Global BulletinAll NewsFDA Approval AlertWomen in Oncology
Expert InterviewsAround the PracticeBetween the LinesFace OffFrom All AnglesMeeting of the MindsOncViewPodcastsTraining AcademyTreatment Algorithms with the Oncology Brothers
Conferences
All JournalsEditorial BoardFor AuthorsYear in Review
Frontline ForumSatellite Sessions
CME/CE
Awareness MonthInteractive ToolsNurse Practitioners/Physician's AssistantsPartnersSponsoredSponsored Media
Career CenterSubscribe
Adverse Effects
Brain Cancer
Breast CancerBreast CancerBreast Cancer
Gastrointestinal CancerGastrointestinal CancerGastrointestinal CancerGastrointestinal CancerGastrointestinal CancerGastrointestinal Cancer
Genitourinary CancersGenitourinary CancersGenitourinary CancersGenitourinary Cancers
Gynecologic CancersGynecologic CancersGynecologic CancersGynecologic Cancers
Head & Neck Cancer
Hematologic OncologyHematologic OncologyHematologic OncologyHematologic Oncology
InfectionInfection
Leukemia
Lung CancerLung CancerLung Cancer
Lymphoma
Neuroendocrine Tumors
Oncology
Pediatric Cancers
Radiation Oncology
Sarcoma
Screening
Skin Cancer & Melanoma
Surgery
Thyroid Cancer
Spotlight -
  • Radiation Oncology
  • Surgery
Adverse Effects
Brain Cancer
Breast CancerBreast CancerBreast Cancer
Gastrointestinal CancerGastrointestinal CancerGastrointestinal CancerGastrointestinal CancerGastrointestinal CancerGastrointestinal Cancer
Genitourinary CancersGenitourinary CancersGenitourinary CancersGenitourinary Cancers
Gynecologic CancersGynecologic CancersGynecologic CancersGynecologic Cancers
Head & Neck Cancer
Hematologic OncologyHematologic OncologyHematologic OncologyHematologic Oncology
InfectionInfection
Leukemia
Lung CancerLung CancerLung Cancer
Lymphoma
Neuroendocrine Tumors
Oncology
Pediatric Cancers
Radiation Oncology
Sarcoma
Screening
Skin Cancer & Melanoma
Surgery
Thyroid Cancer
    • Conferences
    • CME/CE
    • Career Center
    • Subscribe
Advertisement

Diagnostic Delays in Younger Women With Breast Cancer Are Mostly Patient-Related

April 11, 2024
By Gina Mauro
News
Article

Young patients with breast cancer were more likely to be the reason for diagnostic delays vs system delays, partly due to less concern for their symptoms.

"Better awareness on both the public and the practitioner end is needed regarding what is a concerning symptom, and that if things persist or change or get worse, follow-up is important," according to lead study author Katherine Fleshner, MD.

"Better awareness on both the public and the practitioner end is needed regarding what is a concerning symptom, and that if things persist or change or get worse, follow-up is important," according to lead study author Katherine Fleshner, MD.

Patient delays were the most common reasons for diagnostic delays in young women with breast cancer, according to survey results that were presented during a press briefing ahead of the 25th Annual American Society of Breast Surgeons Annual Meeting.1,2

Patient delays were 31.7% of the cause for diagnostic delays compared with 10.7% that were due to system delays. Additionally, predictors of patient delays in this patient population included painful lumps and having a first-degree relative with breast cancer.

Specifically, the median number of weeks that patients waited before seeking care was 2.0 weeks. Reasons for patient delay included patients not being worried about their symptoms (48.5%), waiting to see if it went away (32.9%), someone reassuring them their symptoms were not serious (6.9%), difficulty accessing timely care (6.4%), other priorities (3.6%), and fear (1.7%).

The wait time to a patient’s first doctor’s appointment was mostly less than 1 week, followed by 1 to 2 weeks, 3 to 4 weeks, and more than 4 weeks.

“Many of the reasons for patient delay had to do with patients not being aware that what they were experiencing could be related to malignancy,” lead study author Katherine Fleshner, MD, a postgraduate general surgical fellow of the University of Calgary in Canada, said in a press briefing ahead of the meeting. “The diagnostic journey overall can be complex in this population, mostly because there is a large percentage of benign breast findings in young women. Better awareness on both the public and the practitioner end is needed regarding what is a concerning symptom, and that if things persist or change or get worse, follow-up is important.”

Younger patients with breast cancer generally present differently than older patients and have more aggressive disease phenotypes. For example, younger patients are symptomatic and are often diagnosed at later stages when the disease has metastasized.

“We do know that this is a distinctly different population of patients compared with the typical postmenopausal ones who are diagnosed through screening,” Fleshner said.

Theoretical reasons for this are that younger women are not generally included in screening protocols, breast cancer is not often suspected, and there may be an element of diagnostic delay.

In the pan-Canadian study, young patients were defined as those who are younger than age 40 who present with newly diagnosed breast cancer, which Fleshner said is about 5% of all annual cases. Investigators sought to determine whether the diagnostic delay does exist in this younger patient population in Canada through the presentation of disease, the diagnostic process and timeline, and predictors of diagnostic delay.

Data were analyzed from a cohort of the Reducing the bUrden of Breast cancer in Young Women (RUBY) trial, which comprised patients 40 years and younger who had breast cancer and were enrolled at the time of their first meeting with a surgeon. Patients were prospectively recruited from 32 centers in the Yukon, British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Atlantic Canada, and Quebec regions, and 5 surveys were distributed to them via email and completed between 2015 and 2022. Follow-up was conducted over 5 years.

The surveys comprised questions on demographic data, personal history, medical history, how they came to their diagnosis, wait times, and their perception of their diagnosis process overall.

To define the diagnostic delay, investigators evaluated the time between the first symptom detected by the patient to the first contact with a health care provider (patient delay), first contact with the provider to first doctor’s appointment plus or minus investigations ordered (system delay), and also time from the first appointment to breast cancer diagnosis (system delay). Patient delay was defined as greater than 4 weeks, or 1 menstrual cycle, from onset of symptoms to first contact with a health care professional, while a system delay, was defined as more than 3 weeks from time of presentation to care to time of first imaging test, which was based on Canadian Partnership Against Cancer guidelines.

A total of 1148 patients were included on the study. The median age was 37 years (IQR, 33.9-39.0), most were Caucasian, and 43% were reported being otherwise healthy. A total of 36.8% of patients had a first-degree relative with cancer. Eighty-nine percent of patients had symptoms as their first detection of cancer—77.3% of whom had a palpable mass—followed by screening (8%), routine clinical breast cancer (2%), and incidental finding (1%). Reported symptoms included a painless lump (n = 516), painful lump (n = 208), multiple symptoms (n = 197), breast pain (n = 36), skin/nipple changes (n = 34), and nipple discharge (n = 27).

References

  1. Fleshner K, Yang F, Isherwood S, Xu, Quan ML. Diagnostic delay among young women with breast cancer. Presented at: 25th Annual American Society of Breast Cancer Surgeons Meeting; April 10-14, 2024; Orlando, FL.
  2. Young Women Frequently Delay Breast Cancer Assessment. The American Society of Breast Surgeons. News release. Published April 11, 2024. Accessed April 11, 2024. https://tinyurl.com/yc25bzp7

Recent Videos
Use of a pharmacist-directed resource appears to improve provider confidence and adverse effect monitoring for patients undergoing infusion therapy.
Reshma L. Mahtani, DO, describes how updates from the DESTINY-Breast09, ASCENT-04, and VERITAC-2 trials may shift practice in the breast cancer field.
Stage IV lung cancer may be curable based on the success of the DREAM Program, according to thoracic surgeon, Ankit Bharat, MBBS,
Ankit Bharat, MBBS, a thoracic surgeon, discussed potential treatment emergent adverse effects or complications, as well as strategies for managing them.
Thoracic surgeon, Ankit Bharat, MBBS, discussed surgical strategies among patients with advanced lung cancer diagnoses based on staging.
In a CancerNetwork® YouTube video, Cornelia Tischmacher, a mother of twins from Germany, outlined her receipt of double lung transplantation.
Related Content
Advertisement

Ipatasertib/Fulvestrant Combo Prolongs PFS in ER+/HER2– Metastatic Breast Cancer

Ipatasertib/Fulvestrant Combo Prolongs PFS in ER+/HER2– Metastatic Breast Cancer

Kyle Doherty
June 1st 2025
Article

Patients who received ipatasertib/fulvestrant in the intention-to-treat population achieved a median PFS of 5.32 months compared with 1.94 months in the placebo arm.


Findings highlight a need to incorporate diverse populations when developing guideline-concordant breast cancer care to achieve efficacy for all patients.

Eliminating Racial Disparities in Guideline-Concordant Breast Cancer Care

Oluwadamilola “Lola” Fayanju, MD, MA, MPHS, FACS
April 21st 2025
Podcast

Findings highlight a need to incorporate diverse populations when developing guideline-concordant breast cancer care to achieve efficacy for all patients.


PROs Favor Imlunestrant With/Without Abemaciclib in ER+, HER2– Breast Cancer

PROs Favor Imlunestrant With/Without Abemaciclib in ER+, HER2– Breast Cancer

Tim Cortese
May 31st 2025
Article

Across all 3 treatment arms, global health status/quality of life and functional domains were maintained in the phase 3 EMBER-3 trial.


Experts from Sibley Memorial Hospital discuss how multidisciplinary work has enhanced outcomes such as survival and resource use at their institution.

Elevating the Quality of Cancer Care via Cross-Department Collaboration

Rachit Kumar, MD;Michael J. Pishvaian, MD, PhD;Nina D. Wagner-Johnston, MD;Valerie Lee, MD;Armine K. Smith, MD;Pouneh Razavi, MD;Curtiland Deville Jr., MD
April 7th 2025
Podcast

Experts from Sibley Memorial Hospital discuss how multidisciplinary work has enhanced outcomes such as survival and resource use at their institution.


Sacituzumab Govitecan/Pembrolizumab Show Promise as SOC in 1st Line PD-L1+ TNBC

Sacituzumab Govitecan/Pembrolizumab Show Promise as SOC in 1st Line PD-L1+ TNBC

Kristi Rosa
May 31st 2025
Article

PFS was improved with first-line sacituzumab govitecan plus pembrolizumab for patients with PD-L1–positive metastatic TNBC.


Vepdegestrant Outperforms Fulvestrant in PFS for ESR1-Mutant Advanced Breast Cancer

Vepdegestrant Outperforms Fulvestrant in PFS for ESR1-Mutant Advanced Breast Cancer

Caroline Seymour
May 31st 2025
Article

Vepdegestrant shows significant clinical activity and a favorable safety profile in ESR1-mutant HER2-negative, ER-positive metastatic breast cancer vs fulvestrant.

Related Content
Advertisement

Ipatasertib/Fulvestrant Combo Prolongs PFS in ER+/HER2– Metastatic Breast Cancer

Ipatasertib/Fulvestrant Combo Prolongs PFS in ER+/HER2– Metastatic Breast Cancer

Kyle Doherty
June 1st 2025
Article

Patients who received ipatasertib/fulvestrant in the intention-to-treat population achieved a median PFS of 5.32 months compared with 1.94 months in the placebo arm.


Findings highlight a need to incorporate diverse populations when developing guideline-concordant breast cancer care to achieve efficacy for all patients.

Eliminating Racial Disparities in Guideline-Concordant Breast Cancer Care

Oluwadamilola “Lola” Fayanju, MD, MA, MPHS, FACS
April 21st 2025
Podcast

Findings highlight a need to incorporate diverse populations when developing guideline-concordant breast cancer care to achieve efficacy for all patients.


PROs Favor Imlunestrant With/Without Abemaciclib in ER+, HER2– Breast Cancer

PROs Favor Imlunestrant With/Without Abemaciclib in ER+, HER2– Breast Cancer

Tim Cortese
May 31st 2025
Article

Across all 3 treatment arms, global health status/quality of life and functional domains were maintained in the phase 3 EMBER-3 trial.


Experts from Sibley Memorial Hospital discuss how multidisciplinary work has enhanced outcomes such as survival and resource use at their institution.

Elevating the Quality of Cancer Care via Cross-Department Collaboration

Rachit Kumar, MD;Michael J. Pishvaian, MD, PhD;Nina D. Wagner-Johnston, MD;Valerie Lee, MD;Armine K. Smith, MD;Pouneh Razavi, MD;Curtiland Deville Jr., MD
April 7th 2025
Podcast

Experts from Sibley Memorial Hospital discuss how multidisciplinary work has enhanced outcomes such as survival and resource use at their institution.


Sacituzumab Govitecan/Pembrolizumab Show Promise as SOC in 1st Line PD-L1+ TNBC

Sacituzumab Govitecan/Pembrolizumab Show Promise as SOC in 1st Line PD-L1+ TNBC

Kristi Rosa
May 31st 2025
Article

PFS was improved with first-line sacituzumab govitecan plus pembrolizumab for patients with PD-L1–positive metastatic TNBC.


Vepdegestrant Outperforms Fulvestrant in PFS for ESR1-Mutant Advanced Breast Cancer

Vepdegestrant Outperforms Fulvestrant in PFS for ESR1-Mutant Advanced Breast Cancer

Caroline Seymour
May 31st 2025
Article

Vepdegestrant shows significant clinical activity and a favorable safety profile in ESR1-mutant HER2-negative, ER-positive metastatic breast cancer vs fulvestrant.

Advertisement
About
Advertise
CureToday.com
OncLive.com
OncNursingNews.com
TargetedOnc.com
Editorial
Contact
Terms and Conditions
Privacy
Do Not Sell My Personal Information
Contact Info

2 Commerce Drive
Cranbury, NJ 08512

609-716-7777

© 2025 MJH Life Sciences

All rights reserved.