Department of Surgery, Ngwelezana Hospital, Empangeni, KZN, South Africa.
Department of Surgery, University of KwaZulu-Natal, Durban, KZN, South Africa.
World J Surg. 2021 May;45(5):1316-1322. doi: 10.1007/s00268-020-05931-2. Epub 2021 Jan 18.
Specialist breast cancer nurses (BCNs) have improved the psychological care and follow-up rates of breast cancer (BC) patients. This study sought to determine if breast cancer research workers (BCRWs) as de facto BCNs impacted patients' adherence to treatment by comparing groups with and without these patient navigators; hence assessing our need for BCNs.
Two groups BC patients booked for primary chemotherapy compared. Study group 1 (SG1): no BCRWs/BCNs. Study group 2 (SG2): BCRWs involvement. Assessment of numbers completing primary chemotherapy, undergoing surgery post-neoadjuvant chemotherapy and BCRWs interventions.
SG1: n = 281, 25-89y, mean 52.7y, Stage 4: 35.6%, Stage 3: 64.4%. SG2: n = 154, 21-85y, mean 52.6y, Stage 4: 47.4%, Stage 3: 43.3%, Stage 2: 9%. Primary chemotherapy not completed SG1: 40.2% (113) versus SG2: 13.5% (21); p < 0.00001. SG1: 88% not completing were lost to follow-up. Excluding peri-chemotherapy deaths and discontinuation: SG1: 37.1% did not complete chemotherapy versus SG2: 2.6%, p < 0.00001. SG2: BCRWs: 107 interventions for 58 (37.7%) patients. Therapeutic breast surgery SG1: 103/181 (56.9%) versus SG2: 66/81 (81.5%); p < 0.0001. SG1: main reasons for not having surgery: lost to follow-up during (n = 58) or after (n = 9) chemotherapy. Follow-up SG2: 12-43 months, mortality: 52% (80/154), no lost to follow-ups. SG1: No mortality data.
In our setting, BC patients often do not attend or complete treatments. In this study, BCRWs as de-facto BCNs were beneficial for BC patient care, improving chemotherapy compliance and therapeutic surgical interventions. This highlights the need for BCNs for the management of BC patients in South Africa.
专科乳腺癌护士（BCN）提高了乳腺癌（BC）患者的心理护理和随访率。本研究旨在通过比较有和没有这些患者导航员的组，确定作为事实上的 BCN 的乳腺癌研究人员（BCRW）是否会影响患者对治疗的依从性，从而评估我们对 BCN 的需求。
比较两组接受原发性化疗的乳腺癌患者。研究组 1（SG1）：无 BCRWs/BCNs。研究组 2（SG2）：BCRWs 参与。评估完成原发性化疗、新辅助化疗后接受手术和 BCRWs 干预的人数。
SG1：n=281，25-89 岁，平均 52.7 岁，IV 期：35.6%，III 期：64.4%。SG2：n=154，21-85 岁，平均 52.6 岁，IV 期：47.4%，III 期：43.3%，II 期：9%。SG1 中未完成原发性化疗：40.2%（113）与 SG2 中的 13.5%（21）；p<0.00001。SG1 中 88%未完成者失访。排除化疗期间死亡和停药：SG1：37.1%未完成化疗，而 SG2：2.6%，p<0.00001。SG2：BCRWs：107 项干预措施针对 58 名（37.7%）患者。SG1：乳房肿瘤切除术：103/181（56.9%）与 SG2：66/81（81.5%）；p<0.0001。SG1：未进行手术的主要原因：化疗期间（n=58）或化疗后（n=9）失访。SG2：随访 12-43 个月，死亡率：52%（80/154），无失访。SG1：无死亡率数据。
在我们的环境中，BC 患者经常不参加或完成治疗。在这项研究中，作为事实上的 BCN 的 BCRWs 有利于 BC 患者护理，提高了化疗依从性和治疗性手术干预。这凸显了南非管理 BC 患者需要 BCN 的必要性。
