Breast cancer: Clinical stage at the time of presentation, its correlates and quality of life after treatment

Abstract

Objective: Research worldwide indicates that early presentation of breast cancer leads to early intervention and better prognosis with improved quality of life. Our objectives were to determine the clinical stage of breast cancer in Sri Lankan women at the time of presentation, its correlates and its association with their quality of life after interventions.

Methods: A descriptive cross sectional study was conducted on 200 breast cancer patients attending two selected tertiary care centers in Colombo district, who have undergone treatment. A pre-piloted interviewer-administered questionnaire was used to assess stage of breast cancer at the time of presentation and its correlates. Interviewer-administered SF-36 health survey was used to assess their quality of life.

Results: Early clinical staging (UICC 0, I, II) was seen in 64.6%.  Duration between noticing the first symptom and seeking medical care  is significantly (p< 0.01) associated with age, educational level, self breast examination, breast cancer screening, spouse’s influence and stigma. This duration showed a stronger association (p< 0.001) with presenting symptom, family history, monthly income, availability of transport, initial ayurveda treatment, fear of detection, fear of surgery, embarrassment, and unawareness.

Mean SF 36 score was 46. Fifty nine percent of both early and late clinical staged patients had a score  above mean.

Conclusion: Promotion of self breast examination and screening for breast cancer is of value in early detection and presentation. Improved awareness about breast cancer and a facilitatory health care process would improve outcome of disease.