Patients' help-seeking experiences and delaying in breast cancer diagnosis: A qualitative study

To identify the influencing factors in help-seeking behavior by comparing delayers with non-delayers in Japanese female patients with breast cancer.

This is a descriptive qualitative study. A total of 21 female patients with breast cancer (nine delayers and 12 non-delayers) who were at least 3 months to 5 years postdiagnosis were recruited from two hospitals in Okinawa, Japan. Semistructured interviews were carried out and the results were analyzed by using a qualitative inductive approach.

The comparison between the delayers and non-delayers showed eight barriers to help-seeking behavior that were unique to the delayers: (i) the appearance of symptoms that cannot be definitely linked to breast cancer; (ii) anxiety and fear; (iii) the necessity to prioritize the immediate needs of daily life; (iv) non-disclosure of the situation; (v) the view that medical care is a nuisance; (vi) a desire to surrender to the natural course of things; (vii) confidence that they would not develop cancer; and (viii) inaccessibility of medical facilities. A common trigger for help-seeking that was identified in both the delayers and the non-delayers was the presence of other persons who encouraged seeking a provider evaluation.

The barriers to help-seeking that were found in this study (namely, the emotional reaction and difficult living conditions) are common worldwide. The Japanese patients with breast cancer in the sample tended to emphasize their relationship with family and friends in their help-seeking behavior, which is a common content in Japanese and other Asian cultures. Therefore, health professionals should assess the social conditions of their patients.