Psycho-social factors influencing delay and breast self-examination in women with symptoms of breast cancer

Magarey, Christopher; Todd, Peter B.; Blizard, Peter J.

doi:10.1016/0037-7856(77)90069-5

Cited by 68 publications

(32 citation statements)

References 10 publications

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“…This suggests that women who perform BSE are more knowledgeable of breast cancer (Parsa et al, 2008), and conversely, those who do not perform BSE are less knowledgable and therefore, less wary of changes in their breast or do not understand the urgency of seeking medical advice. This is in contrast with findings by Magarey (1977) and Meechan et al (2002).…”

Section: Discussioncontrasting

confidence: 91%

Non-Practice of Breast Self Examination and Marital Status are Associated with Delayed Presentation with Breast Cancer

Sm¹,

Othman²,

Kc³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussioncontrasting

confidence: 91%

Non-Practice of Breast Self Examination and Marital Status are Associated with Delayed Presentation with Breast Cancer

Sm¹,

Othman²,

Kc³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…This lack of psychological response to discovery of a non-lump breast symptom may be the mechanism that mediates subsequent delay in presentation. The association between symptoms that do not include a lump and a lack of subsequent emotional response may also explain the relationship between womens' absence of suspicion and fear and delay reported by Adam et al (1980) and Cameron and Hinton (1968), as well as the relationship between 'denial' among women presenting with symptoms of breast cancer and delay, which is so widely reported in the social science literature (Henderson, 1966;Greer, 1974;Magarey and Blizzard, 1977;More et al, 1990). None of these earlier studies had evaluated the type of symptom women had developed, alongside their psychological responses.…”

Section: General Practitioner Delaymentioning

confidence: 92%

Who and what influences delayed presentation in breast cancer?

Burgess

Ramirez²,

Richards³

et al. 1998

Br J Cancer

200

250

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Summary This study aimed to examine the extent and determinants of patient and general practitioner delay in the presentation of breast cancer. One hundred and eighty-five cancer patients attending a breast unit were interviewed 2 months after diagnosis. The main outcome measures were patient delay in presentation to the general practitioner and non-referral by the general practitioner to hospital after the patient's first visit. Nineteen per cent of patients delayed 2 12 weeks. Patient delay was related to clinical tumour size > 4 cm (P = 0.0002) and with a higher incidence of locally advanced and metastatic disease (P = 0.01). A number of factors predicted patient delay: initial breast symptom(s) that did not include a lump (OR 4.5, P= 0.003), not disclosing discovery of the breast symptom immediately to someone else (OR 6.0, P < 0.001), seeking help only after being prompted by others (OR 4.4, P = 0.007) and presenting to the general practitioner with a nonbreast problem (OR 3.5, P = 0.03). Eighty-three per cent of patients were referred to hospital directly after their first general practitioner visit. Presenting to the GP with a breast symptom that did not include a lump independently predicted general practitioner delay (OR 3.6, P = 0.002). In view of the increasing evidence that delay adversely affects survival, a large multicentre study is now warranted to confirm these findings that may have implications for public and medical education.Keywords: patient delay; GP delay; breast cancer; psychological response; type of symptom For women who present with symptomatic breast cancer there is, by definition, an interval between first detection of symptoms (either by the woman herself or by another) and the time of diagnosis and treatment. Prolonged delays, usually defined arbitrarily as intervals greater than 12 weeks, occurring during this period have been shown to be associated with increased tumour size (Fisher et al, 1977;Pilipshen et al, 1984; GIVIO, 1986;Neave et al, 1990;Rossi et al, 1990) and more advanced stage of disease (Elwood and Moorehead, 1980;Gould-Martin et al, 1982;Robinson et al, 1984; GIVIO, 1986;Machiavelli et al, 1989;Rossi et al, 1990) and with poor long-term survival (Neave et al, 1990;Afzelius et al, 1994).Given this relationship between delay, stage and survival, it is important to assess in detail the different phases of delay between first detection of a symptom and treatment being commenced. For each of these phases, factors need to be identified that are associated with prolonged delays, so that effective strategies can be planned to reduce the overall interval between first symptom and treatment.The phases of delay can be considered as follows:1. Patient delay. The interval between first detection of a symptom and first presentation to a health professional, usually a general practitioner (GP). 2. GP delay. The interval between first presentation to a GP and onward referral to a hospital. This study examines patient and GP delay in a prospective cohort of women presenting to the ...

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“…In her review of the research literature, Facione (1993) discussed a variety of emotional responses related to symptom finding and presented a list of the different fears women tend to experience after the discovery of their symptoms, such as fear of death, fear of doctors and hospitals, fear of embarrassment, fear of disfigurement, and fear of chemotherapy. In one study, the experience of some of these fears-in particular, fear of dying, fear of breast loss, and fear of cancer itself-were associated with delay (Magarey, Todd, & Blizard, 1977;see also De Nooijer, Lechner, & De Vries, 2001;Grunfeld, Hunter, Ramirez, & Richards, 2003). This finding suggests that intense negative emotions may prevent women from taking appropriate action in regard to their breast symptoms.…”

Section: Emotional Responses and Delaymentioning

confidence: 96%

Ruminative Response Styles and Delay of Seeking Diagnosis for Breast Cancer Symptoms

Lyubomirsky¹,

Kasri²,

Chang³

et al. 2006

Journal of Social and Clinical Psychology

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Women with a ruminative style-a tendency to focus repetitively on the meaning, causes, and consequences of their distress-were hypothesized to delay seeking a diagnosis from a healthcare professional for a potentially dangerous breast symptom relative to women without a ruminative style. In Study 1, 147 female "ruminators" and "non-ruminators" read a vignette in which they imagined they had just discovered a change in their breast, completed measures of affect, and reported their intentions to seek care for this breast symptom. Ruminators were significantly less likely to intend to call the doctor immediately after finding an imaginary breast lump than were non-ruminators. In Study 2, 70 women breast cancer survivors recalled the dates related to their symptom finding and their affective responses to symptom finding. Ruminators delayed the presentation of their breast cancer symptoms to a healthcare professional 39 days longer than did non-ruminators. Furthermore, in both studies, the effects of ruminative style on delay appeared to be moderated in part by the experience of positive mood at the time of symptom discovery. The results of these two studies have significant applied implications, suggesting that ruminative response styles play a role in the delay of presentation of health symptoms.

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Psycho-social factors influencing delay and breast self-examination in women with symptoms of breast cancer

Cited by 68 publications

References 10 publications

Non-Practice of Breast Self Examination and Marital Status are Associated with Delayed Presentation with Breast Cancer

Non-Practice of Breast Self Examination and Marital Status are Associated with Delayed Presentation with Breast Cancer

Who and what influences delayed presentation in breast cancer?

Ruminative Response Styles and Delay of Seeking Diagnosis for Breast Cancer Symptoms

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