Duration of signs and survival in premenopausal women with breast cancer

Condensed. Among 550 women reporting a lump as the first sign of breast cancer, those with this sign for 6 29 months compared to those with 1 - 6 months, had bigger tumors and more frequent axillary node involvement. Overall survival, however, was not significantly different in these two groups. Background. The relationship of delay in diagnosis of breast cancer to survival is uncertain. Methods. We evaluated the relationship of patient-reported duration of signs of breast cancer to survival in participants in a clinical trial of adjuvant hormonal therapy in Vietnam and China. Results. Among 550 women reporting a lump as the first sign of breast cancer and information on when this appeared, the median duration of this sign before diagnosis was 6 months. Comparing two groups of patients with durations of lumps 1 - 6 months and 6 - 29 months, the group with longer duration of lumps had larger tumors clinically and pathologically ( p = 0.0006, and p = 0.004), more frequent axillary node involvement ( p = 0.008), and shorter but not statistically different disease-free and overall survival from the time of diagnosis ( p = 0.09 and 0.35, respectively). Conclusions. Breast cancer evolves slowly in the detectable period of its natural history. The impact of delays in diagnosis of less than 6 months is likely to be very limited; delays more than 6 months appear to have some, but marginal impact on survival.