Factors Responsible For Delayed Presentation and Treatment of Breast Cancer

Aliya Zehra, Ghansham, Hafiza Noor ul Ain, Saba Qaiser, Sadia Arshad, Bilal Burki

Abstract

Objective

To determine the factors responsible for the delayed presentation and treatment of breast cancer in a tertiary care hospital.

Study design

Cross-sectional observational study.

Place & Duration of study

Department of •General Surgery, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from December 2024 to May 2025.

Methods

All women with a diagnosis of breast cancer were included. A form was designed to collect the demographic data of the patients. Questionnaire was made to enter the factors responsible for the delayed presentation and treatment. Women who presented three months after the appearance of symptoms and signs of breast cancer were considered as delayed presenters. Data were entered into SPSS version 25. Mean ±SD were used to report continuous variable and frequency and percentages for the qualitative variables. Chi-square test was applied to determine the association of risk factors with delayed presentation taking p-value <0.05 as significant.

Results

A total of 150 patients were included. The mean age of the women was 45.7±10.4 years. Thirty-seven (24.7%) women aged between 20 – 40-years, 33 (22.0%) 41 - 50, 45 (30.0%) between 50 – 59-year, and 35 (24.0%) over 60-years of age. Thirty-nine women were considered in delayed care seeking group. Twenty-one (53.8%) reported no pain compared to 27 (24.3%) in the non-delayed group (p<0.0001). Majority (n=33 - 84.6%) of the patients in delayed group did not show concern about their symptoms whereas 52 (46.8%) patients in the non-delayed group sought consultation (p<0.0001).

Access to healthcare significantly contributed to delays as 15 (38.5%) women in the delayed group reported lack of facilities compared to 13 (11.7%) in the non-delayed group (p<0.0001). Most striking observation was the lack of knowledge about breast cancer symptoms among 36 (92.3%) women who presented late compared to 34 (30.6%) in the non-delayed group (p<0.0001).

Conclusion

A quarter of the women with breast cancer presented late for treatment. Absence of pain was reported by many patients. Number of patients ignored the initial symptoms. Lack of knowledge about breast cancer, the value of self-examination, and non-availability of nearby healthcare facility were other significant factors for delay in seeking treatment.

Key words

Breast cancer, Risk factors, Education, Pain, Breast mass.