title: The effect of age on delay in diagnosis and stage of breast cancer.
abstract: BACKGROUND
  Young women with breast cancer are more likely to present with more advanced disease and are more likely to die as a result of breast cancer than their older counterparts. We sought to examine the relationship among young age (≤40 years), the likelihood of a delay in diagnosis, and stage.
  
  
  METHODS
  We examined data from women with newly diagnosed stage I-IV breast cancer presenting to one of eight National Comprehensive Cancer Network centers in January 2000 to December 2007. Delay in diagnosis was defined as time from initial sign or symptom to breast cancer diagnosis >60 days.
  
  
  RESULTS
  Among 21,818 women with breast cancer eligible for analysis, 2,445 were aged ≤40 years at diagnosis. Young women were not more likely to have a delay in diagnosis >60 days (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.98-1.19) after adjustment for type of initial sign or symptom. Young women were only modestly more likely to present with higher stage disease after a similar adjustment (OR, 1.18; 95% CI, 1.07-1.31). Women presenting with symptomatic disease, more common in younger women, were more likely to have a delay in diagnosis (OR, 3.31; 95% CI, 3.08-3.56) and higher stage (OR, 4.31; 95% CI 4.05-4.58).
  
  
  CONCLUSIONS
  Young age is not an independent predictor of delay in diagnosis of breast cancer and only modestly is associated with higher stage disease. Presenting with symptoms of breast cancer predicts delay and higher stage at diagnosis.
authors.affiliation: Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA. ahpartridge@partners.org
authors.forename: Ann H
authors.initials: AH
authors.lastname: Partridge
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Hughes
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Ottesen
authors.forename: Yu-Ning
authors.initials: YN
authors.lastname: Wong
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Edge
authors.forename: Richard L
authors.initials: RL
authors.lastname: Theriault
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Blayney
authors.forename: Joyce C
authors.initials: JC
authors.lastname: Niland
authors.forename: Eric P
authors.initials: EP
authors.lastname: Winer
authors.forename: Jane C
authors.initials: JC
authors.lastname: Weeks
authors.forename: Rulla M
authors.initials: RM
authors.lastname: Tamimi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D016001:Confidence Intervals; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D055815:Young Adult