AN AUDIT OF PROVIDER DELAY IN NEWLY DIAGNOSED BREAST CANCER IN A CENTRAL REFERRAL HOSPITAL IN JOHANNESBURG, SOUTH AFRICA.

BACKGROUND: Breast cancer is one of the most common cancers in women worldwide and accounts for an increasing burden of disease in South Africa. One of the factors identified in improving outcome in patients with newly diagnosed breast cancer is decreased time from recognition of a breast symptom to initiation of primary therapy.

METHOD: A total of 257 patients from 1 January 2014 to 31 December 2014 were included in the study. Patient records were examined and date intervals for each patient were recorded from initial presentation to primary therapy. The Results were compared to a standard of 90% of patients reaching primary therapy within 60 days.

RESULTS: Median delay (interquartile range) to primary therapy was 49 days (33-80d). The primary chemotherapy group had a median delay of 48 days (30-71d), the primary endocrine therapy group had a 28 days (22-41d) delay, and the primary surgery group had a delay of 73.5 days (39.8-113.5d). The addition of diagnostic surgery to the treatment plan added 37 days to the primary chemotherapy group and 38 days to the primary surgery group. Notably, 101 patients (39.29%) had a delay greater than 60 days.

CONCLUSION: The centre did not achieve the standard of 90% of patients reaching primary therapy within 60 days. Specifically, 36.8% of patients in the primary chemotherapy group, 58.3% of patients in the primary surgery group and 11.5% of patients in the primary endocrine therapy group did not reach the target. The delay was most pronounced in the group of patients undergoing primary surgery, with a median time to surgery greater than the target time of 60 days. Factors affecting delay to primary surgery warrant further investigation.