Delayed presentation in breast cancer: a study in Iranian women

Abstract

BackgroundA cross sectional study was conducted in Tehran Iran to examine the extent of patient delay and associated factors in the presentation of breast cancer.MethodsA group of newly diagnosed breast cancer patients were interviewed and were asked about the period from first onset of symptoms to first medical consultation to indicate patient delay. This was studied in relation to patients' age, educational level, marital status, family history of breast cancer, history of benign breast disease, number of children and the nature of the first symptom seen.ResultsIn all, 190 breast cancer patients were interviewed. Of these, 75% presented to physician within 3 months. Forty-two patients (25%) delayed more than 3 months. In multivariate regression analysis it was found that there was a risk for longer delay in widowed or divorced women (OR 3.7, 95% CI 1.5–9.7), women with a positive family history of breast cancer (OR 2.8, 95% CI 1.1–7.7), and less educated patients (illiterate: OR 5.2, 95% CI 1.5–17.7; primary schooling: OR 4.6, 95% CI 1.4–14.7). Significant associations also were found between delay presentation and the late stage disease (P = 0.01) and bigger tumor size (P = 0.004).ConclusionThe findings suggest that one in four women with breast cancer present late and this has significant effect on their disease prognosis. To reduce patient delay health education programs regarding breast cancer should be implemented and target women who are at higher risk of delay.

Delay in diagnosis of breast cancer in a developing country: a single centre observational study in a tertiary care hospital in North Kerala, India

“…This was done because delay more than 12 weeks has been shown to result in advanced disease and worse survival. 3 …”

“…It has been proven that patients with longer duration of symptoms present with more advanced disease and that a delay in diagnosis between 3-6 months after onset of symptoms reduces 5-years survival by 7% compared to patients diagnosed within 3 months of onset of symptoms. 3,4 Overall in the western population there has been a fall in deaths caused by breast cancer as a result of breast screening, early diagnosis and better treatment although the relative contribution of these factors is yet to be evaluated. 5 Lack of a screening program and delay in diagnosis is hindering attempts to improve breast cancer survival in India.…”

Appraisal of Breast Cancer Symptoms by Iranian Women: Entangled Cognitive, Emotional and Socio-Cultural Responses

“…The results of two studies showed that 25% (Montazeri et al, 2003) to 42.5% (Harirchi et al, 2005) of Iranian women do not seek medical help until three months or more after initial detection of breast symptoms. Delayed presentation is accompanied with late stage of disease, high mortality (Montazeri et al, 2003) and lower survival (Babu et al, 2011).…”

“…Delayed presentation is accompanied with late stage of disease, high mortality (Montazeri et al, 2003) and lower survival (Babu et al, 2011). Therefore, symptom detection by patients and early response to self-discovered symptoms is important modality to the early diagnosis of breast cancer.…”

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

“…Breast cancer survival rates of women in Asia are approximately half of their Western counterparts (Parkin et al, 2005;Green and Raina, 2008). In Iran, breast cancer is recognized as one of the fastest increasing and the most important women's health issues (Montazeri et al, 2003). Having a mortality rate of 4 per 100,000, breast cancer is the fifth leading cause of death and the third source of burden in malignant diseases for Iranian women (Akbari et al, 2011).…”