UICC World Cancer Congress 2006

Objective: The late diagnosis of breast cancer is much more frequent in those women defined “clinically underserved”, specifically those women who present low social and educational backgrounds, and/or live in rural suburban areas. Breast cancer late diagnosis women have a shorter survival chance than the early ones. The diagnosis delay depends on a series of variables, partly due to the monitoring physician and partly due to the efficiency of the health system overall. Methods: As delay indicator we can consider the TNM of the women who underwent surgical procedures. To have a better view on the phenomenon evolution, we considered the TNM development of the women admitted between 1986 and 2003 in the Istituto Tumori in Naples that admits 500 new breast cancer cases a year. Results: The number of cases T3-T4 went from 15.5% in 1989-1991 to 3% in 1996-1999. In addition, even cases in T2 went from 26 to 29%. Viceversa, little sized tumours diagnosed in T1 and in situ have increased from 55 to 70%. Between 2000 and 2003 data reveal that T3-T4 decrease to 2%, the T2 ones remain stable at 27%, and the T1 ones increase to 71%. Such results confirm the feeling that in Italy there has been a strong increment of breast cancer diagnostic prevention. In northern Italy the increment is mainly due to mammographic screening efficiency, whilst in the south it's mainly due to a different attitude in low class older women toward breast cancer who finally seen it as a preventable and curable disease.