Abstract
Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Mean age was 47.5±12.1 years with a range from 25-77 years. Mean duration of delay was 5.13±4.8 months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.
Highlights
Breast Cancer is the most common female cancer of the world
Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic
Pakistan has highest mortality in Asia due to Breast cancer with around 40,000 deaths annually (Zujewski, 2011) an important reason of this being an advanced stage of cancer at the time of diagnosis in nearly one third of the patients. (Malik, 2002) Besides lack of national screening programs for breast cancer in our country and a low trend in our population of performing regular self examination of breast (Gilani et al, 2010) which prevent an early and timely notification of the disease, an important contribution to this delayed diagnosis is patient delay
Summary
Breast Cancer is the most common female cancer of the world. The delayed diagnosis is more responsible rather than the disease itself in causing mortality of the patient, as early diagnosis and prompt treatment is associated with better prognosis when compared to fatal outcomes related to significantly delayed diagnosis(Afzelius et al.,1994; Gilani et al, 2003). (Malik, 2002) Besides lack of national screening programs for breast cancer in our country and a low trend in our population of performing regular self examination of breast (Gilani et al, 2010) which prevent an early and timely notification of the disease, an important contribution to this delayed diagnosis is patient delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Significant association (p-value
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