Abstract:

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.

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