Saleem Saira, Tariq Sundus, Tariq Saba, Irfan Sofia, Javed Farhan
Dr. Saira Saleem, MBBS., FCPS., FRCS. Professor General Surgery, Madinah Teaching Hospital & The University of Faisalabad, Faisalabad, Pakistan.
Dr. Sundus Tariq, MBBS., MPhil., PhD. Professor Physiology, University Medical & Dental College, The University of Faisalabad, Faisalabad, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):80-85. doi: 10.12669/pjms.39.1.6647.
A delayed presentation of benign breast diseases may lead to a therapeutic challenge when they enlarge enormously or become multiple. Aim of this study was to evaluate the factors leading to delayed presentation of benign breast lumps.
This cross-sectional study was conducted at Madinah Teaching Hospital and Allied Hospital, Faisalabad from January 2019 to October 2021. One hundred and forty five female patients were selected by non-probability purposive sampling. Patients with large size (>5cm) or multiple benign breast lumps were included. An interview was conducted using structured questionnaire translated in Urdu. Factors leading to delayed presentation and social impact scale for stigma were evaluated.
Patients had a mean age of 26.52 ± 6.90 years. The average delay of seeking medical care was 8.48 ± 8.41 months. Factors leading to delayed presentation were; lack of knowledge n=112 (77.2%) and parda (religious issues) n=112 (77.2%), followed by poverty n=109 (75.2%), and fear of cancer n=90 (62.1%). All the sub-scales of stigma, i.e., social rejection, financial insecurity, internalized shame and social isolation were high in late presenters, though, only financial insecurity was significantly high in late presenters (p=0.03).
Lack of awareness, socioeconomic factors and disease related stigma were the main factors related to delayed presentation in young females with benign breast diseases. Addressing these factors may improve timely diagnosis and management of delayed and challenging cases.
良性乳腺疾病若出现巨大增大或变为多发性，延迟就诊可能带来治疗挑战。本研究旨在评估导致良性乳腺肿块延迟就诊的因素。
本横断面研究于2019年1月至2021年10月在麦地那教学医院和费萨拉巴德联合医院开展。通过非概率立意抽样选取了145名女性患者。纳入了患有大尺寸（>5厘米）或多发性良性乳腺肿块的患者。使用乌尔都语翻译的结构化问卷进行访谈。评估导致延迟就诊的因素以及耻辱感的社会影响量表。
患者的平均年龄为26.52±6.90岁。寻求医疗护理的平均延迟时间为8.48±8.41个月。导致延迟就诊的因素有：知识缺乏，n = 112（77.2%），以及宗教问题，n = 112（77.2%），其次是贫困，n = 109（75.2%），以及对癌症的恐惧，n = 90（62.1%）。在延迟就诊者中，耻辱感的所有子量表，即社会排斥、经济不安全、内化羞耻和社会隔离程度都很高，不过，只有经济不安全在延迟就诊者中显著较高（p = 0.03）。
缺乏认知、社会经济因素和疾病相关的耻辱感是年轻女性良性乳腺疾病延迟就诊的主要相关因素。解决这些因素可能会改善对延迟和具有挑战性病例的及时诊断和管理。
