Rossi S, Cinini C, Di Pietro C, Lombardi C P, Crucitti A, Bellantone R, Crucitti F
Istituto di Patologia Speciale Chirurgica, Università Cattolica del Sacro Cuore, Roma, Italy.
Tumori. 1990 Dec 31;76(6):559-62. doi: 10.1177/030089169007600609.
Diagnostic delay in a group of 189 women with breast cancer was studied and correlated with first symptom, stage of disease, histologic grade and prognosis. Diagnostic delay was divided into patient delay (time from the patient's discovery of a symptom to the first medical consultation) and system delay (time from medical diagnosis to treatment). Patients were divided into five groups by patient-delay time: 0 to 30 days; 31 to 90 days; 91 to 180 days; 181 to 365 days; and greater than 365 days. The median diagnostic delay was 60 days (range, 4-980) and was not influenced by patient age, marital status or nature of first symptom. A consistent and direct relationship was found between delay and tumor size, nodal involvement, presence of metastases, and histologic grade of disease at diagnosis. No correlation was found between diagnostic delay and histologic type distribution. The three-year survival rate after treatment was significantly lower for patients with a longer delay. Our data indicate that diagnostic delay appears to be an important determinant of stage at diagnosis in women with breast cancer and that it has an important influence on survival. In most cases, delay was mainly patient dependent (60 days); the median system-dependent delay was 15 days (range, 4-47). Since early treatment is generally accepted to be one of the most important determinants of prognosis in breast cancer patients, a reduction in diagnostic delay may lengthen survival time.
对189名乳腺癌女性患者的诊断延迟情况进行了研究，并将其与首发症状、疾病分期、组织学分级和预后相关联。诊断延迟分为患者延迟（从患者发现症状到首次就医的时间）和系统延迟（从医学诊断到治疗的时间）。根据患者延迟时间将患者分为五组：0至30天；31至90天；91至180天；181至365天；超过365天。中位诊断延迟为60天（范围为4至980天），且不受患者年龄、婚姻状况或首发症状性质的影响。发现延迟与肿瘤大小、淋巴结受累情况、转移灶的存在以及诊断时疾病的组织学分级之间存在一致且直接的关系。未发现诊断延迟与组织学类型分布之间存在相关性。延迟时间较长的患者治疗后的三年生存率显著较低。我们的数据表明，诊断延迟似乎是乳腺癌女性患者诊断时分期的一个重要决定因素，并且对生存有重要影响。在大多数情况下，延迟主要取决于患者（60天）；中位系统依赖性延迟为15天（范围为4至47天）。由于早期治疗通常被认为是乳腺癌患者预后的最重要决定因素之一，减少诊断延迟可能会延长生存时间。
