Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals : Evidence from a national audit of cancer diagnosis

Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved..

INTRODUCTION: Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible.

METHODS: We examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n=2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression.

RESULTS: A total of 56 presenting symptoms were described: breast lump was the most frequent (83%) followed by non-lump breast symptoms, (e.g. nipple abnormalities (7%) and breast pain (6%)); and non-breast symptoms (e.g. back pain (1%) and weight loss (0.3%)). Greater proportions of women with 'non-lump only' and 'both lump and non-lump' symptoms waited 90days or longer before seeking help compared to those with 'breast lump only' (15% and 20% vs. 7% respectively). Quantile regression indicated that the differences in the patient interval persisted after adjusting for age and ethnicity, but there was little variation in primary care interval for the majority of women.

CONCLUSIONS: About 1 in 6 women with breast cancer present with a large spectrum of symptoms other than breast lump. Women who present with non-lump breast symptoms tend to delay seeking help. Further emphasis of breast symptoms other than breast lump in symptom awareness campaigns is warranted.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:48

Enthalten in:

Cancer epidemiology - 48(2017) vom: 26. Juni, Seite 140-146

Sprache:

Englisch

Beteiligte Personen:

Koo, Minjoung Monica [VerfasserIn]
von Wagner, Christian [VerfasserIn]
Abel, Gary A [VerfasserIn]
McPhail, Sean [VerfasserIn]
Rubin, Greg P [VerfasserIn]
Lyratzopoulos, Georgios [VerfasserIn]

Links:

Volltext

Themen:

Breast neoplasms
Delayed diagnosis
Early detection of cancer
Early diagnosis
Female
Journal Article
Primary health care
Signs and symptoms

Anmerkungen:

Date Completed 06.11.2017

Date Revised 10.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.canep.2017.04.010

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM272304212