PATTERN OF DELAYED PRESENTATION OF BREAST CANCERPATIENTS: EVIDENCE FROM RANGPUR MEDICAL COLLEGEHOSPITAL, RANGPUR, BANGLADESH

Abstract

Background: Bangladesh is facing a high burden of breast cancer disease. It is the 2 nd leading cause of cancer death after cervical cancer. Delay in seeking treatment contributes in breast cancer patients’ presentation at the tertiary hospitals when cancer is at an advanced stage and leads to poor prognosis. Late presentation with advanced stage is the common feature of breast cancer patients of Bangladesh. Objectives: The main objective of this study is to explore factors associated with delay in seeking cancer treatment among breast cancer patients at a tertiary care Hospital. Methods: Cross sectional observational study was conducted in the Department of Surgery Rangpur Medical College Hospital, Rangpur from January 2013 to December 2014. Patients who admitted to surgery ward and fulfill inclusion criteria during our study period was included in this study. Sixty two patients with carcinoma breast were included in this study. Thorough search for personal information and reasons behind delayed presentation was made from the patients. Information regarding tumor stage at time of diagnosis was extracted from hospital records and involved pathologic and clinical data. The data was collected in a pre designed data collection sheet. Correlation between personal and social factors and delayed presentation were made to find out the factors responsible for delayed presentation. Results: 36% patients came within 3 months of noticing the lump in breast and 64% delayed more than 3 months. Among 62 patients 76% were from low socioeconomic class, 62% had no formal primary education and 74% took initial treatment from Homeopath and traditional healer. Significant association was found with these patient related factors and delayed presentation. Association was also found between delayed presentation and advanced stage of disease. Conclusion: The findings suggest that 64% women with breast cancer presented late and have significant effect on their disease prognosis. There is a great impact of patient factors (personal and social) on delayed presentation. To reduce patient delay community awareness, health education programs regarding breast cancer should be implemented for target women who are at higher risk of delay.