Delayed presentation of breast cancer patients.

OBJECTIVE To determine the extent and nature of delayed presentation of patients treated for breast cancer at Kenyatta National Hospital (KNH). DESIGN Prospective cross sectional study. SETTING Kenyatta National Hospital (KNH) which is a tertiary, teaching and referral hospital in Nairobi, Kenya. RESULTS A total of 166 patients were recruited into the study. The mean age was 47 years with a range between 17 and 88 years. Females constituted 98.8%, had an average of 4.5 children per subject with a median of 4 and a range of 0-11. A lump as the first noticed symptom present in 87.3% and 52.1% were pre-menopausal. Only 11 (6.62%) patients presented within 30 days of discovering their breast symptom, 34 (20.4%) presented between thirty and ninety days and the remaining 115 (73.1%) presented three months after noticing their symptom. Three reasons accounted for 67.5% of the delay. Thirty three (19.9%) kept away fearing that they would be told they had cancer while 39 (23.5%) presented late because their breast symptom was painless. Another 40 (24.1%) said they had earlier visited medical personnel who had reassured them that their symptoms were benign. CONCLUSION Majority of patients treated for advanced breast disease presented to the healthcare providers at KNH more than three months after noticing their breast symptom and a sizeable number of patients were being reassured falsely that they have benign disease without the benefit of biopsy.