Mamoon Rashid, Rafi C M, Nadira Mamoon.
Late presentation of Carcinoma Breast in Pakistani Women.
Pak Armed Forces Med J Jan ;46(2):11-5.

Carcinoma of the breast is one of the commonest malignancies in women worldwide. Patients in our country usually present late with advanced disease. This study was conducted to delineate the reasons for this late presentation and its impact on the management and prognosis. Delay in presentation was attributed by 73 152.5%) to painlessness of the lump. Sixty-seven patients(48.2%) were afraid of surgery in general while 46133%) were scared of losing the breast. Non availability of a female doctor was cited as a delaying factor by 64 (46%) patients. Lack of education per se was not a significant factor in late presentation as 129 of 139 patients (92.8%) were literate with only 10 (7.2%) being totally illiterate. Fifty one (36.8%) had completed intermediate or higher level of education. Increasing parity was another factor for delay with 12 of 15 (80%) of the nulliparae presenting within one month while only 5 (9.2%) of the 54 women with 4-8 children presenting in this time period. The delay in presentation was found to have a direct brearing on the stage of the disease. 58 patients (31.2%) reported within one month of the onset of symptoms and 22.8%) were in clinical stage-I. 91 patients (48.9%) presented between 1-6 months of the onset and only 7 (3.7%) were in stage-I of the 36 patients (19.3%) who presented after 6 month there were non in stage-I or stage-II.

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