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Reducing diagnostic delay in breast cancer possible therapeutic implications
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19861015)58:8<1756::aid-cncr2820580829>3.0.co;2-v
Subject(s) - medicine , breast cancer , stage (stratigraphy) , disease , pediatrics , population , presentation (obstetrics) , cancer , surgery , environmental health , paleontology , biology
A detailed examination of the diagnostic process of 1110 newly diagnosed breast cancer patients first seen at 63 Italian general hospitals showed that 36% of them were diagnosed more than 3 months after the appearance of the first symptom. Whereas 17% (108/633) of the women with ≤3 months delay were Stage III and IV, the corresponding proportion among women with >3 months delay was 32% (101/320), suggesting that 15% of advanced cases can be attributed to diagnostic delay. A 9% gain in survival at 5 years (66% vs. 57%) could be postulated if reported figures on mortality by stage are applied to our patients with ≤3 months delay compared to those with >3 months. Moreover, examining the two components of delay (first symptom‐first visit and first visit‐final diagnosis) our data suggest that the potential benefits of timely presentation were, for some patients, cancelled by delays arising in the health care system. Breast self‐examination (BSE) was practiced by 34% of the total population, but only 9% did it on a regular monthly basis. Although any type of BSE (regular and irregular) was associated with a smaller primary at presentation, a limited benefit of the procedure in terms of nodal involvement and pathologic stage of disease was evident only among regular BSE performers.