Understanding delay in breast cancer diagnosis and the breast cancer illness experience of culturally diverse young women.

摘要

Public and professional awareness about breast cancer is increasing because of educational campaigns that target women and health care professionals in diverse settings. Often, however, practitioners fail to validate self-identified breast cancer symptoms discovered by women, especially women under 40 years old. Therefore, a diagnosis of breast cancer is often delayed, and when it is finally diagnosed, it is late stage diagnosis.;The purposes of this study were to investigate delay in breast cancer diagnosis and describe the breast cancer illness experience of women 40 years old and younger. The specific aims were to describe young women's self-discovery of breast symptoms; describe their health-seeking path to breast cancer diagnosis and determine if they experience delay; examine ways in which the initial breast cancer diagnosis influence subsequent breast health behavior; explore provider-patient relationships; and determine if delay in breast cancer diagnosis differs across race/ethnicity. The study was grounded in human development, social behavior, and symbolic interactionism frameworks.;The study's design was a descriptive, qualitative design using the narrative technique to analyze 30 ethnically and racially diverse women's breast cancer experience stories. Women living in the San Francisco Bay Area were interviewed.;Findings revealed most young women discovered their breast symptom, which was breast pain, they did not delay seeking medical attention; the breast cancer diagnostic pathways were inconsistent; they did not follow any orderly guidelines; the impact of a delayed diagnosis on subsequent breast health behavior varied; and the interval of delay lasted up to 5 years. Breast cancer diagnostic delays appear to be related to age, pregnancy, family history of cancer, negative patient-provider relationship, pain, and misinterpretation of a breast symptom as normal.;Conclusions of the study were breast symptoms for young women tend to be atypical; there is possibly a link between breast cancer delay and the time period within 5 years of having a child; having a positive patient-provider relationship is important to early diagnosis and treatment. African American women were diagnosed younger, experienced longer delay, and diagnosed at a late stage, even though a majority of them sought early attention for their breast symptom.