Amarinei G, Fagarasan V, Schlanger D and Caziuc A
University of Medicine and Pharmacy "Iuliu Hatieganu", RomaniaFulltext PDF
Background: Delay in the detection of breast cancer is an important topic in health care, both due to its frequency of occurrence and its possible negative effects on the survival of patients. A delay in breast cancer diagnosis may increase the risk of metastatic lymph nodes and the progression of tumor size. Although little is known about the nature of missed and delayed diagnosis it has been suggested that the poorer survival from breast cancer can be attributed to more advanced cancer stages at presentation. Methods: We conducted a systematic review of the literature of the last twenty years on patient, practitioner and system-mediated breast cancer diagnosis and treatment delays, identifying the risk factors that may influence these. We generated hypotheses about the relationship between each risk factor and the delay of diagnosis and treatment. We critically appraised the papers for inclusion in the review according to predefined criteria. The small number of studies of adequate quality did not allow formal meta-analysis. We also registered cases of delayed presentation in our clinic from the last 3 years, trying to determine which risk factors can be influenced, thereby decreasing morbidity associated with delay in diagnosis and treatment of breast cancer. Results: We identified three types of risk factors: Patient-mediated, practitioner-mediated and health-care mediated delay. Most studies were deemed to be of poor quality and were excluded. Among 18 studies of adequate quality, however, there was strong evidence for an association between older age and delay by patients, and moderate evidence that marital status was related to delays by patients. Older age and presentation with a breast symptom other than a lump were strong risk factors for delays. Moderate evidence was shown for several other factors. Discussion: The strength of the current evidence is inadequate to allow for the development of specific strategies in order to shorten delays by patients or providers. Clarification of the findings of this review through a major program of primary research is urgently required. Conclusion: Having sought help for potential cancer symptoms, it is also important that practitioners recognize symptoms, investigate, examine, and refer appropriately, not in a delayed fashion.
Risk factors; Delayed diagnosis; Breast cancer
Amarinei G, Fagarasan V, Schlanger D, Caziuc A. Risk Factors Associated with Delayed Diagnosis of Advanced Breast Cancer. Ann Integr Oncol. 2021;2(1):1010..