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Delay in diagnosis and treatment of breast cancer: implications for education.

Breast cancer is an important health concern for women in the United States. Delay in establishing diagnosis and initiating treatment may result in more advanced disease at the time of diagnosis and worse outcomes. This study evaluates 225 women from a public hospital, a university hospital cancer center, and a private practice. Times to evaluation, diagnosis, and initiation of treatment were examined. The elapsed times for the diagnosis, treatment, and combined intervals were all significantly longer for women seen in the public hospital when compared with private practice (25 and 14 days, p = 0.008, for the diagnosis interval; 15 and 10 days, p = 0.007 for the treatment interval, and 43 and 24 days, p = 0.001 for the intervals combined). Delays of three to six months or more than six months were due primarily to provider misdiagnosis and patient noncompliance in the nonprivate sites. Information learned from this study can be used to educate health care providers, patients, and systems of care to facilitate earlier diagnosis and treatment, thus reducing potentially significant delays and improving patient outcomes.