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Association between mode of breast cancer detection and diagnosis delay
Authors:Anna Crispo  Maurizio Montella  Maddalena Barba  Francesco Schittulli  Maria Rosaria De Marco  Maria Grimaldi  Michele Quaranta  Giuseppe Serravezza  Clementina Savastano  Gerardo Botti  Carlo La Vecchia  Giuseppe D'Aiuto
Institution:1. Department of Epidemiology, National Cancer Institute, “G. Pascale” Foundation, Via M. Semmola, 80131 Naples, Italy;2. Department of Epidemiology, National Cancer Institute, Regina Elena, 00144 Rome, Italy;3. Dipartimento Donna, National Cancer Institute, Ospedale Oncologico, 70124 Bari, Italy;4. Oncology Center, Ospedale “F. Ferrari” Casarano, 73042 Lecce, Italy;5. Department of Medical Oncology, A.O. Ruggi d''Aragona, 84100 Salerno, Italy;6. Department of Pathology, National Cancer Institute, “G. Pascale” Foundation, 80131 Naples, Italy;7. Istituto di Ricerche Farmacologiche ‘Mario Negri’, 20156 Milan, Italy;8. Istituto di Statistica Medica e Biometria ‘G. A. Maccacaro’, Universita` degli Studi di Milano, 20122 Milan, Italy;9. Breast Unit, National Cancer Institute, “G. Pascale” Foundation, 80131 Naples, Italy
Abstract:We investigated the association between mode of breast cancer (Bca) detection and diagnosis delay in a case-series of primary, histologically confirmed Bca patients from Southern Italy.Nine hundred and fifty nine women diagnosed with incident, primary Bca were recruited in two southern Italian regions. We grouped the mode of detection into two categories: Self-Detection (S-D) and Mammography (MG). Diagnosis delay was defined as the time between detection and a histologically confirmed diagnosis of invasive Bca.20.9% detected Bca with MG while 79.1% had S-D Bca. Women who detected Bca themselves (S-D) were more likely to delay breast cancer diagnosis than women who were diagnosed by a mammography (MG) (OR: 2.0; 95% CI: 1.39–2.87); when considering the model adjusted for health system-related characteristics, the risk increased (OR: 2.13; 95% CI: 1.47–3.09).Our study indicates a disadvantage in terms of diagnostic delay for women who were admitted and treated in community hospitals compared to women admitted and treated in breast health services.
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