Conference Abstracts - The 8th International Cancer Congress
Vol. 6, Issue Supplement 2, 2026 · S1-2
Barriers and Facilitators Across the Breast Cancer Care Continuum: A Mixed-Methods Study in North India
Kanika Arora, PhD,Jitendra Kumar Meena, DNB, MD, MBBS,Hari Krishna Raju Sagiraju, MD, PhD, MPH, MBBS,Pallavi Shukla, MBBS, MD, PhD,Akash Kumar, DM, MD, MBBS,Supriya Mallick, MBBS, MD, DNB,Jyoti Sharma, MBBS, MS, MCH,Krithika Rangarajan, MBBS, MD, DNB, PhD,Raja Pramanik, MBBS, MD, DM,Rajesh Sagar, MBBS, MD,Pranay Tanwar, MBBS, MD, PhD,Mohan Bairwa, MBBS, MD,Kalpa Jyoti Das, MBBS, MD,Saurabh Vig, MBBS, MD, DM
Submission received: 2026-08-20 / Accepted: 2026-08-27 / Published: 2026-09-24
Abstract
Background
Breast cancer remains a major public health challenge in India, with delays across the care pathway contributing to advanced-stage presentation and poorer outcomes. While barriers to timely care are well documented, facilitators and their role across the care continuum remain less explored. This study explored multilevel barriers and facilitators to timely breast cancer care at a tertiary cancer centre in North India.
Methods
A mixed-methods approach was used. The qualitative phase comprised 40 in-depth interviews exploring patient experiences, barriers, and facilitators across the diagnostic pathway. Findings informed a structured questionnaire assessing symptom recognition, healthcare-seeking behaviour, referral pathways, healthcare access, and treatment experiences. Quantitative data from 100 breast cancer patients were analysed.
Results
Qualitative findings showed distinct patterns by stage. Early-stage patients described symptom awareness, prior family experience of cancer, family support, and responsive healthcare providers as important facilitators. In contrast, advanced-stage presentation was associated with lack of awareness, misconceptions regarding painless breast lumps, competing family responsibilities, fear, and denial. Delays after initial healthcare contact were reported due to repeated investigations, mistrust of private facilities, and reliance on alternative medicine. Quantitatively, median symptom-to-consultation and consultation-to-diagnosis intervals were 30 days (IQR: 7–150) and 30 days (IQR: 15–90), respectively. Immediate medical consultation was associated with shorter patient delay than initially ignoring symptoms (7 vs 105 days; p<0.001). A facilitating response after symptom disclosure was similarly associated with shorter delay (7 vs 90 days; p<0.001). Lack of awareness and family-related barriers were associated with longer patient delay (60 vs 7 days; p<0.001). Consultation-to-diagnosis delay was longer in Stage III–IV than Stage 0–II disease (60 vs 30 days; p=0.023).
Conclusion
Timely breast cancer care is shaped by interconnected patient, family, and health-system factors. Addressing lack of awareness, strengthening family support, and streamlining diagnostic pathways may help reduce delays and promote earlier diagnosis.