Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain.
Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.
Ann Surg Oncol. 2021 Jul;28(7):3714-3721. doi: 10.1245/s10434-020-09409-2. Epub 2020 Nov 27.
The diagnosis or treatment of breast cancer is sometimes delayed. A lengthy delay may have a negative psychological impact on patients. The aim of our study was to evaluate the sociodemographic, clinical and pathological factors associated with delay in the provision of surgical treatment for localised breast cancer, in a prospective cohort of patients.
This observational, prospective, multicentre study was conducted in ten hospitals belonging to the Spanish national public health system, located in four Autonomous Communities (regions). The study included 1236 patients, diagnosed through a screening programme or found to be symptomatic, between April 2013 and May 2015. The study variables analysed included each patient's personal history, care situation, tumour history and data on the surgical intervention, pathological anatomy, hospital admission and follow-up. Treatment delay was defined as more than 30 days elapsed between biopsy and surgery.
Over half of the study population experienced surgical treatment delay. This delay was greater for patients with no formal education and among widows, persons not requiring assistance for usual activities, those experiencing anxiety or depression, those who had a high BMI or an above-average number of comorbidities, those who were symptomatic, who did not receive NMR spectroscopy, who presented a histology other than infiltrating ductal carcinoma or who had poorly differentiated carcinomas.
Certain sociodemographic and clinical variables are associated with surgical treatment delay. This study identifies factors that influence surgical delays, highlighting the importance of preventing these factors and of raising awareness among the population at risk and among health personnel.
乳腺癌的诊断或治疗有时会被延误。较长的延误可能会对患者产生负面影响。我们的研究旨在评估与局部乳腺癌手术治疗延迟相关的社会人口学、临床和病理因素，这是在一个前瞻性队列的患者中进行的。
这是一项观察性、前瞻性、多中心研究，在西班牙国家公共卫生系统的十家医院进行，这些医院位于四个自治区（地区）。该研究纳入了 2013 年 4 月至 2015 年 5 月期间通过筛查计划或出现症状的 1236 名患者。研究分析的变量包括每位患者的个人病史、护理情况、肿瘤病史以及手术干预、病理解剖、住院和随访的数据。治疗延迟定义为活检和手术之间超过 30 天的时间。
超过一半的研究人群经历了手术治疗的延迟。在没有正规教育的患者和寡妇中，治疗延迟更为严重，那些不需要帮助进行日常活动的人、那些有焦虑或抑郁的人、那些 BMI 较高或合并症较多的人、那些有症状的人、那些没有接受 NMR 光谱检查的人、那些组织学表现为非浸润性导管癌以外的人、以及那些分化较差的癌患者，他们的治疗延迟时间更长。
某些社会人口学和临床变量与手术治疗的延迟有关。本研究确定了影响手术延迟的因素，强调了预防这些因素的重要性，并提高了高危人群和卫生人员的认识。
