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Barriers to Timely Diagnosis and Management of Breast Cancer: Observations from a Tertiary Referral Center in Resource Poor Setting

Indian Journal of Surgical Oncology volume 11, pages 287–293 (2020)Cite this article

Abstract

Breast cancer (BC) is the most common cancer among females worldwide, with over 2 million cases diagnosed every year. In India, it is the most common malignancy overall (15.4%) and accounts for about 27% female cancers. Morbidity and mortality remain high despite improvements in BC therapeutics. Conventionally, a gap of more than 3 months between noticing symptoms and commencing treatment is considered delay in BC management. Delays make BC an important public health problem and lead to poor outcomes. This study aims to identify patient perceived barriers to BC management. A self-designed structured questionnaire consisting of questions pertaining to multiple aspects of BC presentation and management was prepared. The study was conducted from October 2017 to September 2018 and results were analyzed. A delay of 3 months or more was seen in 284 of the 435 patients (65.3%), among which 179 was patient delay, 69 due to provider delay, and 36 due to a combined contribution of both factors. Provider factors were associated with prolonged delay. Misdiagnosis at first consult was the most common factor perceived by patients as a barrier, followed by delay in referral, distance from hospitals, lack of information, financial constraints, and logistic issues. A significant patient and provider delay exists in BC management which prevents effective early therapy. Effective tackling of these barriers may result in the betterment of BC management outcomes. Robust screening, education of patients and providers, and awareness promotion and infrastructure development will be useful in this regard.

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Affiliations

  1. Department of Endocrine & Breast Surgery, King George’s Medical University, Shah Mina Road, Shatabdi Phase II, KGMU, Lucknow-03, India

    M. Shreyamsa, Pooja Ramakant, Kul Ranjan Singh, Sasi Mouli & Anand Kumar Mishra

  2. Department of Pediatrics, King George’s Medical University, Lucknow, India

    Devina Singh

  3. Department of General Surgery, King George’s Medical University, Lucknow, India

    Akshay Anand & A. A. Sonkar

Authors
  1. M. Shreyamsa
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  2. Devina Singh
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  3. Pooja Ramakant
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  4. Akshay Anand
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  5. Kul Ranjan Singh
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  6. Sasi Mouli
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  7. Anand Kumar Mishra
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  8. A. A. Sonkar
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Correspondence to Kul Ranjan Singh.

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Shreyamsa, M., Singh, D., Ramakant, P. et al. Barriers to Timely Diagnosis and Management of Breast Cancer: Observations from a Tertiary Referral Center in Resource Poor Setting. Indian J Surg Oncol 11, 287–293 (2020). https://doi.org/10.1007/s13193-020-01037-2

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  • DOI: https://doi.org/10.1007/s13193-020-01037-2

Keywords

  • Breast cancer
  • Delay
  • Barriers
  • Breast cancer awareness