Ferdause Jannatul, Ahmed Nusrat, Rahman Lubaba, Rahatul Aain Kazi Ridwana, Ferdausi Farhana Afrin, Kadir A K M Shafiul, Haque Md Ariful
Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh.
Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh.
Medicine (Baltimore). 2025 Mar 7;104(10):e41775. doi: 10.1097/MD.0000000000041775.
Breast cancer poses a significant health challenge for women globally, with survival rates varying widely between and within countries. The correlation between delayed diagnosis and lower survival rates is well-established, emphasizing the importance of addressing barriers to early presentation to improve survival rates in low-middle-income countries like Bangladesh. The objective of the study was to assess how often breast cancer patients present late, pinpoint the underlying reasons for the delay, and examine any potential links between delayed presentation and socio-demographic factors in our context. A prospective cross-sectional study was conducted at Ahsania Mission Cancer and General Hospital from July 2023 to December 2023. The study focused on newly diagnosed breast cancer patients attending the outpatient department. Following the provision of consent, the patient's information was obtained through face-to-face interviews and a review of their medical records. Diagnostic delay was defined as 90 days or more from the onset of symptoms to the initiation of medical treatment (by expert physicians). The collected data was stratified based on various socio-demographic variables, including age, marital status, education status, and socio-economic status. Data analysis and visualization were performed using Microsoft Excel and SPSS V 25. The study involved 242 participants; the majority (126, 52.06%) were aged 41 to 60 and came from a low-income, uneducated social background. Stage II breast cancer was the most common presentation (137, 56.6%). The average duration from diagnosis was 5.18 months, and nearly half of the patients (112, 46.28%) experienced more than 3 months of diagnostic delay. The delay in diagnosis was significantly associated with the patient's socio-economic status and the stage of cancer. The primary cause of delayed diagnosis was a lack of awareness about breast cancer symptoms, particularly the painless nature of breast lumps, which patients either did not notice or did not consider serious enough to seek medical attention, followed by the initial pursuit of alternative treatments. To facilitate earlier breast cancer diagnosis, policies should prioritize community-based education programs and adequate screening procedures, as well as expanded healthcare access.
乳腺癌对全球女性的健康构成了重大挑战，各国之间以及各国内部的生存率差异很大。延迟诊断与较低生存率之间的关联已得到充分证实，这凸显了在孟加拉国等中低收入国家消除早期就诊障碍以提高生存率的重要性。本研究的目的是评估乳腺癌患者延迟就诊的频率，找出延迟的根本原因，并考察在我们的研究背景下延迟就诊与社会人口因素之间的潜在联系。2023年7月至2023年12月在阿赫萨尼亚使命癌症综合医院进行了一项前瞻性横断面研究。该研究聚焦于在门诊部就诊的新诊断乳腺癌患者。在获得患者同意后，通过面对面访谈和查阅病历获取患者信息。诊断延迟定义为从症状出现到开始接受治疗（由专家医生进行）的时间为90天或更长。收集的数据根据各种社会人口变量进行分层，包括年龄、婚姻状况、教育程度和社会经济状况。使用Microsoft Excel和SPSS V 25进行数据分析和可视化。该研究涉及242名参与者；大多数（126名，52.06%）年龄在41至60岁之间，来自低收入、未受过教育的社会背景。II期乳腺癌是最常见的表现（137例，56.6%）。从诊断到就诊的平均时长为5.18个月，近一半的患者（112例，46.28%）经历了超过3个月的诊断延迟。诊断延迟与患者的社会经济状况和癌症分期显著相关。延迟诊断的主要原因是对乳腺癌症状缺乏认识，尤其是乳房肿块的无痛性，患者要么没有注意到，要么认为不够严重而未寻求医疗关注，其次是最初寻求替代治疗。为促进乳腺癌的早期诊断，政策应优先考虑基于社区的教育项目、适当的筛查程序以及扩大医疗服务可及性。
