Department of Medical Oncology, University Hospital Puerta del Mar, Avenida de Ana de Viya 21, 11009, Cádiz, Spain.
Department of Medical Oncology, University Hospital Puerto Real, Carretera Nacional IV, Km. 665, Puerto Real, 11510, Cádiz, Spain.
Clin Transl Oncol. 2018 Oct;20(10):1345-1352. doi: 10.1007/s12094-018-1867-7. Epub 2018 Apr 9.
To analyse any delays in breast cancer diagnosis and surgical treatment, influence of clinical and biological factors and influence of delays on survival.
METHODS/PATIENTS: A descriptive, observational, and retrospective study was conducted between 2006 and 2016 on stages I-III breast cancer patients. This is a retrospective review of health records to collect data on delays, patients' clinical data, biological features of the tumour and information on treatment. Mortality data from the National Death Index.
In 493 evaluable patients, the median of days from the first symptom to mammography, biopsy, and surgery was 41, 57, and 92, respectively. The median of days from screening mammography to biopsy and surgery was 10 and 51, respectively. From biopsy to surgery, the median was 34 days in every case. Over the last 5 years, an increase in biopsy-surgery delay has been observed (p = 0.0001). Tumour stages I and II vs. stage III (RR 1.74. 95% CI 1.08-2.80, p = 0.027), diagnosis in screening (RR 0.66. 95% CI 0.45-0.96, p = 0.030), and use of magnetic resonance imaging (RR 2.08. 95 CI 1.21-3.56, p = 0.008) condition a greater biopsy-surgery delay. No influence of delays on survival has been identified.
Delays in diagnosis and surgery in the case of women diagnosed on the basis of symptoms may be improved. There is a temporary tendency to a greater delay in surgery. Some clinical and biological factors must be taken into account to optimise delays. Survival results are not adversely affected by delays.
分析乳腺癌诊断和手术治疗的任何延迟，临床和生物学因素的影响，以及延迟对生存的影响。
方法/患者：这是一项 2006 年至 2016 年期间对 I-III 期乳腺癌患者进行的描述性、观察性和回顾性研究。这是对健康记录的回顾性审查，以收集有关延迟、患者临床数据、肿瘤的生物学特征以及治疗信息的数据。国家死亡指数的死亡率数据。
在 493 例可评估患者中，从首次症状到乳房 X 光检查、活检和手术的中位天数分别为 41、57 和 92。从筛查乳房 X 光检查到活检和手术的中位天数分别为 10 和 51。在每种情况下，从活检到手术的中位天数为 34 天。在过去的 5 年中，观察到活检-手术延迟增加（p = 0.0001）。I 期和 II 期肿瘤与 III 期肿瘤（RR 1.74，95%CI 1.08-2.80，p = 0.027）、筛查诊断（RR 0.66，95%CI 0.45-0.96，p = 0.030）和磁共振成像（RR 2.08，95%CI 1.21-3.56，p = 0.008）的使用会导致更大的活检-手术延迟。未发现延迟对生存有影响。
基于症状诊断的女性在诊断和手术方面的延迟可能会得到改善。手术延迟暂时有增加的趋势。必须考虑一些临床和生物学因素，以优化延迟。生存结果不受延迟的不利影响。
