Understanding women’s perspectives on breast cancer is essential for early breast cancer diagnosis and to avoid diagnosis delay: A mixed method study.

Abstract

e24036 Background: Breast Cancer is the most common cancer in women worldwide. Since 2017, MVR Cancer Centre is a tertiary care hospital, New national guidelines focused on clinical breast exam and mammogram require that women be aware of and seek care for breast concerns. Therefore, this study aims to understand women’s perspective on breast cancer diagnosis. Methods: Sequential explanatory method was used to satisfy the objectives of the study. A crossectional survey was conducted to conveniently sampled women aged 30 and older to assess women’s perspectives on breast cancer and care-seeking behavior. We did a qualitative interview among selected breast cancer women to know about the reasons of delayed diagnosis and treatment delay. Results: Among 378 women with a median age of 49 (IQR: 34–62) years, 73% have heard of cancer and 30% have received self-breast examination. Women self-evaluated their knowledge of breast cancer (from 1-none to 10-extremely knowledgeable) with a median response of 3 (IQR: 1–4). Only 24% felt they knew any signs or symptoms of breast cancer. Encouragingly, 42% of women were fairly-to-very confident they would notice changes in their breasts, with 22% of women practicing self-breast examination and 8% reporting they had received a past breast exam. Overall, 64% said they would be somewhat-to-very likely to seek care if they noticed breast changes, with 98% noting severity of symptoms as a motivator. However, altered sexuality (43%), fear of losing a breast - Womanhood(70%) and fear of a poor diagnosis (48%) were most frequent barriers to care seeking. In assessing knowledge of risk factors, about 70% of women did not know any risk factors for breast cancer whereas 12% of women believed long term contraceptive use a risk factor. However, 37% and 35% of women did not think that family history or being older were risk factors, respectively. Social recognition as woman, existence of womanhood, cost of treatment and related financial burden and fear of complications and death are the themes emerged from the qualitative study. Conclusions: The success of efforts to improve early diagnosis in a setting without population-based screening depends on women being aware of breast cancer signs and symptoms, risks, and ultimately seeking care for breast concerns. Unfortunately, most women said they would seek care if they noticed a severity in the signs and symptoms of cancer, but the low levels of cancer knowledge, symptoms, and common risk factors highlight the need for targeted community education and awareness campaigns.