Evidence map›Paper›PMID 28549339›Full record

ArticleCancer epidemiology2017

Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis.

Minjoung Monica Koo, Christian von Wagner, Gary A Abel, Sean McPhail, Greg P Rubin, Georgios Lyratzopoulos

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 2 pooled it
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 2 syntheses or guidelines pooled it, 170 citations in OpenAlex.

  1. Pooled it
  2. Lung cancer with breast metastasis: a case report and review of the literature.The Journal of international medical research · 2023
    Pooled it
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Minjoung Monica KooUniversity College London, 1-19 Torrington Place, London WC1E 6BT, UK. Electronic address: monica.koo14@ucl.ac.uk.
Christian von WagnerUniversity College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Gary A AbelUniversity of Exeter, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK.
Sean McPhailUniversity College London, 1-19 Torrington Place, London WC1E 6BT, UK; National Cancer Registration and Analysis Service, Public Health England Zone A, 2nd Floor, Skipton House, 80 London Road, London SE1 6LH, UK.
Greg P RubinSchool of Medicine, Pharmacy and Health, Durham University, Stockton on Tees TS17 6BH, UK.
Georgios LyratzopoulosUniversity College London, 1-19 Torrington Place, London WC1E 6BT, UK; National Cancer Registration and Analysis Service, Public Health England Zone A, 2nd Floor, Skipton House, 80 London Road, London SE1 6LH, UK; Cambridge Centre for Health Services Research, University of Cambridge, Cambridge CB2 0SR, UK.
University College London · GBDurham University · GBPublic Health England · GBUniversity of Cambridge · GBUniversity of Exeter · GB

Funding

Cancer Research UK 18180Cancer Research UK A18180Department of Health 106/0001
6 · The paper itself

Abstract

introductionMost symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible.

methodsWe examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n=2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression.

resultsA total of 56 presenting symptoms were described: breast lump was the most frequent (83%) followed by non-lump breast symptoms, (e.g. nipple abnormalities (7%) and breast pain (6%)); and non-breast symptoms (e.g. back pain (1%) and weight loss (0.3%)). Greater proportions of women with 'non-lump only' and 'both lump and non-lump' symptoms waited 90days or longer before seeking help compared to those with 'breast lump only' (15% and 20% vs. 7% respectively). Quantile regression indicated that the differences in the patient interval persisted after adjusting for age and ethnicity, but there was little variation in primary care interval for the majority of women.

conclusionsAbout 1 in 6 women with breast cancer present with a large spectrum of symptoms other than breast lump. Women who present with non-lump breast symptoms tend to delay seeking help. Further emphasis of breast symptoms other than breast lump in symptom awareness campaigns is warranted.

Indexed as

AgedBreast NeoplasmsEarly Detection of CancerFemaleHumansMiddle AgedPrimary Health CareBreast neoplasmsDelayed diagnosisEarly detection of cancerEarly diagnosisFemalePrimary health careSigns and symptoms

Identifiers

PMID28549339
PMCPMC5482318
OpenAlexW2620708638

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.