PURPOSE Stage at diagnosis is a key determinant of breast cancer prognosis. In this study, we characterize stage at diagnosis and determine factors associated with advanced stage at diagnosis among women diagnosed with invasive breast cancer in Addis Ababa, capital city of Ethiopia. METHODS Stage information was collected from medical records of 441 women with invasive breast cancer seen in seven major health facilities in Addis Ababa, from January 2017 to June 2018; these seven facilities capture 90% of all incident breast cancer cases in the city. We used multivariable Poisson regression model with robust variance to determine factors associated with advanced stage at diagnosis. RESULTS The predominant tumor histology was ductal carcinoma (83.7%). More than half of the tumors' grade was moderately or poorly differentiated. The median tumor size at presentation was 4 cm. Sixty-four percent of the patients were diagnosed at advanced stage of the disease (44% stage III and 20% stage IV), with 36% of the patients diagnosed at early-stage (5% stage I and 31% stage II). The prevalence of advanced stage disease was significantly higher among women who used traditional medicine before diagnostic confirmation (adjusted prevalence ratio [aPR] = 1.31; p = 0.001), had patient delay of >  3 months (aPR = 1.16; p = 0.042) and diagnosis delay of > 2 months (aPR = 1.24; p = 0.004). But it was lower among women who had history of breast self-examination (aPR = 0.77; p = 0.021). CONCLUSIONS Advanced stage at diagnosis of breast cancer among women in Addis Ababa is strongly associated with use of traditional medicine and with prolonged time interval between symptom recognition and disease confirmation. Community- and health systems-level interventions are needed to enhance knowledge about breast cancer and facilitate timely diagnoses.

中文翻译：

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埃塞俄比亚亚的斯亚贝巴女性乳腺癌晚期诊断的相关因素。

目的 诊断阶段是乳腺癌预后的关键决定因素。在这项研究中，我们描述了埃塞俄比亚首都亚的斯亚贝巴诊断为浸润性乳腺癌的女性的诊断阶段，并确定了与诊断晚期相关的因素。方法 从 2017 年 1 月至 2018 年 6 月在亚的斯亚贝巴七个主要医疗机构就诊的 441 名浸润性乳腺癌女性的医疗记录中收集分期信息；这七个设施捕获了该市所有乳腺癌病例的 90%。我们使用具有稳健方差的多变量泊松回归模型来确定与诊断晚期相关的因素。结果 主要的肿瘤组织学是导管癌（83.7%）。超过一半的肿瘤级别是中度或低度分化的。出现时的中位肿瘤大小为 4 厘米。64% 的患者被诊断为疾病晚期（44% 的 III 期和 20% 的 IV 期），36% 的患者被诊断为早期（5% 的 I 期和 31% 的 II 期）。在确诊前使用传统药物的女性中，晚期疾病的患病率显着更高（调整后患病率 [aPR] = 1.31；p = 0.001），患者延迟 > 3 个月（aPR = 1.16；p = 0.042）和诊断延迟 > 2 个月（aPR = 1.24；p = 0.004）。但在有乳房自我检查史的女性中较低（aPR = 0.77；p = 0.021）。结论亚的斯亚贝巴女性乳腺癌的晚期诊断与传统医学的使用以及症状识别和疾病确认之间的时间间隔延长密切相关。需要社区和卫生系统层面的干预措施来增强对乳腺癌的了解并促进及时诊断。