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An exploration of why women with breast cancer symptoms present late in seeking treatment at Komfo Anokye Teaching Hospital, Ghana

Research output: ThesisDoctoral Thesis

  • Eseenam Agbeko
Publication date2017
Number of pages200
Awarding Institution
  • Lancaster University
Original languageEnglish


INTRODUCTION: In line with most developing African countries about 85% of breast cancer patients who attend Komfo Anokye Teaching Hospital (KATH), Ghana, present with stage III/IV disease. This study aimed at understanding what factors influence health seeking behaviour and the decision to seek help in women with breast cancer symptoms.
METHOD: Women presenting for the first time with clinical stage III/IV breast cancer symptoms to KATH breast clinic were purposively selected for the study between May 2015 and March 2016. In-depth interviews were conducted to explore the women’s symptom appraisal process and the events that prompted health seeking. The Andersen behavioural model for health service use was the conceptual basis for the thematic analysis, with a critical realist perspective. Interpretation of how the identified factors interacted with each other and how they ultimately evolved to influence decision making was done.
RESULTS: Fifteen women were interviewed. They were aged between 24 – 79 years. Ten of them had symptoms consistent with clinical stage III and 5 had clinical stage IV breast cancer. Time from symptom identification to attending KATH was 4 - 24 months. The first symptom identified was a breast lump or breast swelling. These were initially appraised as “normal/not serious” because they did not affect the woman’s daily functioning. The trigger to seek medical help was worsening of their symptom such that daily function was affected. At this stage, the women were willing to do whatever was required to access healthcare. Misunderstanding of the investigations required and the referral process also contributed to their late presentation to KATH.
CONCLUSION: Women appraise their breast symptoms as not needing medical attention until they worsen. Opportunities at first hospital presentation to educate women with breast symptoms on the value of investigations and the need to follow through with referrals could potentially influence health seeking behaviour of women with breast cancer symptoms positively.