Introduction
Breast cancer is the most common cancer for women, with an estimated
685,000 fatalities worldwide in 2020.1 Fortunately,
with the widespread availability of screening and the advancement of
medical technology, the survival rate of breast cancer patients in
developed countries has exceeded 80%.2 Meanwhile, the
mortality rate has been reported to increase by up to two to three times
with a delay of only 12 weeks in the initial diagnosis and subsequent
treatment.3 Therefore, providing an appropriate
approach for each patient’s situation is essential to encourage patient
screening and consultation for early detection.4
Since the 2011 triple disaster (earthquake, tsunami, and nuclear
disaster), more attention has been paid to disasters and crises as
external factors affecting breast cancer screening and consultations.
Several reports have indicated that breast cancer patients in Fukushima
were reluctant to receive medical consultations after the disaster,
resulting in prolonged refrains, with mortality rates increasing among
those who delayed their consultations.5-7 Furthermore,
under the ongoing COVID-19 pandemic, breast cancer patients’ refraining
from seeing doctors and postponement or cancellation of surgeries and
examinations have also been reported.8, 9
Several factors have been named relevant to medical consultation delays
after disasters and crises such as reduction of health priorities due to
the significant changes in the surrounding
environment.7, 10 In addition, a post-disaster case
study in Fukushima indicated that reduced support from family and
friends was associated with delays in medical
visits.11 Refraining from hospital visits due to the
fear of being infected with the COVID-19 can also be interpreted in this
context.9, 12 Further, personality factors have been
also noted as possible factors associated with delays in hospital
visits.13, 14
However, there have not been enough studies on breast cancer patients
that systematically evaluated the factors such as lower health
priorities, personality, and support from the surrounding community in
patients who delayed their medical visits in actual cases of disasters
and crises. Therefore, we took into consideration of contributions of
these factors to the patient delay in crisis situations in this paper,
by focusing on a breast cancer patient who visited our hospital for
suspected breast cancer symptoms, interrupted her visits for as long as
2 years due to the state of emergency against the COVID-19 pandemic, and
was diagnosed with advanced cancer.