Patient perspectives on strengths, barriers, and recommendations for improvement in breast cancer diagnosis in Tanzania: a qualitative study

Breast cancer is the second most common cancer among women in Tanzania. However, many women face various obstacles in obtaining a breast cancer diagnosis. While efforts to understand these barriers and ways to tackle them have been made, few efforts have been made to solicit recommendations on how to improve breast cancer diagnosis directly from patients. This study, therefore, explored the experiences of Tanzanian women in securing a breast cancer diagnosis and gathered their recommendations for improving the diagnostic pathway in a resource-constrained setting. We conducted a qualitative study involving 14 women who completed breast cancer treatment at Muhimbili National Hospital and Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Data were collected through in-depth, semi-structured interviews. Interview prompts focused on the participant’s experiences related to the breast cancer diagnostic process. Data were analyzed using the Model of Pathways to Treatment framework and a rapid analysis approach. Participants had a median age of 49.5 (range 40–60) years. All participants were cancer survivors of which 71% (10/14) were also patient advocates. Strengths identified within the health system included the availability of primary care and specialized cancer care services, some health insurance coverage, and social welfare support from various healthcare facilities. Barriers to timely diagnosis included financial and logistical constraints, insufficient resources in healthcare facilities, and limited breast cancer knowledge among non-specialized healthcare providers. Participants also reported complicated referral pathways, delays in receiving biopsy results, and poor patient-provider communication. Recommendations for improvement included enhancing patient-provider communication, reducing costs for diagnosis, strengthening pathology services, and incorporating psychological support in breast cancer care. This study highlights the strengths and weaknesses of Tanzania’s healthcare system for breast cancer diagnosis from the perspectives of patients. Initiatives to improve breast cancer care should build on existing evidence and prioritize integrating patient suggestions, such as improving patient-provider communication and strengthening pathology services.