Delays in presentation and treatment of breast cancer in Enugu, Nigeria.

TLDR: For breast cancer prevention programs in Nigeria to succeed, they must in addition to breast awareness and screening programs, address the institutional bottlenecks, the dearth of knowledge among primary care physicians and improve referrals from alternative practitioners and prayer houses.

Abstract: To assess the delays and define the causes of delay in presentation and treatment of breast cancer patients inEnugu,Nigeria. Across-sectional survey of breast cancer patients using a semi structured questionnaire. SurgicalOncology unit,University ofNigeriaTeachingHospitalEnugu, (UNTH-E),Nigeria. 164 consecutively presenting breast cancer patients seen between June 1999 andMay 2005. Most of the patients (82.3%) reported for initial evaluation at a modern health facility while 17.5% reported first toAlternative practitioners. Forty six patients (26.4%) presented within a month of noticing the symptoms while 72 (45.3%) delayed more than 3 months. In contrast, 18 (17%) were seen at the site of definitive treatment within one month of seeking help at the initial hospital while 73.4% had a delay of more than 3months after the initial hospital contact. Institutional or physician induced delayswere present in 46.2% of the caseswhile patient related delayswere present in 79.2% of cases.Only use of alternative practitioners for initial treatmentwas significantly related to delays ofmore than threemonths before presentation (p= 0.017). For breast cancer prevention programs in Nigeria to succeed, they must in addition to breast awareness and screening programs, address the institutional bottlenecks, the dearth of knowledge among primary care physicians and improve referrals fromalternative practitioners and prayer houses. Keywords: Breast cancer, delayed presentation, treatment,Nigeria.