title: Breast cancer patients' presentation for oncological treatment: a single centre study.
abstract: BACKGROUND
  Breast cancer patients are presenting at advanced stages for oncological treatment in Nigeria and World Health Organization predicted developing countries' breast cancer incidence and mortality to increase by year 2020.
  
  
  METHODS
  Prospective observational hospital based study that enrolled breast cancer patients from catchment area of an oncology service hospital in Nigeria between 2007 and 2013. Patients' demographics, breast cancer burden and health care giver presentation variables were analysed for causal factors of seeking medical help and what determines commencement of effective oncological treatment.
  
  
  RESULTS
  Forty-six patients were enrolled, 19.6% of them presented primarily to oncologist while 80.4% presented secondarily for oncological treatment. There is a significant difference in presentation time for oncological treatment (t = -3.56, df = 42.90, p = 0.001) between primary (M =11.56 ± 5.21 weeks) and secondary presentation (M= 52.56 ± 10.27weeks). Tumor burden of those that presented secondarily were significantly more advanced (U = 78.5, p = 0.011) and, univariate analysis reveals that: patients' matrimonial setting, breast cancer awareness and mode of discovery of breast symptoms are patient related factors that determines their choice of health care providers and, determinant of effective oncological treatment is patient first contact health care provider.
  
  
  CONCLUSIONS
  Patients' bio-characteristics that determine their choice of health care provider should be incorporated into community breast cancer sensitization drives. Additionally, there is a need for a government agency assign the task of accrediting and defining scope of enterprise of health care institutions and their health care providers in our pluralist health system.
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Akinbolaji Andrew
authors.initials: AA
authors.lastname: Akinkuolie
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Amarachukwu Chiduziem
authors.initials: AC
authors.lastname: Etonyeaku
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Olalekan
authors.initials: O
authors.lastname: Olasehinde
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
authors.forename: Olukayode Adeolu
authors.initials: OA
authors.lastname: Arowolo
authors.affiliation: Department of Surgery, Obafemi Awolowo University, Teaching Hospitals Complex Ile-Ife, Nigeria.
authors.forename: Rereloluwa Nicodemus
authors.initials: RN
authors.lastname: Babalola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009549:Nigeria; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013997:Time Factors
keywords: Breast cancer; oncological treatment; presentation