Background: Early diagnosis is a key determinant factor for prognosis and survival of breast cancer.  However delay in diagnosis and advanced stage presentations are common problems in Ethiopia. More than half of breast cancer cases are diagnosed at advanced stage and the barriers for early diagnosis are not well studied explored in the country. Hence we aimed to explore the perceived barriers for early diagnosis of breast cancer from patient and health care provider’s perspective in South and Southwest Ethiopia.

Methods: A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and health care providers giving service to breast cancer patients, in six public hospitals located at urban and rural areas.  Twelve breast cancer patients and thirteen health care providers were purposively selected. A thematic analysis was done using the open code software version 4.02.

Result: Two main themes of barriers, (Health system and patient related) were identified.  Lack of knowledge and awareness to the disease, beliefs on traditional and religious means of treatments, lack of social and financial support to seek the care, were the patient related barriers and, misdiagnosis of cases, long distance referrals, high diagnostic costs, long waiting time for diagnostic tests, unavailability of screening and diagnostic tests in the visiting hospital, were the major barriers for early diagnosis from the health system perspective.

Conclusion and recommendation: Barriers for early diagnosis of breast cancer are broad and multidimensional from individual to facility level. The lack of awareness and knowledge was the most explained patient related barrier and misdiagnosis at presentation and prolonged waiting times were the health system related barriers. Thus, it would be good to raise the awareness at the community and facility level for early diagnosis and management. The health facilities have to improve service capacity and referral linkage for patients coming with breast abnormalities or cancer.

Key words: Breast cancer, early diagnosis, barriers, Ethiopia