Operable breast cancer patients with diagnostic delay--oncological and emotional characteristics.
OBJECTIVE
Delayed diagnosis in cancer patients often implies presentation with advanced disease with poorer prognosis as a consequence. The aim of the present study was to gain more insight into mechanisms which determine patient delay in the diagnosis of operable breast cancer, stages I and II.


METHODS
Patient delay was related to socio-demographic, psychological and clinical-oncological variables in 96 consecutive patients investigated one day before surgery.


RESULTS
Patients with a diagnostic delay for one month or more (N=29) reported increased emotional control compared to patients without delay (N=67) (Mean score on Courtauld Emotional Control scale (CEC) 54.5 vs 46.4; p=0.003) and more often grade I tumour (17 out of 29 vs 16 out of 67 patients; p=0.002). Diagnostic delay was predicted independently by tumour differentiation (hazard ratio=5.0; p<0.01 (95% CI: 1.7-14.8)) and emotional control (hazard ratio=5.1; p<0.01 (95% CI: 1.6-16.1)). Multivariate survival analysis with tumour grading and patient delay as covariates showed significant survival effect for tumour differentiation only (hazard ratio=4.4; p<0.05 (95% CI: 1.3-15.4)).


CONCLUSIONS
There seems to be an association between aggressiveness of tumour growth, diagnostic delay and emotional control in patients with early stage breast cancer. Clinical implications of these findings are discussed.
Department of Psychiatry, Rogaland Central Hospital, Institute of Psychiatry, University of Bergen, 4068 Stavanger, Norway. l-tjemsl@online.no
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Søreide
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D013315:Stress, Psychological