Villarreal-Garza Cynthia, Platas Alejandra, Miaja Melina, Fonseca Alan, Mesa-Chavez Fernanda, Garcia-Garcia Marisol, Chapman Judy-Anne, Lopez-Martinez Edna A, Pineda Claudia, Mohar Alejandro, Galvez-Hernandez Carmen L, Castro-Sanchez Andrea, Martinez-Cannon Bertha-Alejandra, Barragan-Carrillo Regina, Muñoz-Lozano Jose F, Goss Paul, Bargallo-Rocha Juan E, Aguilar Dione, Cardona Servando, Canavati Mauricio
Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico.
Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico.
JCO Glob Oncol. 2020 Mar;6:395-406. doi: 10.1200/JGO.19.00264.
The pilot-phase report of the Joven & Fuerte prospective cohort broadly characterizes and assesses the needs of Mexican young women with breast cancer (YWBC).
Women age ≤ 40 years with nonmetastatic primary breast cancer were consecutively accrued from 2 hospitals. Data were collected at the first/baseline oncology visit and 2 years later using a sociodemographic survey, European Organisation for Research and Treatment of Cancer Quality-of-Life (QOL) Questionnaire Core 30 (QLQ-C30) and Breast Cancer-Specific QOL Questionnaire (QLQ-BR23), Hospital Anxiety and Depression Scale (HADS), Female Sexual Functioning Index (FSFI), Sexual Satisfaction Inventory, and patients' medical records. Pearson χ and 2-sided tests were used for statistical analysis. An unadjusted value < .05 was considered significant.
Ninety patients were included, all with government health care coverage. Most had low monthly household incomes (98%) and at least a high school education (59%). There was a considerable prevalence of unpartnered patients (36%) and unmet parity (25%). Patients' most common initial symptom was a palpable mass (84%), and they were most frequently diagnosed with stage III disease (48%), with 51% having had a physician visit ≤ 3 months since detection but 39% receiving diagnosis > 12 months later. At baseline, 66% of patients were overweight/obese, and this proportion had significantly increased by 2 years ( < .001). Compared with baseline, global QLQ-C30 had improved significantly by 2 years ( = .004), as had HADS-Anxiety ( < .001). However, both at baseline and at 2 years, nearly half of patients exhibited FSFI sexual dysfunction.
These preliminary findings demonstrate that YWBC in Mexico have particular sociodemographic and clinicopathologic characteristics, reinforcing the necessity to further describe and explore the needs of these young patients, because they may better represent the understudied and economically vulnerable population of YWBC in limited-resource settings.
Joven & Fuerte前瞻性队列研究的试点阶段报告广泛描述并评估了墨西哥年轻乳腺癌女性（YWBC）的需求。
年龄≤40岁的非转移性原发性乳腺癌女性患者连续从2家医院纳入。在首次/基线肿瘤学就诊时以及2年后收集数据，使用社会人口学调查、欧洲癌症研究与治疗组织生活质量（QOL）问卷核心30（QLQ-C30）和乳腺癌特异性生活质量问卷（QLQ-BR23）、医院焦虑抑郁量表（HADS）、女性性功能指数（FSFI）、性满意度量表以及患者的病历。采用Pearson χ检验和双侧检验进行统计分析。未校正的P值<0.05被认为具有统计学意义。
纳入90例患者，均有政府医保覆盖。大多数患者家庭月收入较低（98%），至少接受过高中教育（59%）。未婚患者（36%）和未生育患者（25%）的比例相当高。患者最常见的初始症状是可触及肿块（84%），最常被诊断为III期疾病（48%），51%的患者在发现后≤3个月就诊，但39%的患者在12个月后才得到诊断。基线时，66%的患者超重/肥胖，2年后这一比例显著增加（P<0.001）。与基线相比，全球QLQ-C30在2年后显著改善（P = 0.004），HADS焦虑量表得分也显著改善（P<0.001）。然而，在基线和2年时，近一半的患者存在FSFI性功能障碍。
这些初步研究结果表明，墨西哥的YWBC具有特定的社会人口学和临床病理特征，这进一步凸显了有必要进一步描述和探索这些年轻患者的需求，因为他们可能更好地代表了资源有限环境中未得到充分研究且经济上处于弱势的YWBC群体。
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