Journal Article

Causes of diagnostic and treatment delays in locally advanced breast cancer: a nationwide multicenter survey and electronic health records analysis in Turkiye

Akan, Arzu, Bolukbasi, Yasemin, Buyukuysal, M Cagatay, Gumusay, Ozge, Basım, Pelin, Dalcı, Kubilay, Comert, Mustafa, Uras, Cihan, Vural, Veli, Maralcan, Gokturk, Kaya, Hamide, Ugurlu, M Umit, Ozaydın, Yigit, Bakir, Nurullah, Emiroglu, Selman, Olmez, Ozgur, Tasdoven, Ilhan, Kebudi, Abut, Kocer, H Belma, Karadeniz Cakmak, Guldeniz, Ucar, B Imge, Varlı, Metin, Pergel, Ahmet, Kucuk, G Ozan, Cabioglu, Neslihan, Bakkal, Bekir H, Tali, Ufuk, Akcay, Mufide, Karanlik, Hasan, Batu, H Figen, Dogan, Lutfi, Badak, Bartu, Dilege, Ece, Kivilcim, Taner, Agcaoglu, Orhan, Canturk, N Zafer, Ozcinar, Beyza, Ozkurt, Enver, Balbaloglu, Hakan, Ozmen, Vahit, Alicioglu, Banu, Aktas, Aysegul, Sakman, Gurhan, Ersoy, Yeliz, Deniz, Oguzhan, Zihni, İsmail, Altinok, Ayse, Yıldırım, Emine, Filiz, A İlker, Kafadar, Tolga, Gurleyik, Gunay, Ozkan Gurdal, Sibel, Uzunkoy, Ali, Sezer, Atakan, Haberal, Elifcan, Dag, Ahmet, Bahadir, Burak, Yildirim, A Cihat, Koksal, Hande, Gulcelik, M Ali, Bayir, Duygu, Yıldız, O Eren, Gunay, Semra, Morkavuk, Barıs

2025

Overview

Abstract Delays in breast cancer (BC) diagnosis and treatment negatively impact survival outcomes. Understanding patient- and provider-related factors behind these delays is crucial. This study aimed to identify nationwide reasons for delayed diagnosis and treatment of locally advanced BC in Turkiye. A prospective, multicenter hospital-based survey was conducted across 35 institutions between 2023 and 2024. Patient- and provider-related delays were assessed via a structured 61-item face-to-face survey, supplemented by clinical data from electronic health records. Delays exceeding 3 months were clinically categorized as significant. A total of 1322 women participated from seven regions across Turkiye. Factors contributing to diagnostic delays on a national level included economic reasons (5.5%), lack of family support (3.3%), lack of knowledge (12.4%), lack of time due to household work (3.8%), difficulty in finding an appointment (6.7%), pregnancy-related reasons (1.1%), fear of losing the breast (8.9%), fear of death (9.8%), and transportation difficulties (5.1%). Provider-related delays were infrequent. About 89.3% of the patients had the initial doctor appointment and 89.6% had the first specialist consultation within one month. Treatment planning was predominantly based on a multidisciplinary team decision in 88.3% of patients. Regarding treatment initiation, 93.2% started required treatment within 1 month of decision. Patient-related factors are the major causes of diagnostic delay in Turkiye. On the other hand, from the provider’s perspective, the presence of multidisciplinary teams, including dedicated breast surgeons, represents a key factor in ensuring the timely implementation of diagnostic procedures and treatment strategies.

• Publisher: Oxford University Press
• Subject: Adult / Aged / Archives & records / Breast cancer / Breast Neoplasms - diagnosis / Breast Neoplasms - therapy / Cancer / Computerized medical records / Delayed Diagnosis - statistics & numerical data / Diagnosis / Diagnostics / Economic factors / Electronic health records / Electronic Health Records - statistics & numerical data / Electronic medical records / Family support / Fear / Fear & phobias / Female / Health records / Health services / Housework / Humans / Interdisciplinary aspects / Knowledge management / Medical decision making / Medical diagnosis / Medical records / Medical treatment / Middle Aged / Multidisciplinary teams / Patients / Polls & surveys / Pregnancy / Prospective Studies / Surgeons / Surveys / Surveys and Questionnaires / Time-to-Treatment - statistics & numerical data / Treatment Delay / Turkey - epidemiology / Women