Breast cancer: Factors influencing late-stage presentation at the Mankweng Hospital breast cancer clinic, Polokwane, Limpopo Province, South Africa
DOI:
https://doi.org/10.7196/SAMJ.2022.v112i11b.16834Keywords:
Breast cancerAbstract
Background. Female breast cancer remains the most common cancer in many parts of the world. According to GLOBOCAN (2021), female breast cancer has become the most commonly diagnosed cancer, surpassing lung cancer. Women in low- and middle-income countries are reported to seek medical help at an advanced stage of the disease, which negatively affects the prognosis, irrespective of the care available.
Objectives. To determine factors influencing late-stage diagnosis of breast cancer in women at the specialist breast cancer clinic at
Mankweng Hospital in Polokwane, Limpopo Province, South Africa.
Methods. The study was conducted at the Mankweng breast cancer clinic in the rural province of Limpopo over the 18-month period July 2020 - December 2021 and applied a quasi-experimental design to determine the stage of breast cancer at the time of presentation to the clinic, and factors influencing late-stage presentation.
Results. Of the study sample, 269 patients were female (98%) and 5 male (2%). The majority of the females (n=203; 75%) had late-stage
cancer at presentation, only 66 (25%) being in the early stages.
Conclusion. Most of the patients (76%) presented with late-stage disease. The main reason for the delay was lack of knowledge about breast cancer and its symptoms (not painful, not considered serious). Of concern is the higher proportion of educated patients presenting with late-stage disease compared with the group with a lower level of education.
References
Bevers TB, Helvie M, Bonaccio E, et al. Breast cancer screening and diagnosis, version 3.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2018;16(11):1362-1389. https://doi. org/10.6004/jnccn.2018.0083
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394-424. https://doi.org/10.3322/caac.21492
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209-249. https:// doi.org/10.3322/caac.21660
Rayne SL, Schnippel K, Kruger D, Benn CA, Firnhaber C. Delay to diagnosis and breast cancer stage in an urban South African breast clinic. S Afr Med J 2019;109(3):159-163. https://doi.org/10.7196/ SAMJ.2019.v109i3.13283
Moodley J, Cairncross L, Naiker T, Momberg M. Understanding pathways to breast cancer diagnosis among women in the Western Cape Province, South Africa: A qualitative study. BMJ Open 2016;6:e009905. https://doi.org/10.1136/bmjopen-2015-009905
Ramathuba DU, Ratshirumbi CT, Mashamba TM. Knowledge, attitudes and practices toward breast cancer screening in a rural South African community. Curationis 2015;38(1):1172-1179. https://doi. org/10.4102/curationis.v38i1.1172
Asoogo C, Duma SE. Factors contributing to late breast cancer presentation for health care amongst women in Kumasi, Ghana. Curationis 2015;38(1):a1287. https://doi.org/10.4102/curationis.v38i1.1287 8. Joffe M, Ayeni O, Norris SA, et al. Barriers to early presentation of breast cancer among women in Soweto, South Africa. PLoS ONE 2018;13(2):e0192071. https://doi.org/10.1371/journal.pone.0192071 9. National Department of Health, South Africa. Breast cancer control policy. June 2017. https://www.health.gov.za/wp-content/uploads/2021/07/breast-cancer-policy.pdf (accessed October 2021).
Mavhungu R, Bhuiyan MMZU, Ooko F. Profile of patients seen at Pietersburg and Mankweng breast cancer clinics in Limpopo. S Afr Med J 2021;111(11b):1129-1131. https://doi.org/10.7196/SAMJ.2021. v111i11b.16108
Marcus TS, Lunda S, Fernandez L. Delayed breast cancer presentation: Hospital data should inform proactive primary care. Afr J Prim Health Care Fam Med 2013;5(1):503-509. https://doi.org/10.4102/ phcfm.v5i1.503
Mckenzie A, Schneider H, Schaay N, Scott V, Sanders D. Primary health care systems (PRIMASYS): Case study from South Africa. Geneva: World Health Organization, 2017. https://www.researchgate. net/publication/327552599_Case_study_from_South_Africa_PRIMARY_HEALTH_CARE_ SYSTEMS_PRIMASYS (accessed 20 February 2022).
Ibrahim NA, Oludara MA. Socio-demographic factors and reasons associated with delay in breast cancer presentation: A study in Nigerian women. Breast 2012;21(3):416-418. https://doi.org/10.1016/j. breast.2012.02.006
Čačala SR, Gilart J. Factors relating to late presentation of patients with breast cancer in Area 2, KwaZulu-Natal, South Africa. J Glob Oncol 2017;3(5):497-501. https://doi.org/10.1200/ JGO.2016.008060
Trupe AL, Rositch A, Dikerson L, Lucas S, Harvey SC. Knowlegde and attitudes about breast cancer in Limpopo, South Africa. J Glob Oncol 2017;3(5):509-514. https://doi.org/10.1200/ JGO.2016.008102
Damiani G, Federico B, Basso D, et al. Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: A cross sectional study, BMC Public Health 2012;12:99. https://doi. org/10.1186/1471-2458-12-99
Begum SA, Mahmud T, Rahman T, et al. Knowledge, attitude and practice of Bangladeshi women towards breast cancer: A cross sectional study. Mymensingh Med J 2019;28(1):96-104.
Lince-Deroche N, Rayne S, van Rensburg C, Sithabiso CB, Holele MP. Breast cancer in South Africa: Developing an affordable and achievable plan to plan to improve detection and survival. South African Health Review, 1 December 2017:181-188. https://hdl.handle.net/10520/EJC-c8497946c
Downloads
Published
Issue
Section
License
Copyright (c) 2022 MMZU Bhuiyan, MM Maele, R Mavhungu, F Ooko
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Licensing Information
The SAMJ is published under an Attribution-Non Commercial International Creative Commons Attribution (CC-BY-NC 4.0) License. Under this license, authors agree to make articles available to users, without permission or fees, for any lawful, non-commercial purpose. Users may read, copy, or re-use published content as long as the author and original place of publication are properly cited.
Exceptions to this license model is allowed for UKRI and research funded by organisations requiring that research be published open-access without embargo, under a CC-BY licence. As per the journals archiving policy, authors are permitted to self-archive the author-accepted manuscript (AAM) in a repository.
Publishing Rights
Authors grant the Publisher the exclusive right to publish, display, reproduce and/or distribute the Work in print and electronic format and in any medium known or hereafter developed, including for commercial use. The Author also agrees that the Publisher may retain in print or electronic format more than one copy of the Work for the purpose of preservation, security and back-up.
