Poor, young breast cancer patients may experience delays in seeking care

A team led by Kathryn J. Ruddy, MD, MPH, and Dr. Ann H. Partridge, MD, MPH, surveyed 585 women recently diagnosed with breast cancer at or under the age of 40 years. This work was conducted at the Dana-Farber Cancer Institute in Boston, MA, where Dr. Partridge works. Dr. Ruddy is currently working at the Mayo Clinic in Rochester, MN. The investigators found that 80 percent of the women detected their own breast abnormalities. Among women with self-detected breast cancers, 17 percent experienced a delay of at least 90 days before they visited a health care provider for an evaluation, and 12 percent reported a delay of at least 90 days between that visit and their diagnosis. Women with poorer financial status were more likely to experience a delay between detecting an abnormality and visiting a health care provider.

"Because we discovered that women who are less financially comfortable are more likely to delay seeking medical attention for breast abnormalities that later are diagnosed as breast cancer, it appears that economic disparity may be an important consideration in future development of interventions to reduce delays," said Dr. Ruddy. "The findings may lead to research focusing on whether reducing copays and 'hidden' costs of seeking medical care -- such as parking charges, child-care expenses, and lost wages -- may improve the timeliness of diagnosis in this population."

The authors also noted a non-significant trend toward more advanced disease in women who experienced a delay between seeing a health care provider and receiving a diagnosis. But because substantial delays only impacted a minority of women who detected their own breast abnormalities, they concluded that factors besides delays -- such as tumor biology -- are likely more influential on breast cancer outcomes in most cases.