Breast cancer is the most frequent malignancy among females in Pakistan and near half of the patients present with locally advanced stages. Poverty and lack of awareness about the disease and its management in the region may be the factors for delayed presentation.
To determine the frequency of locally advanced breast cancer (LABC), the reasons of delay and the association between socio-demographic variables with the delayed presentation
315 histologically confirmed breast cancer patients were interviewed. Age at diagnosis, Family history, Education; Marital; Socio-economic and Menopausal status were the socio-demographic data obtained. LABC was defined in terms of the American Joint Committee on Cancer “TNM staging system”. Questions were also asked about their beliefs and understanding of the disease which might lead to their delayed presentation. Results were analyzed using SPSS version 17.
39.0 % of patients presented as locally advanced disease. Out of those, 40.7 % wasted time using alternative medicines; 25.2 % was not having enough resources; 17.1 % presented late due to painless nature of the disease; 10.6% felt shyness and 6.5% presented late due to other reasons (pregnancy or lactation). Age, family history, socio-economic and educational status were significantly associated with delayed presentation (P < 0.05). Education and socioeconomic status were found to be two independent factors related to the delayed presentation after adjustment for other factors (OR of 2.26, 2.29 and 95% CI was 1.25-4.10, 1.06-4.94 respectively).
Significant percentage of women with breast cancer in North of Pakistan present with advanced stage of disease due to their misconceptions and false beliefs about the disease. These can be mended by educating the focused groups identified in the study. Long-term impact will be in terms of increased survival rates in these patients with reduced overall burden of the disease in the region.