The effects of patient delay and symptoms other than a lump on survival in breast cancer

Abstract
This study examined the relationship of survival in breast cancer to delay in treatment and the presence of symptoms. Data were analyzed for 664 patients diagnosed from 1975–1979 at 15 hospitals in Brooklyn, New York. Pathologic risk factors were defined to classify breast cancer into less (Class I) or more aggressive (Class III) disease. Delay and survival were not significantly associated among women diagnosed with Class I disease. Delay was associated with poor survival for patients with Class III disease (P < 0.001). The presence of symptoms other than a lump was associated with longer delay and poorer survival in patients with Class II and III disease. These findings suggest that the contradictory relationship between delay and survival reported by others may be due to variations in the proportions of slow and fast growing tumors and that fast growing tumors must be treated promptly for a successful result.