Women in low- and middle-income countries where the prevalence and mortality of breast cancer are growing rapidly are more likely to be diagnosed at advanced stages, which negatively affects their treatment outcomes and chance of survival. The current literature in those settings tends to focus largely on explaining patient delay in seeking medical attention for breast symptoms. Meanwhile, little is known as to what prompts women to attend screening and diagnostic services after discovering symptomatic breasts. Drawn upon the data from in-depth interviews with 33 breast cancer patients in Central Vietnam conducted in 2019, this paper examines the context of women's decisions about breast screening and how the practice of seeking cancer diagnosis occurred. Our findings reveal an absence of a national screening program and that seeking medical advice was conducted on an ad hoc basis after self-detection of breast symptoms. Women's interpretations of symptomatic breasts as suspicious signs of cancer, the co-occurrence of important life events, or encouragement by people in their social network motivated women to seek medical attention at different public and private health facilities. Their encounters with the health sector often involved multiple visits across time and space in which they experienced various forms of diagnosis delay produced by the health system. Our study carries implications for interventions to encourage women's awareness of early cancer symptoms and prompt medical presentation after self-discovery of symptomatic breasts.

中文翻译：

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癌症诊断的轨迹：越南女性为何以及何时寻求乳房症状的帮助。

在乳腺癌患病率和死亡率快速增长的低收入和中等收入国家，女性更有可能在晚期被诊断出来，这对她们的治疗结果和生存机会产生了负面影响。这些环境中的当前文献往往主要集中在解释患者因乳房症状寻求医疗救助方面的延迟。同时，很少有人知道是什么促使女性在发现有症状的乳房后参加筛查和诊断服务。本文利用 2019 年对越南中部 33 名乳腺癌患者进行的深入访谈所获得的数据，探讨了女性做出乳房筛查决定的背景，以及寻求癌症诊断的做法是如何发生的。我们的调查结果表明，缺乏全国筛查计划，并且在自我检测乳房症状后临时寻求医疗建议。女性将有症状的乳房解释为癌症的可疑征兆、重要生活事件的共同发生或社交网络中人们的鼓励促使女性在不同的公共和私人医疗机构寻求医疗救助。他们与卫生部门的接触往往涉及跨越时间和空间的多次访问，在此期间他们经历了卫生系统产生的各种形式的诊断延迟。我们的研究对干预措施具有重要意义，以鼓励女性了解早期癌症症状并在自我发现有症状的乳房后及时就医。