Study of Diagnostic Delay among Symptomatic Breast Cancer Patients in Northern India: A Mixed-Methods Analysis from a Dedicated Breast Cancer Centre

Abstract

Objective: We conducted this study to understand the factors that contribute to the delay in diagnosis of symptomatic breast cancer patients. Methodology: We did a prospective analytical study with both quantitative and qualitative components over 14 months. The total delay in diagnosis of breast cancer from first symptom onset was defined as diagnostic delay. Presentation delay was defined as the time duration between the first symptom and the first visit to a health care provider. Provider delay was defined as the time duration between the presentation to a health care provider and the final diagnosis. Three hundred female breast cancer patients with a diagnostic delay of at least 3 months were interviewed using a pre-tested semi-structured questionnaire. Results: We found that more than 50% of patients with delayed presentation were between 30-50 years of age. Painless breast lump was the most common initial symptom. More than 70% of patients presented with locally advanced and metastatic disease. The patient-related delay was more common than provider delay. Breast cancer awareness (p = 0.040) and reasons for delay (p = 0.014) were found to significantly influence the delay. More than 70% of patients reported their symptoms to male members of their families. Conclusion: Breast cancer awareness is the single most important determinant influencing diagnostic delay among symptomatic patients.

Duration of the patient interval in breast cancer and factors associated with longer delays in low‐and middle‐income countries: A systematic review with meta‐analysis

“…Detailed information about each article is included in Table S1. The majority of articles reported on studies conducted in countries in Africa (32%), 22–37 followed by South‐East Asia (30%), 38–51,71 the Middle East (20%), 52–61 Latin America (16%), 62–69 and Eastern Europe (2%) 45,70 . Two articles reported on patients from more than one country 24,45 …”

“…Detailed information about each article is included in Table S1. The majority of articles reported on studies conducted in countries in Africa (32%), [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] followed by South-East Asia (30%), [38][39][40][41][42][43][44][45][46][47][48][49][50][51]71 the Middle East (20%), [52][53][54][55][56][57][58][59][60][61] Latin America (16%), [62][63][64][65][66][67][68][69] and Eastern Europe (2%). 45,...…”

“…Detailed information about each article is included in Table S1 . The majority of articles reported on studies conducted in countries in Africa (32%), 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 followed by South‐East Asia (30%), 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 71 the Middle East (20%), 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 Latin America (16%), 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 and Eastern Europe (2%). 45 , 70 Two articles reported on patients from more than one country.…”