Extent of patient delay and its clinical implications among breast cancer patients of the professorial surgical unit, NCTH, Ragama

Abstract

Introduction Delay in diagnosis of breast cancer results in poor outcome. Objective The aim of the study was to assess the extent of patient delay and its association with presenting complains, breast self-examination, stage of breast cancer at presentation and time of presentation. Method Retrospectively analyzed the data from the breast cancer registry (March 1999- December 2009) maintained at professorial surgical unit, NCTH, Ragama. All patients of the registry included in the study. Patients who detected by screening test (except breast self-examination) were excluded. Patient delay was defined as time from onset of first symptoms to first consultation of a doctor. Patient delay of >3 month considered as late presentation and <3 month early presentation. Results Of the study population (n=134, median age 52, range 30-88years) majority was late presenters (88, 65.6%). The median patient delay was 170days (range 1- 72days). A palpable lump in the breast was the commonest presenting complain among both early (28, 60.8%) and late (48, 54.5%) presenters. Of the early presenters 11 (23.9%) and of the late presenters 12(13.6%) performed breast self-examination. Twenty-seven (47.8%) of the early presenters 32(36.3%) of the delayed presenters had early stage breast cancer at presentation. There have been 36 (72%) late presenters among first 5patients and 29(58%) late presenters among last 5patients of the breast cancer registry. Conclusion Most of the patients are late presenters but duration of patient delay has improved with time. Health conscious patients who performed breast self-examination seem to present early for medical advice. Early presentation may improve the patient outcome because majority has early stage breast cancer.