Understanding why women with breast cancer present late
Kiang, Wen Wei
Date of Issue2017
Lee Kong Chian School of Medicine (LKCMedicine)
Introduction: Breast cancer (BC) has the highest incidence and mortality of all cancers among women in Singapore. Despite increasing affluence, education, healthcare accessibility, and the institution of nation-wide breast screening programmes, the incidence of locally advanced breast cancer (LABC) remains much higher than that seen in Western countries. Locally advanced breast cancer is often attributed to delayed presentation and our study aims to elucidate the factors underlying this. Methods: A total of 100 consecutive women who presented with LABC were systematically interviewed using a self-designed questionnaire. The featured questions explore each patient’s socioeconomic status, known risk factors of BC, awareness of BC and screening, as well as BC screening compliance. Results: We found that the women were generally well-educated and had good BC awareness. Notably, the majority of women acknowledged that screening was effective in detecting BC. However, compliance to screening was poor, with most women not doing regular breast self-examination (BSE) or mammographic screening because they saw no need for screening if asymptomatic. It was noted that this group of women were younger, better educated, financially stable, and have a better general awareness of BC and screening. Conclusion: The mismatch between knowledge and practices was evident, being in stark contrast to previous studies in less-developed countries, where there was a strong correlation between BC awareness and screening compliance. The women who did not feel screening was required if asymptomatic clearly misunderstood the purpose of screening, which is for asymptomatic individuals. There again appears to be a mismatch between general BC knowledge and understanding of screening, highlighting a potential failure in BC education programmes in imparting this particular concept. This study highlights a need to educate Singaporean women about the rationale and purpose of BC screening.
Final Year Project (FYP)