Clinical Implications of Delay in the Diagnosis and Treatment of Early Stage Breast Cancer
Dennis Citrin, Sara Mortensen, Shelly Smekens, Christina Shannon and James Grutsch
World Journal of Psycho-Social Oncology 2013, 2:2
We reviewed the incidence and clinical implication of primary treatment delay in a population of newly diagnosed breast cancer patients.
The original medical record of 591 patients referred to Cancer Treatment Centers of America at Midwestern Regional Medical Center (CTCA/MRMC) with recurrent breast cancer was reviewed and data stored electronically to be analyzed. Approval from our Institutional Review Board (IRB) was not required as this was a retrospective record review with no direct patient contact and no specific patient information or identification was published.
In 95 patients there was a delay of at least six months between the first symptoms of breast cancer and the start of treatment. All but one of the 95 patients presented with a palpable mass. Median delay for the entire group was 18 months. The cause of the delay in starting treatment was; physician error (27/591), patient refusal (65/591) and patient inability to obtain medical care (2/591). Length of delay due to physician error was shorter, and delay due to patients declining medical treatment was significantly longer. Those 23 patients who had attempted to control their disease with alternative treatments before coming to Cancer Treatment Centers of America at Midwestern Regional Medical Center (CTCA/MRMC) were more likely to decline our treatment recommendations.
Delay in diagnosis and treatment of patients with early stage breast cancer is still a common event due to physician error, or more commonly patient reluctance to seek treatment. Delay is associated with higher probability of advanced disease.