Factors associated with delay in presentation of breast cancer in Benin

Background: Late presentation accounts for the high morbidity and mortality associated with breast cancer. Aim: To determine the factors associated with late presentation of breast cancer in our environment. Setting: The University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Methods: In this prospective study, questionnaires were administered to 103 consecutive patients with breast cancer over a 5-year period (April 1999-March 2004). Information obtained included duration of symptoms, marital status, level of education and degree of knowledge of breast cancer. Others included consultation of tradomedical practitioners/spiritualists and the availability of medical personnel/facility in the areas of domicile of the patients. Results: A total of 77 (74.8%) patients presented with late breast cancer. Only 3 (2.9%) presented within 4 weeks of onset of symptoms (median 38 weeks). Late presentation was identified in 45 of 51 unmarried patients (88.3%) and in 32 of 52 married patients (61.5%). None of 15 illiterate, 1 of 22 secondary and 2 of 8 tertiary educated patients presented within 4 weeks of onset of symptoms. Whereas 90% of patients had accessible health care, 18 (7.5%) and 52 (50.5%) still patronized traditional healers and spiritual-miracle working homes respectively. None was deterred by fear of surgery while 7 were delayed by the primary physician. Conclusion: Sustained massive public enlightenment campaign and continuing medical education for health practitioners are necessary for the achievement of early presentation of breast cancer. Keywords : Factors, Delayed presentation, Breast cancer PHMJ Vol. 2 (2) 2008: pp. 97-102