Breast Cancer Research and Treatment

, Volume 66, Issue 3, pp 209–215 | Cite as

An Assessment of Delays in Obtaining Definitive Breast Cancer Treatment in Southern Italy

  • Maurizio Montella
  • Anna Crispo
  • Gerardo Botti
  • Mariarosaria de Marco
  • Giovanna de Bellis
  • Gabriella Fabbrocini
  • Michele Pizzorusso
  • Mario Tamburini
  • Giuseppe D'Aiuto
Conference Report


Female population is medically underserved in Southern Italy (in comparison with other Italian regions). In a recent systematic review of published studies, delays of 3–6 months between symptom onset and treatment have been clearly associated with lower survival rates for breast cancer patients. The aim of this study was to examine breast cancer delays in medically underserved patients in Southern Italy, in order to recognize their determinating factors so as to provide women with a better opportunity for survival. The variables examined were age, education, symptom status at first presentation: symptomatic and asymptomatic, date of first symptom presentation, date of first consultation with a health provider, consulted provider, tumor size and nodal status, according to the pTNM system. Time intervals were categorized into: <1 month, 1–3 months and >3 months for patient and medical delay; 1–3 months, 3–6 months, >6 months for overall delay. Patient delay was associated with education: a higher risk was found for women with ≤5 years school attendance (OR=3.3, 95%, CI 2.0–5.6). Medical delay was seen to be associated with the professional figure: significant differences were found between senologists (oncologist exclusively dedicated to breast cancer) and other specialists (OR 3.5, 95%, CI 1.5–8.4). Age and symptomatic presentation were found to be high risk factors. Concerning tumor size in overall delay in cases >2cm had OR values were of 2.4 (95%, CI 1.5–3.7). In conclusion our study suggests that diagnostic delay is associated with medically underserved status and can be reduced by educating younger and less educated women, as suggested in other studies and by providing training programs for members in the medical profession.

breast cancer education medically underserved medical delay medical profession overall delay patient delay tumor size 


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Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Maurizio Montella
    • 1
  • Anna Crispo
    • 1
  • Gerardo Botti
    • 2
  • Mariarosaria de Marco
    • 1
  • Giovanna de Bellis
    • 1
  • Gabriella Fabbrocini
    • 3
  • Michele Pizzorusso
    • 4
  • Mario Tamburini
    • 1
  • Giuseppe D'Aiuto
    • 4
  1. 1.Departments of EpidemiologyNational Cancer InstituteNaplesItaly
  2. 2.Cellular PathologyNational Cancer InstituteNaplesItaly
  3. 3.Department of Biology and Cellular and Molecular Pathology, Medical Statistical Division, Faculty of Medicine“Federico II” UniversityNaplesItaly
  4. 4.Surgical Oncology, Fondazione “G. Pascale”National Cancer InstituteNaplesItaly

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