Background: Breast cancer (BC) is a prevalent form of cancer and a leading cause of death among women worldwide. In Saudi Arabia, it accounted for 31.8% among females of all new cancer cases reported in 2018. Following the declaration of COVID-19 as a global pandemic, there was a complete redistribution of healthcare resources to face this crisis, which caused a significant delay in the management of various diseases, including BC. There is currently a lack of research in our region on the facility time interval in BC management. Therefore, this study aimed to fill this gap by determining the timelines of diagnosis, management, and factors influencing the delay. Methods: This observational retrospective study included all female patients diagnosed with BC at or referred to King Abdullah Medical City (KAMC) in Makkah, Saudi Arabia, between January 2020 and August 2021. The data for this study were obtained from a centralized electronic chart review of all included patients at the KAMC center. Results: A total of 76 patients were included in the study, with a mean age of 50 ± 11 years. In terms of the disease management duration, 20 patients (26.3%) completed their management within 30 days, 28 patients (36.8%) had a management duration between 31 and 60 days, and the management duration of 28 patients (36.8%) exceeded 60 days. Patient deposition showed a significant association with delay (p = 0.033). A higher incidence of delays at the initiation of treatment was observed in patients who failed to attend appointments (p < 0.001). Among patients who skipped two or more appointments, 12 individuals (80%) experienced a delay of more than 60 days. Moreover, appointment cancellation was associated with delayed treatment initiation (p = 0.03). Patients' age and comorbidity showed no significant association (p = 0.49, p = 0.24, respectively). Conclusion: Our findings highlight the significant impact of patient deposition and canceled or skipped appointments on delayed initiation of therapy for BC patients. Further research should be conducted to evaluate the impact of COVID-19 on other malignancies.
Introduction: Heterotopic pancreatic (HP) tissue defined as tissue that is found outside the anatomical location of the pancreas. It can occur anywhere in the gastrointestinal tract with the stomach and small bowel being the most common sites. The diagnosis of HP is considered difficult and usually discovered as an incidental finding in laparotomy. However, it can present as a case of intussusception or even perforation. Case Presentation: In this case, we report a 23-year-old male with a history of abdominal pain with vomiting that lasted for 7 days. Computed tomography (CT) scan was suggestive of intussusception. Laparotomy was done and a mass was found adherent to the jejunal wall. Partial resection of the jejunum was performed including the mass. The histopathological analysis confirmed it to be mixed exocrine and endocrine heterotopic pancreatic tissue. Conclusion: Heterotopic pancreatic tissue in the jejunum is rare. However, it should be considered in the differential diagnosis of jejunal masses.
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