Pathways to breast cancer presentation – Associate Professor Jennifer Moodley
Associate Professor Jennifer Moodley
Pathways to breast cancer presentation.
Breast cancer is a major public health burden and remains the commonest cancer among women worldwide, including in South Africa. Similar to other developing countries, the majority of patients in South Africa present with late stage disease which is associated with a poorer outcome. Research on factors associated with delayed breast cancer presentation from developing countries is limited. The aim of the project is to explore and understand women’s pathway to breast cancer diagnosis and factors influencing this journey determine magnitude of and factors associated with delayed presentation of breast cancer. Qualitative and quantitative research methods will be used to meet the study objectives. Results of the study could have public benefit by providing information for targeted early detection interventions.
A total of 204 women were interviewed about their journey from the discovery of a breast sign to a diagnosis of breast cancer. The average age of women was 55 years, 75% had a high school or higher education and the majority were unemployed. The commonest symptom was a breast lump. Overall 22% of women presented with late stage disease, which is associated with a poorer outcome. The median time between discovery of a symptom and diagnosis was 110 days. This interval was divided into 3 intervals viz. the patient, diagnostic and pre-treatment intervals. Predictors of a longer patient interval were an initial symptom appraisal as possibly breast cancer and an increase in lump size as a trigger for seeking care. Women who had a past history of a breast fibroadenoma had a significantly longer diagnostic interval. Women who required surgery as the first mode of treatment also had a longer pre-treatment interval.
- Understanding pathways to breast cancer diagnosis Qualitative exploration of symptom appraisal health seeking behaviour
- Understanding pathways to breast cancer diagnosis among women in the Western Cape Province, South Africa: a qualitative study. Jennifer Moodley, Lydia Cairncross, Thurandrie Naiker, Mariette Momberg. BMJ Open 2016.