Factors Associated With Delayed Presentation of Breast Cancer Among Women Attending Breast Clinics

Background: Breast cancer is the most common malignancy among women worldwide and represents a major public health concern due to its increasing incidence and associated mortality. Early detection services play a crucial role in reducing breast cancer-related morbidity and mortality through timely diagnosis and treatment. Evaluation of the quality of breast cancer early detection services is essential for identifying strengths and areas requiring improvement. Objectives: To assess the quality of breast cancer early detection services provided at the Breast Early Detection Unit of Al-Khansaa Teaching Hospital in Mosul, Iraq. Methods: A hospital-based cross-sectional audit study was conducted at the Breast Early Detection Unit of Al-Khansaa Teaching Hospital, Mosul, Iraq, from March 2025 to April 2026. The study included 330 women attending the unit for breast cancer screening, diagnostic evaluation, or follow-up services. Data were collected using a structured questionnaire and review of clinical records. Information regarding sociodemographic characteristics, referral pathways, breast self-examination practices, mammography history, diagnostic services, waiting time, final diagnosis, and patient satisfaction was obtained and analyzed using the Statistical Package for Social Sciences version 31. Results: Women aged 40–49 years constituted the largest age group (28.8%), and most participants were married (78.2%) and urban residents (74.2%). Breast lump was the most common reason for attendance (40.9%), followed by breast pain (25.8%). Self-referral represented the main source of attendance (45.5%), while Primary Health Care Centers accounted for 28.8% of referrals. Regular breast self-examination was reported by 27.3% of women, whereas 58.2% had never undergone mammography. Clinical breast examination was performed for all participants, breast ultrasonography for 84.8%, and mammography for 65.2%. Most women received imaging services on the same day (57.6%) or within one week (28.8%). Fibroadenoma (27.9%) and fibrocystic breast changes (25.5%) were the most common diagnoses, while breast cancer was identified in 11.5% of participants. Overall, 77.2% of women were satisfied or very satisfied with the services provided, and 74.2% rated the quality of services as good or excellent. Conclusions: The Breast Early Detection Unit at Al-Khansaa Teaching Hospital provides accessible and comprehensive breast cancer early detection services with high levels of patient satisfaction and efficient diagnostic service delivery. However, the low rates of regular breast self-examination, previous mammography utilization, and routine screening attendance indicate the need for enhanced public awareness, improved screening uptake, and stronger collaboration between primary healthcare facilities and specialized breast services to promote earlier detection of breast cancer.