title: Misconceptions about breast lumps and delayed medical presentation in urban breast cancer patients.
abstract: BACKGROUND
  Despite current recommendations for women to be screened for breast cancer with mammography every 1 to 2 years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom.
  
  
  METHODS
  In a population-based study of breast cancer, we examined factors potentially associated with patient delay in seeking health care for a breast symptom among 436 symptomatic urban breast cancer patients (146 white, 197 black, and 95 Hispanic). Race/ethnicity, socioeconomic status, health care access and utilization, and misconceptions about the meaning of breast lumps were the key independent variables.
  
  
  RESULTS
  Sixteen percent of patients reported delaying more than 3 months before seeking medical advice about breast symptoms. Misconceptions about breast lumps and lacking a regular provider, health insurance, and recent preventive care were all associated with prolonged patient delay (P < 0.005 for all). Misconceptions were much more common among ethnic minorities and women of lower socioeconomic status.
  
  
  CONCLUSIONS
  Reducing patient delay and disparities in delay will require educating women about the importance of getting breast lumps evaluated in a timely manner and providing greater access to regular health care.
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, M/C 923, Chicago, IL 60612, USA. garthr@uic.edu
authors.forename: Garth H
authors.initials: GH
authors.lastname: Rauscher
authors.forename: Carol Estwing
authors.initials: CE
authors.lastname: Ferrans
authors.forename: Karen
authors.initials: K
authors.lastname: Kaiser
authors.forename: Richard T
authors.initials: RT
authors.lastname: Campbell
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Calhoun
authors.forename: Richard B
authors.initials: RB
authors.lastname: Warnecke
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D055088:Early Detection of Cancer; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008875:Middle Aged; D012959:Socioeconomic Factors