Researchers who sought to determine why breast cancers are more deadly
in young women found that only a minority of young women experience long
delays between the time they detect a breast abnormality and the time
they receive a diagnosis, but delays in seeking care are more common in
women with fewer financial resources. The findings are published early
online in CANCER,
a peer-reviewed journal of the American Cancer Society.
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.
