DECIPHERING THE CAUSES FOR A LATE FIRST MEDICAL CONSULTATION AMONG BREAST CANCER PATIENTS WHO ATTEND A SUBURBAN BUENOS AIRES HOSPITAL

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

Mar del Plata

Congreso; Sociedad argentina de investigación clínica; 2022

Breast cancer (BC) is still one of the main causes of cancer mortality in women worldwide. Delays in diagnosis and treatment impact on patient survival and thus, identifying women with higher risk of late presentation may allow designing preventive strategies. The aim of this study was to evaluate the time for first medical consultation among women with BC attending the Magdalena V. de Martínez hospital and to determine the causes that may influence this delay and its impact on cancer stage at diagnosis. Three hundred BC patients were interviewed using a self-reported questionnaire and socioeconomic and demographic variables were collected, namely highest education level completed, employment status and BC awareness. These answers were associated to patient clinical records, clinical staging, and tumor size, among others. The median age of our cohort was 58 years and the mean age of first childbirth was 22 years. Seventy one percent of the patients had incomplete primary or high school education and 77% of the tumors (231/300) were self-detected. Moreover, delay in the first medical visit was more than one month in 77% of the cases, being ignorance the most common cause of postponement. Even though 77% reported awareness of breast self-examination, only 22% of the patients practiced it. Regarding tumor size, 87% of the tumors were palpable (T1c-T4) and 47% of the patients had locally advanced or metastatic stages at their first visit. We found significant differences in the proportion of patients with incomplete school education and higher delays in first visit (Fisher p=0.017). Also, patient delays were associated with larger tumors (Fisher p=0.029) and advanced stage (lymph-node positive IIa to IV; Fisher p=0.0046). These results indicate that efforts should be aimed at early detection to reduce the stage at diagnosis which may impact on overall survival. A major drawback seems to be the difficulties in completing school studies in low-income households.