Analysis of Presentation Delay in Patients with Advanced Breast Cancer Visiting Dharmais National Cancer Hospital

Iskandar Iskandar, Retna Siwi Padmawati, Susanna Hilda Hutajulu, Meidina Fajrin


Background: Breast cancer is still one of the significant causes of the increasing mortality rate due to cancer. Treatment of breast cancer patients was delayed by 66.34%. The majority of patients arrive at stages IIIB and IV and are therefore treated at an advanced stage. This study aimed to analyze the factors causing the arrival delay of breast cancer patients to Dharmais Cancer Hospital with advanced stages.


Methods: A descriptive study with a qualitative approach was used as the research design. Indepth interviews and document reviews were used to collect data. In-depth interviews were conducted with 12 advanced-stage breast cancer patients. Thematic data analysis was performed by tracing and identifying the main topics of the entire interview process. The triangulation method was used to validate the data by conducting interviews with 4 patient families and 2 oncology surgeons, as well as document review.


Results: The presentation delay of advanced breast cancer patients was analyzed based on the interpretation and recognition of symptoms. There was an attitude of ignoring when there were symptoms and not seeking treatment. On psychological factors, there was a feeling of fear after being diagnosed and a sense of worry in the treatment process. On socioeconomic factors, there was no early detection, lack of information on early detection, waiting time constraints, and the selection of alternative treatments.


Conclusions: Late-stage breast cancer patients were drawn to Dharmais Cancer Hospital due to issues with the interpretation and experience of symptoms, psychological issues patients reported, and socioeconomic difficulties during treatment. As a result, patients must be given additional care to deal with late arrivals, especially in cases of advanced breast cancer.


advanced breast cancer, delay, factors

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DOI: 10.33371/ijoc.v18i1.1025

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WHO. Cancer 2021 [internet]. Available from: (accessed December 19, 2021).

Arafah ABR, Notobroto HB. Faktor Yang Berhubungan Dengan Perilaku Ibu Rumah Tangga Melakukan Pemeriksaan Payudara Sendiri (Sadari). Indones J Public Heal. 2018;12:143.

Suzanna E, Siraqit E, Rahayu P, Shalmont G, Anwar E, Andalusia R. Registrasi Kanker Berbasis Rumah Sakit di RS Kanker Dharmais. Indones J Cancer. 2012.

Surgical Oncology Cancer Registry. Profiles Of Cancer Patient At Dharmais Cancer Center Hospital As National Referral Hospital In Indonesia From 2017-2021. Unpublished n.d.

Kesehatan LB. Penyakit Katastropik Berbiaya Mahal Tetap Dijamin Program JKN-KIS. 2020.

Rivera-Franco MM, Leon-Rodriguez E. Delays in breast cancer detection and treatment in developing countries. Breast Cancer Basic Clin Res. 2018;12.

Hansen RP, Olesen F, Sørensen HT, et al. Socioeconomic patient characteristics predict delay in cancer diagnosis: A Danish cohort study. BMC Health Serv Res. 2008;8:1–10.

Khakbazan Z, Taghipour A, Roudsari RL, Mohammadi E. Help seeking behavior of women with self-discovered breast cancer symptoms: A meta-ethnographic synthesis of patient delay. PLoS One. 2014;9:1–24.

Kumar A, Bhagabaty SM, Tripathy JP, et al. Delays in diagnosis and treatment of breast cancer and the pathways of care: A mixed methods study from a tertiary cancer centre in north east India. Asian Pacific J Cancer Prev. 2019;20:3711–21.

Bonsu AB, Ncama BP. Recognizing and appraising symptoms of breast cancer as a reason for delayed presentation in Ghanaian women: A qualitative study. PLoS One. 2019;14:1–21.

Kemenkes RI. Peraturan Menteri Kesehatan Republik Indonesia No. 34 Tahun 2015 Tentang Penanggulangn Kanker Payudara Dan Kanker Leher Rahim, 2015.

Saputra AU, Mulyadi B, Banowo BS. Systematic Review: Efektivitas Beberapa Metode Pendidikan Kesehatan Program Pencegahan Kanker Payudara terhadap Pengetahuan, Sikap dan Tindakan Remaja tentang Sadari. J Keperawatan Jiwa Persat Perawat Nas Indones. 2021;9:365–80.

Ghazali SM, Othman Z, Cheong KC, et al. Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer. Asian Pac J Cancer Prev. 2013;14:1141–5.

Ambarwati G. Pemenuhan Kebutuhan Psikososial Pasien Kanker Payudara Yang Menjalani Kemoterapi Di RSUD Tugurejo Semarang. Thesis, Faculty of Medicine, Universitas Diponegoro. 2017.

Brannon L, Feist J, Updegraff JA. Health psychology an introduction to behavior and health: Eighth Edition. California: Wadsworth; 2014.

Atashbahar O, Bahrami MA, Asqari R, Fallahzadeh H. An examination of treatment seeking behavior affecting factors: A qualitative study in Iran. World Appl Sci Journal. 2013;25(5):774-78.

Husni M, Romadoni S, Rukiyati D. Hubungan Dukungan Keluarga dengan Kualitas Hidup Pasien Kanker Payudara di Instalasi Rawat Inap Bedah RSUP Dr. Mohammad Hoesin Palembang Tahun 2012. J Keperawatan Sriwij. 2015;2:77–83.

Binhussien BF, Medhat G. Awareness of breast cancer screening and risk factors among Saudi females at family medicine department in security forces hospital, Riyadh. J Fam Med Prim Care. 2017;6:169–70.

Fajri LN, Susilo DH, Sustini F. Penyebab Keterlambatan Penanganan Pada Kasus Kanker Rongga Mulut Di Rsud Dr. Soetomo Surabaya. JUXTA J Ilm Mhs Kedokt Univ Airlangga. 2016;8:1–6.

Seneviratne S, Lawrenson R, Harvey V, et al. Stage of breast cancer at diagnosis in New Zealand: Impacts of socio-demographic factors, breast cancer screening and biology. BMC Cancer 2016;16.

Djatmiko A, Octovianus J, Fortunata N, Andaru I. Profil Cancer Delay pada Kasus Kanker Payudara di RS Onkologi Surabaya. Indones J Cancer. 2013;7:47–52.

Shidqi ZN, Saraswati LD, Kusariana N, Sutiningisih D. Faktor-Faktor Keterlambatan Diagnosis Kanker pada Pasien Kanker Payudara: Systematic Review. J Epidemiol Kesehat Komunitas. 2022;7:471–81.


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