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Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis
INTRODUCTION: Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible. METHODS: We examined the presenting symptoms of...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5482318/ https://www.ncbi.nlm.nih.gov/pubmed/28549339 http://dx.doi.org/10.1016/j.canep.2017.04.010 |
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author | Koo, Minjoung Monica von Wagner, Christian Abel, Gary A. McPhail, Sean Rubin, Greg P. Lyratzopoulos, Georgios |
author_facet | Koo, Minjoung Monica von Wagner, Christian Abel, Gary A. McPhail, Sean Rubin, Greg P. Lyratzopoulos, Georgios |
author_sort | Koo, Minjoung Monica |
collection | PubMed |
description | INTRODUCTION: Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible. METHODS: We examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n = 2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression. RESULTS: A total of 56 presenting symptoms were described: breast lump was the most frequent (83%) followed by non-lump breast symptoms, (e.g. nipple abnormalities (7%) and breast pain (6%)); and non-breast symptoms (e.g. back pain (1%) and weight loss (0.3%)). Greater proportions of women with ‘non-lump only’ and ‘both lump and non-lump’ symptoms waited 90 days or longer before seeking help compared to those with ‘breast lump only’ (15% and 20% vs. 7% respectively). Quantile regression indicated that the differences in the patient interval persisted after adjusting for age and ethnicity, but there was little variation in primary care interval for the majority of women. CONCLUSIONS: About 1 in 6 women with breast cancer present with a large spectrum of symptoms other than breast lump. Women who present with non-lump breast symptoms tend to delay seeking help. Further emphasis of breast symptoms other than breast lump in symptom awareness campaigns is warranted. |
format | Online Article Text |
id | pubmed-5482318 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-54823182017-06-29 Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis Koo, Minjoung Monica von Wagner, Christian Abel, Gary A. McPhail, Sean Rubin, Greg P. Lyratzopoulos, Georgios Cancer Epidemiol Research Article INTRODUCTION: Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible. METHODS: We examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n = 2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression. RESULTS: A total of 56 presenting symptoms were described: breast lump was the most frequent (83%) followed by non-lump breast symptoms, (e.g. nipple abnormalities (7%) and breast pain (6%)); and non-breast symptoms (e.g. back pain (1%) and weight loss (0.3%)). Greater proportions of women with ‘non-lump only’ and ‘both lump and non-lump’ symptoms waited 90 days or longer before seeking help compared to those with ‘breast lump only’ (15% and 20% vs. 7% respectively). Quantile regression indicated that the differences in the patient interval persisted after adjusting for age and ethnicity, but there was little variation in primary care interval for the majority of women. CONCLUSIONS: About 1 in 6 women with breast cancer present with a large spectrum of symptoms other than breast lump. Women who present with non-lump breast symptoms tend to delay seeking help. Further emphasis of breast symptoms other than breast lump in symptom awareness campaigns is warranted. Elsevier 2017-06 /pmc/articles/PMC5482318/ /pubmed/28549339 http://dx.doi.org/10.1016/j.canep.2017.04.010 Text en © 2017 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Research Article Koo, Minjoung Monica von Wagner, Christian Abel, Gary A. McPhail, Sean Rubin, Greg P. Lyratzopoulos, Georgios Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis |
title | Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis |
title_full | Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis |
title_fullStr | Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis |
title_full_unstemmed | Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis |
title_short | Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis |
title_sort | typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: evidence from a national audit of cancer diagnosis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5482318/ https://www.ncbi.nlm.nih.gov/pubmed/28549339 http://dx.doi.org/10.1016/j.canep.2017.04.010 |
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