Women with breast cancer who do not have palpable masses experience delays that may affect their outcomes. It is important for women and healthcare providers to be aware that breast cancer's earliest symptom may not be a breast mass. Patients and providers should have a low threshold to seek evaluation by a breast health specialist.
Typical and Atypical Symptoms in Women with Breast Cancer: Evidence of Variation in Diagnostic Intervals from a National Audit of Cancer Diagnosis
Authors: Koo, M. M. et al.
Source: Presented as a poster at the annual conference of the National Cancer Research Institute, 6 November 2016
The investigators evaluated over 2,300 cases of breast cancer in a national database. They looked at the presenting symptoms that these women had and put them into different groups accordingly. Most women had palpable breast masses. The term “other symptoms” was used to describe nipple and skin abnormalities, breast pain, ulceration, contour abnormalities or infection/inflammation of the breast. For each group, they noted the time between onset of symptoms and seeing a primary provider, as well as time between presenting to a primary provider and being referred to a specialist.
The group found that women with palpable breast masses waited the shortest amount of time before seeing a primary provider, and those providers referred them to a specialist in the general range of 0 to 7 days after seeing the patient. Women who had “other symptoms” waited about 1.5 times longer before seeing a primary provider, and those providers took about 1.6 times longer to refer their patients. Women who had both a palpable mass and other symptoms waited twice as long to see a provider as women who only had palpable masses. For these women, their primary providers waited 2.5 times longer to send them to a specialist.
Not all women with breast cancer present with palpable breast masses. This study demonstrates that women with other symptoms experienced a delay in evaluation. It is important for both patients and healthcare providers to be aware of the many possible symptoms of breast cancer so that new complaints can be evaluated quickly.