Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
PLoS One. 2021 May 25;16(5):e0252008. doi: 10.1371/journal.pone.0252008. eCollection 2021.
Breast cancer is the leading cause of death in Singaporean women, with advanced stage rendering a poorer prognosis. This study aims to explore the barriers to early presentation, information needs and sources in patients with locally advanced breast cancer (LABC).
MATERIALS & METHODS: A convenience sample of patients who presented with locally advanced breast cancer to the Department of General Surgery in a teaching tertiary hospital were recruited for the study. We conducted semi-structured interviews face to face with the recruited patients. We recorded the interviews, transcribed them verbatim and analysed using thematic content analysis.
Twenty-three participants were recruited of which 12 were Chinese and 11 were Malay women. Mean age was 60 years (± 13 SD). The most common knowledge barrier resulting in delay was the misconception that a breast lump must be painful to be malignant. Other knowledge barriers include the lack of knowledge and misinformation from the internet or other social media platforms. Some perceived barriers include fear of diagnosis, fear of treatment and fear of imposing financial burden on family members. A significant proportion of participants were also not aware of a national breast screening programme.
Our study has found that barriers to early presentation of women with locally advanced breast cancer remain similar and have persisted over the years despite targeted efforts. There is a need for a rethink of existing strategies and to develop new innovative ways to reach out to this group of patients.
乳腺癌是新加坡女性死亡的主要原因，晚期乳腺癌的预后较差。本研究旨在探讨局部晚期乳腺癌（LABC）患者就诊时的障碍、信息需求和信息来源。
便利选取在一所教学型三级医院普外科就诊的局部晚期乳腺癌患者作为研究对象。我们对招募的患者进行了面对面的半结构式访谈。我们记录了访谈内容，逐字转录，并进行主题内容分析。
共招募了 23 名参与者，其中 12 名为华人，11 名为马来人。平均年龄为 60 岁（±13 标准差）。导致延迟就诊的最常见知识障碍是错误观念，即乳房肿块必须疼痛才是恶性的。其他知识障碍包括缺乏来自互联网或其他社交媒体平台的知识和错误信息。一些感知障碍包括对诊断的恐惧、对治疗的恐惧和对给家庭成员带来经济负担的恐惧。相当一部分参与者也不知道国家的乳房筛查计划。
我们的研究发现，尽管有针对性的努力，但女性局部晚期乳腺癌患者就诊时的障碍仍然相似且多年来一直存在。需要重新考虑现有的策略，并开发新的创新方法来接触这一群体的患者。
