Women with inoperable or locally advanced breast cancer -- what characterizes them? A retrospective review of 157 cases.
BACKGROUND
Breast cancer is the most common cancer among Danish women. Locally advanced breast cancer occurs in a relatively large proportion of all new primary breast cancer diagnoses and for unexplained reasons 20-30% of women with breast cancer wait more than eight weeks from the initial breast cancer symptom(s) before seeking medical advice.


METHODS
In this study, we performed a retrospective review of the medical records of patients referred to The Department of Breast Surgery, Rigshospitalet in Copenhagen in the period between 2006 and 2011, to characterize women presenting with breast cancer either larger than 5 cm or locally advanced breast cancer/inoperable breast cancer (LABC/IOBC). The aim of the study was to characterize these women concerning age, social status, co-morbidity, defined anamnestic parameters concerning breast history and delay in seeking medical advice, to explore whether common traits among these parameters could be identified which could account for the late diagnosis.


RESULTS
We identified 157 cases. The median age of our cohort was 67 years (range 30-98) and did not differ from all women with breast cancer, but with a high risk of severe medical co-morbidity, psychiatric co-morbidity or dementia. However, 42% did not reveal any history of a psychiatric or somatic co-morbidity did not take psychoactive drugs and had no previous benign breast disorder. They were living in their own homes, were married, did not suffer from dementia, could have a first-degree relative with a history of breast cancer, but still presented with breast cancer characterized as LABC/IOBC, without any apparent reason. Among these 42%, more than half had neglected their obvious symptoms of breast cancer.
Rigshospitalet, Department of Plastic Surgery, Breast Surgery and Burncare, Copenhagen, Denmark. w.laegevagt@gmail.com
Waseem Asim Ghulam
WA
El-Charnoubi
Jesper Brink
JB
Svendsen
Ulla Brix
UB
Tange
Niels
N
Kroman
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D015897:Comorbidity; D057210:Delayed Diagnosis; D003717:Denial, Psychological; D003718:Denmark / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D012923:Social Class; D013997:Time Factors