CLINICAL AND SOCIAL PROBLEMS IN YOUNG WOMEN WITH BREAST CARCINOMA

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Abstract
Studies have noted that Asian women tend to have invasive breast cancer at a younger age compared with their Western counterparts. This is a rising trend among women in Singapore. This study compares 46 women less than or equal to 35 years with 313 women greater than 35 years who were treated in a teaching hospital between January 1983 and December 1989. Despite better education, the younger women (less than or equal to 35 years) were no different from their older counterparts in delaying medical consultation for more than 3 months after self-detection (39 vs 38.6%) though a higher percentage of older women procrastinated for over a year (16.6 vs 6.5%). As a result, 28% of younger women and 21.6% of older women presented with late disease (TNM Stage III and IV). Primary healthcare physicians contributed towards further delay among 65% of women less than or equal to 35 years. They were more suspicious when breast lumps were detected in women greater than 35 years and only 8% had delayed referrals. Failure in advising early biopsy added further delay (greater than 3 months) in 27.6% of younger patients whereas it was seldom delayed for the other older group (0.3%). Eight patients less than or equal to 35 years were initially reluctant to undergo definitive surgery. These cumulative delays resulted in progression of disease in seven patients of the 11 patients whose therapy was delayed more than 6 months.

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