Women who completed breast cancer treatment at two major cancer centers in Dar es Salaam, Tanzania, describe a diagnostic journey shaped by both strengths and serious obstacles in the country’s healthcare system, according to a qualitative study published in BMC Cancer. The research, led by Zainab A. Illonga and colleagues, interviewed 14 women who had finished breast cancer treatment at Muhimbili National Hospital and Ocean Road Cancer Institute, gathering their firsthand accounts of how they secured a diagnosis and what they believe should change.
The study used in-depth, semi-structured interviews and analyzed the data through the Model of Pathways to Treatment framework alongside a rapid analysis approach. Participants had a median age of 49.5 years, with a range spanning 40 to 60 years. All were cancer survivors, and 71 percent of them, or 10 of the 14 women interviewed, also worked as patient advocates, giving the research team access to perspectives from women with both personal and advocacy experience navigating the diagnostic pathway.
Breast cancer is the second most common cancer among women in Tanzania, yet many women face multiple obstacles in obtaining a timely diagnosis. While prior efforts have mapped these barriers, the researchers note that few studies have solicited improvement recommendations directly from patients themselves. This gap motivated the study’s dual focus: documenting the lived experience of the diagnostic process and collecting concrete suggestions for change in a resource-constrained setting.
Participants identified several strengths within the Tanzanian health system. These included the availability of primary care and specialized cancer care services, some health insurance coverage, and social welfare support offered through various healthcare facilities. These positive elements suggest that the system has structural foundations on which future improvements could be built, rather than starting from scratch.
Against these strengths, the women described significant barriers that delayed their diagnoses. Financial and logistical constraints made it difficult to reach and afford diagnostic services. Healthcare facilities suffered from insufficient resources, limiting the quality and speed of care available. Perhaps most strikingly, participants reported that non-specialized healthcare providers often had limited knowledge of breast cancer, which could delay recognition of symptoms and appropriate referral.
The barriers extended beyond individual facilities to the structure of the referral system itself. Women described complicated referral pathways that made navigating from one level of care to the next confusing and time-consuming. Delays in receiving biopsy results added further waiting time, prolonging the period between initial suspicion and confirmed diagnosis. Poor patient-provider communication compounded these problems, leaving women without clear information about their condition or next steps.
When asked what should change, the participants offered specific recommendations. They called for enhanced patient-provider communication, so that women receive clearer and more supportive information throughout the diagnostic process. They urged reductions in the costs of diagnosis, reflecting the financial burden that many described. They also recommended strengthening pathology services, addressing the bottleneck that delayed biopsy results, and incorporating psychological support into breast cancer care, recognizing the emotional toll of the diagnostic journey.
The study’s authors conclude that initiatives to improve breast cancer care in Tanzania should build on existing evidence and prioritize integrating patient suggestions, particularly improving communication between patients and providers and reinforcing pathology capacity. Because the findings come from a small qualitative sample of 14 women at two facilities in Dar es Salaam, they represent the perspectives of survivors who completed treatment rather than women who dropped out of care, and the authors present them as patient-informed guidance rather than a comprehensive national assessment.
By centering the voices of women who experienced the diagnostic pathway directly, the study adds a patient-derived layer to the evidence base on cancer care in Tanzania. The researchers emphasize that integrating these suggestions into future initiatives could help ensure that reforms reflect the realities patients face, from the first encounter with a healthcare provider to the moment a biopsy result finally arrives.
Subject of Research: Patient perspectives on breast cancer diagnosis barriers and improvements in Tanzania
Article Title: Patient perspectives on strengths, barriers, and recommendations for improvement in breast cancer diagnosis in Tanzania: a qualitative study
Article References: Illonga, Z. A., Kimambo, A. H., Haddadi, S., Luhuti, K., Mushi, B. P., Ibrahim, P. M., Selekwa, M., Philipo, G. S., BA, R. F., Mvungi, N. T., Vuhahula, E. A., MA, J. G., Van Loon, K., Mmbaga, E. J., & Ng, D. L. (2026). Patient perspectives on strengths, barriers, and recommendations for improvement in breast cancer diagnosis in Tanzania: a qualitative study. BMC Cancer. https://doi.org/10.1186/s12885-026-17230-5
Image Credits: AI Generated
DOI: 10.1186/s12885-026-17230-5
Keywords: breast cancer, Tanzania, qualitative study, diagnosis, patient perspectives, healthcare barriers, pathology services, patient-provider communication, Muhimbili National Hospital, Ocean Road Cancer Institute, cancer care, health system
