Audit of delayed presentation in breast cancer from a tertiary centre in the Niger Delta, Nigeria

Abstract

Context: Breast cancer is the most common cause of cancer-related morbidity and mortality in women in developing countries, compounded by delayed presentation. Determining the contemporary reasons for delayed presentation in our environment, is necessary to properly guide enlightenment campaigns, enhance their effectiveness and improve patient survival.
Subjects and Methods: A 1-year audit of consecutive histologically-confirmed breast cancer patients presenting to University of Benin Teaching Hospital was done. Socio-demographic data, time to presentation with reasons, stage at presentation were obtained in a proforma and analyzed.
Results: 92% of patients had delayed presentation. 270 patients with complete records were included in the study. Mean age of patients was 47.6±11.0years, most were between 40 – 49 years (32.2%). Most patients in the study were married (75.6%), of lower class (52.2%) and had tertiary education (55.9%). Delay of 12 – 15months occurred most (54.8%) with advanced stage disease (Stages 3/4; 73%). Use of alternative medicine accounted for most of the delay (48.9%) while fear of mastectomy (30.4%), financial (6.7%) and referral problems (6.7%) were other common reasons.
Conclusion: Delay in presentation is common in our breast cancer patients. Use of alternative medicine, fear of mastectomy, financial issues were common reasons for delay. There should be proper regulation of alternative medical practice to forestall bogus claims of cancer treatment. More affordable and accessible screening centres, insurance coverage of cancer care, alongside enlightenment about effect of delayed presentation and appropriate cancer care in religious houses, amongst traditional rulers and other custodians of cultural practices are required to help mitigate negative beliefs resulting in delayed presentation.