Tennvall J, Möller T, Attewell R
Department of Oncology, University Hospital, Lund, Sweden.
Acta Chir Scand. 1990 Sep;156(9):591-6.
An effort has been made to study possible delaying factors in the diagnosis and primary treatment of breast cancer. The data are based on 273 female patients, referred to the Department of Oncology, Lund, constituting 50% of all primary breast carcinomas without a previous malignancy diagnosed in 1986 in a catchment area of 1.2 million. Of these, 68% initially consulted a general or private practitioner, whereas only 21% directly consulted surgical departments. The interval from the initial consultation to operation, analysed multivariately, was correlated to the number of referral-steps (13 vs. 75 days), the category of physician initially consulted (15 vs. 33 days), and the outcome of a combined positive or negative mammography + aspiration cytology (13 vs. 58 days). If one or both of these diagnostic procedures were negative, the delay varied considerably between the four categories of physicians initially consulted. The median time between decision and start of radiotherapy was 38 days, constituting 46% of the time from the initial consultation to start of this treatment modality.
已开展一项研究，探讨乳腺癌诊断及初次治疗中可能存在的延误因素。数据来源于273名女性患者，这些患者被转诊至隆德肿瘤学系，占1986年在一个120万人口集水区内确诊的所有原发性乳腺癌患者（此前无恶性肿瘤诊断史）的50%。其中，68%的患者最初咨询全科医生或私人执业医生，而直接咨询外科科室的仅占21%。经多变量分析，从初次咨询到手术的间隔时间与转诊次数（13天对75天）、最初咨询的医生类别（15天对33天）以及乳腺X线摄影和穿刺细胞学检查联合结果为阳性或阴性（13天对58天）相关。如果这两种诊断程序中的一种或两种结果为阴性，那么在最初咨询的四类医生之间，延误情况差异很大。从决定放疗到开始放疗的中位时间为38天，占从初次咨询到开始这种治疗方式总时间的46%。
