Time Interval between Self-Detection of Symptoms to Treatment of Breast Cancer

BACKGROUND: In India breast cancer is the number one cancer among females with an incidence rate of 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. India continues to have a low 5-year survival rate of breast cancer with only 66.1% as compared to 90% in developed countries. The major reason for low survival is that patients are diagnosed with cancer at high stage. The present study attempts to delineate the time interval between self-detection of breast cancer symptoms and seeking care and to find the main reasons for delay in seeking care. METHODS: A cross sectional study was undertaken from October 2016 to March 2017 in a population based cancer registry (PBCR) and hospital based cancer registry (HBCR) located in south of India. Histologically confirmed breast cancer patients (N=181) were interviewed at hospital using a pre-tested semi structured questionnaire. RESULTS: The median time interval between the self-detection of breast cancer symptoms and first contact with general physician was 60 [IQR 30-180] days. The median time to diagnosis from the first contact was 30 [IQR 10 - 60] days and the overall median time span from self-detection of symptoms to treatment was 150 [IQR 95-265] days. The major reason given for not seeking medical care in time was lack of awareness in identifying the cancer symptoms both among patients and primary care providers. CONCLUSION: There was considerable delay from self-detection of symptoms to cancer specific primary treatment of breast cancer. We found lack of awareness among patients as well as in primary care providers to be the major concern for delay. Awareness among the target population and health care professionals would have to be improved for early diagnostics and access to care.