[Time and space in the care pathways of women suffering from breast cancer]

Facing breast cancer, women in precarious situations are more likely to be diagnosed at an advanced stage, and when detected at the same stage, they are more to die as well as faster. In this paper, we analyze a corpus of 40 semi-structured interviews conducted in six cancer services in hospitals of the Paris area on the care pathways of women with breast cancer. The analysis focuses on the beginning of the pathways (until the first treatments) and concentrates on their spatial and temporal dimension in the light of precariousness. Depending on the women's situations with regard to precariousness, the spatial and temporal organization of the pathways differs. There are socially differentiated latency periods that delay diagnosis (prior to meeting a medical professional) or the beginning of treatment (in relation to rights, the responsiveness of the health care system, and the interactions between women and the system). Spatially, the geometry of the pathways is variable and reflects different expectations of health institutions and medical staff according to the social profiles of the women. However, a detailed analysis of the pathways allows us to nuance these differences in terms of precariousness. The women's capacity to be autonomous, their network of contacts, the accessibility and responsiveness of the health care system, as well as the sensitive and emotional dimension of this stressful event affect the pathways both in terms of time and space.