Understanding diagnostic delays among newly diagnosed breast cancer patients at a tertiary cancer care center in a low-middle-income country like Bangladesh

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.