Procrastinating with Breast Cancer Symptoms

An intriguing study published in the British Journal of General Practice has found that a surprising number of women who develop symptoms of breast cancer put off seeking medical care-often at considerable risk.

The researchers, led by psychologist Caroline Burgess of St. Thomas's Hospital in London, noted that earlier studies had shown that as many as 20 to 30 percent of women with definite breast cancer symptoms postpone seeking treatment. To understand why, they interviewed 46 women who had recently been diagnosed with breast cancer and categorized them into two groups: those who had sought treatment within two weeks of detecting some symptom of breast cancer; and those that had delayed seeking treatment for more than three months.

The researchers found that the women who delayed treatment were more likely to have developed symptoms that were less well known to the general public, such as an inverted nipple or a puckering of the breast (compared to the detection of a lump). These women were more likely to be concerned about "bothering their doctor," and they tended to place their personal health at a lower priority than pressing matters at home and on the job.

Nonetheless, once they finally sought treatment, these women were likely to closely monitor their condition and to seek appropriate treatment if their condition worsened.

The authors said that their findings contradict the traditional notion that "denial" is the prime factor in preventing many women from seeking treatment; they suggested that ignorance of symptoms may also play an important role. Nonetheless, they acknowledged that their findings were somewhat ambiguous and that further research was needed.

"What appears to be denial of serious medical problems or non-compliance with treatment could be interpreted as the individual's wish to explore other options or simply displaying an optimistic or hopeful attitude," they wrote.

Burgess' team called current breast cancer education efforts seriously inadequate. "The public perception of the presenting symptoms of breast cancer may need to be broadened," they urged.

SOURCE:
British Journal of General Practice, December 2001; 51:967-971

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