Effect of care-delivery delay on the survival of Mexican women with breast cancer

Ángeles-Llerenas, Angélica; Torres-Mejı́a, Gabriela; Lazcano‐Ponce, Eduardo; Uscanga-Sánchez, Santos; Mainero-Ratchelous, Fernando; Hernández-Ávila, Juan Eugenio; Morales-Carmona, Evangelina; Hernández-Ávila, Mauricio

doi:10.21149/spm.v58i2.7793

Cited by 29 publications

(27 citation statements)

References 71 publications

(92 reference statements)

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“…The main complaint -breast nodule (53% of cases) -and the most common histological subtype -infiltrating ductal carcinoma (85.5% of cases) -are similar to those found in other specialized studies 4,20 . Considering 139 patients who had information on the initial staging, the majority -110 women -were diagnosed with intermediate stages.…”

Section: Discussionsupporting

confidence: 85%

“…Upon analyzing 73 patients in the state of São Paulo, Trufelli et al 4 reported 17 cases of stage I, 28 cases of stage II, 17 case of stage III and 4 cases of stage IV. In a study by Angeles Llerenas et al 20 , in a Mexican multi-institutional analysis with 854 patients, this distribution was also similar: 88 cases of stage I, 324 cases of stage II, 342 cases of stage III and 62 cases of stage IV.…”

Section: Discussionmentioning

confidence: 62%

“…Another Brazilian study 23 , carried out in Vale do Cariri, Ceará, compares this waiting time to start treatment between private and public institutions. The mean time was significantly lower in the private institution (39 days) than in the public institution (71.5 days) (p = 0.031).In a Mexican study 20 , the mean treatment interval was 37 days.…”

Section: Discussionmentioning

confidence: 86%

“…The analysis of the delay in the diagnosis and treatment of breast cancer is always performed by retrospective studies, 4,20 similar to the present investigation, or by systematic reviews 8 . The ethical impediment for prospective studies is obvious for the subject, since it is not possible to randomize groups and wait for a malignant cancer to evolve.…”

Section: Discussionmentioning

confidence: 92%

See 3 more Smart Citations

Evaluation of delays in diagnosis and treatment of breast cancer in a reference center: a retrospective analysis

Bezerra¹,

Bezerra²,

Santos³

et al. 2019

Mastology

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Objetivos: Avaliar possíveis causas de atraso no diagnóstico e tratamento do carcinoma mamário em uma população atendida exclusivamente pelo Sistema Único de Saúde (SUS) do Brasil. Métodos: Foi realizada uma análise retrospectiva dos prontuários de 173 pacientes tratadas no Instituto Materno Infantil Prof. Fernando Figueira (IMIP), entre janeiro de 2011 e dezembro de 2017. Intervalos de tempo (intervalo de biópsia e de tratamento) foram relacionados com variáveis sociodemográficas e clínicas por meio de análise estatística. Resultados: A média de idade foi 56,36 anos, 116 mulheres (67,1%) eram da região metropolitana do Recife e a maioria era analfabeta ou tinha até 8 anos de escolaridade. O intervalo de biópsia variou entre 0 e 826 dias (41,42; med 12,50), enquanto o intervalo de tratamento variou entre 0 e 460 dias (94,6; med 69,0). Não houve associação estatisticamente significante desses intervalos com variáveis clínicas como procedência, nível educacional, idade, estadiamento, tipo de tratamento e situação clínica das pacientes ao final do estudo. Conclusões: Embora o diagnóstico e tratamento precoces do câncer de mama sejam fundamentais, os dados da presente investigação mostraram que atrasos medianos de três meses para início do tratamento em hospital público não foram associados com piora do prognóstico ou sobrevida das pacientes.PALAVRAS-CHAVE: neoplasias da mama; diagnóstico tardio; sobrevida. RESUMO ABSTRACTObjectives: To evaluate possible causes of delay in the diagnosis and treatment of breast cancer in a population treated exclusively by the Brazilian Unified Health System (SUS) of Brazil. Methods: A retrospective analysis of the medical patient charts of 173 patients treated at IMIP, between January 2011 and December 2017. Time intervals (biopsy and treatment intervals) were associated with sociodemographic and clinical variables utilizing statistical analysis. Results: The mean age was 56.36 years, 116 (67.1%) were from Recife's metropolitan region and the majority were illiterate or had up to 8 years of schooling. The biopsy interval ranged between 0 and 826 days (41.42; med 12.50) while the treatment interval ranged from 0 and 460 days (94.6; med 69.0). There was no statistically significant association of these intervals with clinical variables such as origin, educational level, age, tumor staging, type of treatment and clinical situation of the patients at the end of the study. Conclusions: Although the early diagnosis and treatment of breast cancer are fundamental, the data of this present investigation showed that median delays of 3 months for starting treatment in a public hospital were not associated with worsening of prognosis or survival of the patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 92%

See 2 more Smart Citations

Evaluation of delays in diagnosis and treatment of breast cancer in a reference center: a retrospective analysis

Bezerra¹,

Bezerra²,

Santos³

et al. 2019

Mastology

View full text Add to dashboard Cite

show abstract

“…In Mexico, BC is the most common cause of cancer‐related mortality among women . Although data on the clinical stages of breast cancer are scarce and are not nationally representative, existing studies have reported that 45%–48% of cases are diagnosed in stages III and IV, and only between 10% and 20% in stages 0 and I . In a previous study, both patient delay and health system delay were found to be independently associated with increased probability of advanced BC among Mexican women .…”

Section: Introductionmentioning

confidence: 91%

Barriers and Explanatory Mechanisms of Delays in the Patient and Diagnosis Intervals of Care for Breast Cancer in Mexico

et al. 2017

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This study's findings suggest that policy in low- and middle-income countries (LMICs) should be directed toward reducing delays in diagnosis, before the implementation of mammography screening programs. The results suggest several factors susceptible to early diagnosis interventions. To reduce patient delays, the usually proposed intervention of awareness promotion could better work in LMIC contexts if the message goes beyond the advertising of screening mammography to encourage the recognition of potential cancer symptoms and sharing of symptoms with significant others. To reduce diagnosis delay, efforts should focus on strengthening the quality of public primary care services and improving referral routes to cancer care centers.

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Time to treatment and hospital visits for patients undergoing neoadjuvant chemotherapy for breast cancer in a single payer system

Guay

Cordeiro

Roberts

2022

Journal of Surgical Oncology

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Background and Objectives Neoadjuvant chemotherapy (NAC) requires coordination of various services to ensure timely and accurate delivery of care. This can result in multiple hospital visits and extend time to treatment (TTT). The primary purpose of our study was to evaluate time to NAC for patients at a regional cancer centre. Healthcare resource use in the form of hospital visits before NAC was also evaluated. Methods A retrospective chart analysis of patients with invasive breast cancer who underwent NAC between 1 January 2012 and 31 December 2018 was performed. Results Overall, 286 patients underwent NAC. Median TTT was 22 days (range: 2–105). Median number of visits between first consultation and NAC was 5 (range: 0–12). Majority of additional visits were for diagnostic imaging/interventions, with a median number of 4 visits (range: 0–10). Each additional hospital visit increased time to NAC treatment by 14%. Conclusions Women undergoing NAC require multiple visits before initiating treatment—the majority of these visits are for diagnostic imaging. These results support the need for the coordination of multidisciplinary care and diagnostic imaging for breast cancer patients undergoing NAC to reduce hospital visits, improve the patient experience, and reduce TTT.

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Effect of care-delivery delay on the survival of Mexican women with breast cancer

Cited by 29 publications

References 71 publications

Evaluation of delays in diagnosis and treatment of breast cancer in a reference center: a retrospective analysis

Evaluation of delays in diagnosis and treatment of breast cancer in a reference center: a retrospective analysis

Barriers and Explanatory Mechanisms of Delays in the Patient and Diagnosis Intervals of Care for Breast Cancer in Mexico

Time to treatment and hospital visits for patients undergoing neoadjuvant chemotherapy for breast cancer in a single payer system

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