Factors leading to delayed and challenging presentation of benign breast lumps in young females

Abstract

Background and Objective: A delayed presentation of benign breast diseases may lead to a therapeutic challenge when they enlarge enormously or become multiple. Aim of this study was to evaluate the factors leading to delayed presentation of benign breast lumps.
 Methods: This cross-sectional study was conducted at Madinah Teaching Hospital and Allied Hospital, Faisalabad from January 2019 to October 2021. One hundred and forty five female patients were selected by non-probability purposive sampling. Patients with large size (>5cm) or multiple benign breast lumps were included. An interview was conducted using structured questionnaire translated in Urdu. Factors leading to delayed presentation and social impact scale for stigma were evaluated.
 Results: Patients had a mean age of 26.52 ± 6.90 years. The average delay of seeking medical care was 8.48 ± 8.41 months. Factors leading to delayed presentation were; lack of knowledge n=112 (77.2%) and parda (religious issues) n=112 (77.2%), followed by poverty n=109 (75.2%), and fear of cancer n=90 (62.1%). All the sub-scales of stigma, i.e., social rejection, financial insecurity, internalized shame and social isolation were high in late presenters, though, only financial insecurity was significantly high in late presenters (p=0.03).
 Conclusion: Lack of awareness, socioeconomic factors and disease related stigma were the main factors related to delayed presentation in young females with benign breast diseases. Addressing these factors may improve timely diagnosis and management of delayed and challenging cases.
 doi: https://doi.org/10.12669/pjms.39.1.6647
 How to cite this: Saleem S, Tariq S, Tariq S, Irfan S, Javed F. Factors leading to delayed and challenging presentation of benign breast lumps in young females. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6647
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Evaluation of benign breast diseases.

“…2,13 In literature, there is no significant differences in the age groups of patients presenting with fibroadenoma. 3 Inflammatory conditions like acute mastitis and abscess formation was the 2nd large group (n=20, 20.05%) in our Study. Most of the patients were in 3rd (n=8) and 4th (n=6) decades of life.…”

“…14 Inflammatory conditions are less frequently diagnosed in young unmarried girls diagnosis of acute mastitis before progressing to abscess formation, can easily managed with antibiotics and thereby avoiding surgery. 3 Tuberculous mastitis is a rare condition and its incidence is 0.1% in developing and 3-4% in developed countries. 15 Aslam HM has noted 1.6% cases of granulomatous mastitis in his study.…”

“…Its specificity is 99.6%, Sensitivity 97.4%, positive predictive value (PPV) 99.6%, negative predictive value (NPV) 97.6% and accuracy is 98.5%. 3 BBDs includes a variety of conditions lesions with different presenting complaints. 4 It includes mastalgia, nipple discharge, breast abscess, acute /chronic mastitis, granulomatous mastitis, cyst, galactorhea, ductal papilloma, traumatic fat necrosis and benign tumours like fibroadenoma and Phylloides tumour.…”

“…The presenting complaints are lumpy breast, mastalgia, nipple discharge and inversion. 3 In literature, there is an upward trend in the presentation of breast diseases. Therefore an early diagnosis through triple assessment is of utmost importance to reveal its true nature and subsequent management.…”