Factors associated with Late-Stage Diagnosis of Breast Cancer among Egyptian Women

Abstract

Background: Detecting Breast Cancer (BC) at earlier stages comes with a better prognosis, while diagnosis at late stages has poor outcomes and escalating mortality rates from the disease. The study aims to understand the factors associated with the latestage diagnosis of BC in Egypt.
 Design and Methods: A sample of 400 women with a pathologically confirmed BC were enrolled from one of the main tertiary cancer hospitals in Egypt. A cross-sectional study design was conducted. The collected data included: clinical characteristics of the tumor, socio-demographic characteristics of the studied women, reproductive and medical history, screening practices, and the time from symptom onset to definite diagnosis as suspected predictors to the stage of BC at diagnosis. Data was analyzed by crude odds ratios (95% confidence interval) and multivariate logistic regression analysis.
 Results: The study revealed that 47.5% were diagnosed at late stages (40% at stage III/ 7.5% at stage IV), while (52.5%) were diagnosed at early stages (6.5% at stage I/46% at stage II). A binary logistic regression model showed that unmarried females (p=0.012), had non-luminal molecular subtype of BC including HER2 enriched and triple-negative tumors (p<0.001), presentation with breast changes and a non-palpable lump (p=0.024) or nonbreast symptoms (P=0.002), a delay longer than 3 months to the first presentation by patients (p<0.001), and a delay to definite diagnosis longer than 1 month by providers (p<0.001) were significant risk factors of late-stage diagnosis of BC.
 Conclusions: Late-stage diagnosis of BC in Egypt is associated with the aggressiveness of some molecular subtypes and other important modifiable factors that should be addressed.

Factors Causing Delayed Presentations of Breast Cancer among Female patients in Sulaimaniyah Governorate, Iraq

“…Contrary to predictions and other studies [3,31], we found that an absence of breast self-examination was associated with an increased chance of early presentation. One of the reasons why these women may appear late is because, unlike a trained doctor, they may miss any mass or change in the breast if they perform breast self-examination using the wrong technique or at the incorrect time.…”

“…Earlier research [8,31,32] demonstrated that BC screening behaviours measured by professional breast examination or mammography were related to a lower likelihood of late presentation. At the Breast Disease Treatment Clinic in Sulaimaniyah, regular clinical breast examinations and mammograms are recommended as BC screening measures; therefore, every woman should be aware of this healthcare.…”