New York University School of Medicine, New York, NY, USA.
Breast. 2011 Apr;20 Suppl 2:S54-9. doi: 10.1016/j.breast.2011.02.012. Epub 2011 Mar 2.
In Mexico, breast cancer is the leading cancer-related death among women and most cases are diagnosed at advanced stages (50-60%). We hypothesized health system factors could be partly responsible for this delay and performed a prospective review of 166 new breast cases at a major public hospital in Mexico City. Our analysis confirmed the prevalence of locally advanced and metastatic disease (47% of patients). A subset analysis of 32 women with confirmed stage I-IIIC breast cancer found an average time interval of 1.8 months from symptom onset to first primary care consultation (PCC), with an additional 6.6 months from first PCC to confirmed diagnosis, and 0.6 months from diagnosis to treatment initiation. Patients underwent an average of 7.9 clinic visits before confirmed diagnosis. Findings suggest that protracted referral time from primary to specialty care accounts for the bulk of delay, with earlier stage patients experiencing longer delays. These findings reveal a critical need for further study and exploration of interventions.
在墨西哥，乳腺癌是导致女性死亡的主要癌症之一，大多数病例在晚期（50-60%）诊断。我们假设卫生系统因素可能是导致这种延迟的部分原因，并对墨西哥城一家主要公立医院的 166 例新乳腺癌病例进行了前瞻性回顾。我们的分析证实了局部晚期和转移性疾病的流行（47%的患者）。对 32 例确诊为 I-IIIC 期乳腺癌的患者进行亚组分析发现，从症状出现到首次初级保健咨询的平均时间间隔为 1.8 个月，从首次初级保健咨询到确诊的时间间隔为 6.6 个月，从确诊到开始治疗的时间间隔为 0.6 个月。在确诊前，患者平均接受了 7.9 次就诊。结果表明，从初级保健到专科护理的转诊时间延长是导致大部分延迟的原因，早期患者的延迟时间更长。这些发现揭示了进一步研究和探索干预措施的迫切需要。
