Why does a woman with a lump in her breast delay seeking medical attention?
This problem has puzzled doctors for years.
Many theories have been advanced to explain this often iatal delay. Chief among them is that women are afraid to face the truth; that they play a child's magical game, telling themselves the lump will disappear.
A recent survey at Charity hospital by a psychiatrist from the Louiliana State university medical school appears to disprove this theory. Few Act Quickly
In conducting this survey, Dr, Max Sugar interviewed 50 women with masses in their breasts. A minority came in the .minute they discovered the trouble. The majority procrastinated.
Dr. Sugar, clinical instructor in psychiatry at the LSU mediealj school, is scheduled to report on the survey Thursday at the annual convention of the Americani Medical ^Association in Miami Beach, Fla.
His report shows:
1. Those who delayed seeking medical advice were motivated not by fear but by complete indifference to life and living.
2. Those who made a beeline to the doctor's office the minute they discovered a lump in their breast were motivated by fear.
Dr. Sugar told those attending the convention that his survey also disproves the belief, held by some, that ignorance of the seven danger signals of cancer often causes the delay. * 'Knew About Danger'
"Each of the 50 women I interviewed knew about these danger signals, even the illiterates," he explained.
The phychiatrist said the women who delayed coming in exhibited a typical defeatist attitude.
"Most of them," he added, "were sad, unhappy people. Some were widows, with * little to look forward to in life. Some had been victims of tragedy and were resigned to the possibility of tragedy recurring. Some said io them-
selves, 'What the use? If it's cancer, I'll probably die anyway.' Others told themselves the lump was just a little bruise which would probably disappear in time —this despite the fact that the mass had been present for years."
Dr. Sugar said during the interview he attempted to evaluate each woman's attitude toward the possibility of breast surgery.
"Those who delayed coming in exhibited the same air of resignation toward surgery," he said. "They said things like 'Well, if it's got to be done, it's got to be done.' It was almost, as though they had stopped living." WORRY OVER FIGURES
By contrast, said the psychiatrist, those who came in at the
first sign that something was wrong were equally fearful regarding surgery.
'.The prompt women in the group were extremely worried about what breast removal would do to their figures," added Dr. Sugar.
Thef psychiatrist said many studies have been carried on in the past to determine why a woman delays in seeking medical aid when she discovers a lump in her breast.
"But most of these surveys were conducted after the cancer had been discovered and surgery had been performed," Dr. Sugar explained, "We felt it would be better to carry on our survey ahead of time. It's not easy to
get a true picture after an operation since, in retrospect, there is a tendency to distort things. We decided a clearer picture could be obtained without the influence of a positive cancer diagnosis plus subsequent surgery and hos-pitalization."
Dr. Sugar said he obtained the information during hour-long, typical psychiatric interviews at Charity hospital.
Asked if anything can be done to prevent such delay on the part of women with lumps in their breasts, the psychiatrist replied, "This is a i8job for the family physician.
YEARLY CHECKUP
■It is important for every worn* an over 35 years of age to have a yearly checkup. Such a checkup should include both an emotional and a physical evaluation. You don't have to be a psychiatrist to see that a patient is sad
and resigned or depressed. Although the patient with resignation may not indicate they have symptonis of a possible malignancy the family doctor can take this resignation as a cue for a more careful physical examination." Dr. Sugar said some fear is a
very healthy thing—that it leads to proper protective measures. He said it's the person who does not show healthy fear who is in danger.
The idea for the survey was suggested by Dr. Charles Wat-kins, head of the psychiatric department of the LSU medical school.
PHOTO: DR. MAX SUGAR, psychiatrist at Louisiana State university medical school, has found indifference to life and living as the .reason why the majority of women fail to seek immediate medical attention when they develop lumps in the breasts. He interviewed 50 women in a survey. Here's a typical interview scene with an unidentified patient. He will report on the survey to th« American Medical Association Thursday.
