Non-Practice of Breast Self Examination and Marital Statusare Associated with Delayed Presentation with Breast Cancer

Abstract

Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease,resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancerand identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosedwith primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data werecollected by face-to-face interview using a structured questionnaire and from medical records. We examinedassociations between delayed presentation (presenting to a physician more than 3 months after self-discovery ofa symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benignbreast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from othersto seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation rangedfrom tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantlyhigher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced orwidowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married womenand women who never performed breast self examination were more likely to delay presentation comparedto those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayedpresentation for breast cancer symptoms among Malaysian women is high and that marital status and breastself examination play major roles in treatment-seeking for breast cancer symptoms.