Nursing in Practice Autumn 2021 (issue 121) | Page 23

TACKLING DELAYS IN METASTATIC BREAST CANCER DIAGNOSIS

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Some people may present with metastatic breast cancer from the start and for some , it can develop after many years , sometimes even over a decade after a person ends treatment for primary breast cancer . It can present with many different symptoms which vary depending on where in the body the cancer has spread to . Many of these symptoms are not specific to metastatic breast cancer and can make it harder to diagnose .
“ BEING DIAGNOSED QUICKLY WOULD HAVE SAVED ME FOUR AND A HALF MONTHS OF PAIN , SUFFERING AND ANXIETY . I WAS CONSTANTLY WORRYING ABOUT WHAT WAS WRONG WITH ME .” – Aliya
Many people with undiagnosed metastatic breast cancer experience pain and their symptoms are likely to worsen without diagnosis and treatment . Pain will often reduce mobility , capacity to work or to care for children , impacting on many aspects of daily life . Unexplained symptoms cause huge anxiety for women and their families and calls to Breast Cancer Now ’ s Helpline are often from people who are distressed by these concerns .
Sadly , too often , people with metastatic breast cancer experience delays in diagnosis . This urgently needs to be addressed through a combination of patients being informed of metastatic breast cancer signs and symptoms upon completing primary breast cancer treatment , healthcare professionals having the knowledge and support they need to ensure a prompt diagnosis , and a clear referral pathway when individuals present to health care professionals with symptoms . In Breast Cancer Now ’ s 2019 UK survey of people living with metastatic breast cancer 1 , nearly one in four ( 24 %) respondents who had previously been treated for breast cancer had to visit their GP three or more times with symptoms before being diagnosed . In addition , around
20 % were treated for another health condition by their GP before eventually being diagnosed with metastatic breast cancer .
There are unprecedented time and resource pressures being placed on primary care due to backlogs caused by the COVID-19 pandemic . Nurses and GPs may see very few people with metastatic breast cancer , limiting their exposure to and experience in identifying potential metastatic breast cancer symptoms . With metastatic breast cancer sometimes developing many years after a primary diagnosis , it is critical that primary care professionals and their patients feel confident to recognise the symptoms of metastatic breast cancer and as a result , patients are referred back into the system to ensure prompt diagnosis .
Possible signs of secondary breast cancer include :
Unexpected weight loss and loss of appetite
Severe or ongoing headaches Altered vision or speech
Loss of balance or any weakness or numbness to the limbs
Any lumps or swelling under the arm , breastbone or collarbone
That ’ s why Breast Cancer Now , the charity that ’ s steered by world-class research and powered by life-changing care , provide access to information for primary care nurses to support them in identifying the signs and symptoms of metastatic breast cancer as quickly as possible and ensuring patients see the GP . This is vital so that when people are affected by this incurable disease , they get the prompt access to treatment and support that we know can be so crucial at keeping the cancer under control , slowing its spread and giving them the best quality of life as they deserve .
Find out more about the signs and symptoms of metastatic breast cancer : breastcancernow . org / sbcsymptoms
Discomfort or swelling under the ribs or across the upper abdomen
A dry cough or feeling out of breath Feeling sick most of the time Feeling much more tired than usual
Pain in the bones , for example in the back , hips or ribs , that doesn ’ t get better with pain relief and may be worse at night
Breast Cancer Now is a charity registered in England and Wales ( 1160558 ), Scotland ( SC045584 ), and the Isle of Man ( 1200 ).
1
Breast Cancer Now survey undertaken by Quality Health in 2019 of 2,102 people living with secondary breast cancer in the UK .