis: A cause for concern

Abstract

Objectives Delayed presentation, diagnosis, and treatment negatively impact the survival of breast cancer patients. This study aimed to describe the time to initiation of treatment after breast cancer diagnosis and causes of delay to help identify targets for future interventions. Material and Methods A prospective study was carried out on breast cancer patients who had delay initiating two major oncologic treatments (chemotherapy and mastectomy) between July 2018 and June 2021. Data were analyzed by SPSS version 23.0. Results Sixty-two of 146 patients (42.5%) delayed initiating oncologic treatments. All patients were females, and their ages ranged from 21 to 70 years, with a median age of 48 years (mean 46.9 ± 10.3 years). Median durations of symptoms at presentation and between diagnosis and commencement of treatments were 6 and 10 months, respectively. The mean lump size at presentation and before treatment were 8.2 cm and 15.4 cm, respectively. Early versus advanced breast cancer was 21 (33.8%) vs. 41 (66.1%) at presentation and 2 (3.2%) vs. 60 (96.8%) before treatment. Major reasons for delayed treatment include the use of alternative therapy (48.4%), financial problems (24.2%), fear of surgery (9.7%), chemotherapy side effects (8.1%), and family interference (4.8%). The length of delay was not affected by the patient’s age, marital status, or level of education (p > 0.05). Conclusion Patients had longer delays in initiating treatments after breast cancer diagnosis. Focusing on causes of secondary patient delay is equally as important as early detection and diagnosis.