Deciphering the causes for a late first medical consultation among breast cancer patients who attend a suburban Buenos Aires hospital

COIANIS, MARCELA; SALDAIN, LEO; GRANDONI, MARÍA VICTORIA; SURDO, CECILIA; BURRUCHAGA, JAVIER; MARTINEZ VAZQUEZ, PAULA; DONATI, ANDREA; DE MORI, NANCY; CASSERLY, PEDRO; KENNEL, BEATRIZ; SPENGLER, EUNICE; LANARI, CLAUDIA; LAMB, CAROLINE A.

Mar del Plata

Congreso; Sociedad Argentina de Investigación Clínica; 2022

Breast cancer (BC) is still one of the main causes of cancer mortalityin women worldwide. Delays in diagnosis and treatment impact onpatient survival and thus, identifying women with higher risk of latepresentation may allow designing preventive strategies. The aimof this study was to evaluate the time for first medical consultationamong women with BC attending the Magdalena V. de Martínezhospital and to determine the causes that may influence this delayand its impact on cancer stage at diagnosis. Three hundred BCpatients were interviewed using a self-reported questionnaire andsocioeconomic and demographic variables were collected, namelyhighest education level completed, employment status and BCawareness. These answers were associated to patient clinical records,clinical staging, and tumor size, among others. The medianage of our cohort was 58 years and the mean age of first childbirthwas 22 years. Seventy one percent of the patients had incompleteprimary or high school education and 77% of the tumors (231/300)were self-detected. Moreover, delay in the first medical visit wasmore than one month in 77% of the cases, being ignorance themost common cause of postponement. Even though 77% reportedawareness of breast self-examination, only 22% of the patientspracticed it. Regarding tumor size, 87% of the tumors were palpable(T1c-T4) and 47% of the patients had locally advanced or metastaticstages at their first visit. We found significant differences in theproportion of patients with incomplete school education and higherdelays in first visit (Fisher p=0.017). Also, patient delays were associatedwith larger tumors (Fisher p=0.029) and advanced stage(lymph-node positive IIa to IV; Fisher p=0.0046). These results indicatethat efforts should be aimed at early detection to reduce thestage at diagnosis which may impact on overall survival. A majordrawback seems to be the difficulties in completing school studies inlow-income households.