Delay between Breast Cancer Detection and Arrival at Specialist Clinic Preliminary Revelations of Multicentered Survey in Nigeria

Download Article

DOI: 10.21522/TIJPH.2013.05.04.Art053

Authors : Olayide Sulaiman Agodirin, Olayide Sulaiman Agodirin, Olatoke SA, Rahman GA, Kolawole O


Delay between breast cancer detection and arrival at specialist clinic. Preliminary revelations of multicenter survey in Nigeria

Background: Level of breast cancer awareness and rate of late presentation usually have inverse relationship. The parallel relationship witnessed in Nigeria is a paradox requiring urgent intervention.

Aim: To understand the paradox, we described the patient’s journey from lump detection to arrival at the specialist clinic. Barring awareness, identifying where the major delays still resided will help to re-direct our strategies in the control of breast cancer scourge.

Method: Cross-sectional multicenter questionnaire based survey conducted in surgery outpatient clinics of 10 tertiary institutions in North central and Southwestern Nigeria. Face-to-face interview was conducted using pretested questionnaire. Data was analyzed using SPSS, version 18. p-value was set at 0.05.

Results: One hundred newly diagnosed women responded in this preliminary analysis. Age ranged 26-80 years (mean 50.5± 13.2). Eighty-one (81%) were aware of breast cancer before detecting their lump(s). Eighty-eight (88%) had lumps ≤5cm at detection. Sixty-nine (69%) (p= 0.0001) visited the first orthodox personnel when their lumps were ≤5cm. Only 39(39%) arrived at specialist clinic when their lumps were ≤5cm. Ninety-five respondents (95%) (p=0.0001) visited orthodox personnel first to seek treatment. The first personnel was general practitioner 72% of the times (p=0.0001) (see figure 2). Fifty-eight (58%) consulted the first orthodox personnel within 8 weeks (p=0.133). Only 26% arrived at a specialist clinic within 8 weeks (p=0.0001). Mean interval from detection to first personnel was shorter (61 days) than mean interval between first personnel and specialist clinic (157 days) (P=0.0001)

Conclusion: The longest stretch of journey was between the first orthodox consultation and the specialist clinic.

Keywords: breast cancer, detection, Journey to specialist clinic.


[1].     among south western Nigerian women. International Journal of Current Research. 2015;7.

[2].     Adeoti M, Agodirin O, Odu O, Oguntola A, Bello T, Aderounmu A. The role of men in early detection of their spouses' breast lump(s)/cancer. The Nigerian Journal of General Practice. 2011; 9(2).

[3].     Azubuike S, Okwuokei S. Knowledge, attitude and practices of women towards breast cancer in Benin City, Nigeria. Ann Med Health Sci Res. 2013; 3(2):155-60.

[4].     Amosu A, Degun A, Thomas a, Babalola O. Assessment of awareness, perception, specific knowledge, and screening behavior regarding breast cancer among rural women in Ipokia local government area. Ogun State Nigeria. Archives of Applied Science Research. 2011; 3(2):253-65.

[5].     Babatunde AS, B. Agboola, J. Nwokoro, C. Belief and practices associated with late presentation in patients with breast cancer; an observational study of patients presenting in a tertiary care facility in Southwest Nigeria. African Journal of Cancer. 2015; 7(4):178-85.

[6].     Ermiah E, Abdalla F, Buhmeida A, Larbesh E, Pyrhonen S, Collan Y. Diagnosis delay in Libyan female breast cancer. BMC Research Notes. 2012; 5:452.

[7].     Ezeome ER. Delays in presentation and treatment of breast cancer in Enugu, Nigeria. Niger J Clin Pract. 2010; 13(3):311-6.

[8].     Isara AR, Ojedokun CI. Knowledge of breast cancer and practice of breast self-examination among female senior secondary school students in Abuja, Nigeria. J Prev Med Hyg. 2011; 52(4):186-90.

[9].     Norsa'adah B, Rampal KG, Rahmah MA, Naing NN, Biswal BM. Diagnosis delay of breast cancer and its associated factors in Malaysian women. BMC Cancer. 2011; 11:141.

[10].  Oche M, Ayodele S, Umar A. Breast cancer and mammography: current knowledge attitudes and practices of female health workers in tertiary health institution in Northern Nigeria. Public Health Research. 2012; 2(5):114-9.

[11].  Olayide AS, Halimat AJ, Samuel OA, Ganiyu RA, Soliu OA. Level of Awareness and Knowledge of Breast Cancer in Nigeria. A Systematic Review. Ethiop J Health Sci. 2017; 27(2):163-74.

[12].  Oluwatosin OA, Oladepo O. Knowledge of breast cancer and its early detection measures among rural women in Akinyele Local Government Area, Ibadan, Nigeria. BMC Cancer. 2006; 6:271.

[13].  Olugbenga-Bello A, Oladele EA, Bello TO, Ojo JO, Oguntola AS. Awareness and breast cancer risk factors: perception and screening practices among females in a tertiary institution in Southwest Nigeria. Niger Postgrad Med J. 2011; 18(1):8-15.

[14].  Oladimeji KE, Tsoka-Gwegweni JM, Igbodekwe FC, Twomey M, Akolo C, Balarabe HS, et al. Knowledge and Beliefs of Breast Self-Examination and Breast Cancer among Market Women in Ibadan, South West, Nigeria. PLoS One. 2015; 10(11):e0140904.

[15].  Sharma K, Costas A, Shulman LN, Meara JG. A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. J Oncol. 2012; 2012:121873.

[16].  Tobin E, Okeowo P. Breast self-examination among secondary school teachers in south-south Nigeria: A survey of perception and practice. Journal of Public Health and Epidemiology. 2014; 6(5):169-73.