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通过坚持严格的诊断和治疗算法,优化认证乳腺中心的流程质量,研究结构和社会人口因素对治疗开始的影响。

Optimized process quality in certified breast centers through adherence to stringent diagnostic and therapeutic algorithms effects of structural as well as socio-demographic factors on start of therapy.

机构信息

Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Universitätsfrauenklinik Würzburg, Josef-Schneider-Straße 4, 97080, Würzburg, Germany.

出版信息

Arch Gynecol Obstet. 2023 Apr;307(4):1097-1104. doi: 10.1007/s00404-022-06666-2. Epub 2022 Aug 5.

Abstract

PURPOSE

An increasing incidence of breast cancer can be observed worldwide. Since a delay of therapy can have a negative impact on prognosis, timely cancer care is an important quality indicator. By receiving treatment at a certified breast cancer center, the patient has the best chance of treatment in accordance with guidelines and the best prognosis. The identification of risk factors for a delay of therapy is of central importance and should be the basis for a continuous optimization of treatment at breast cancer centers.

METHODS

This retrospective study included women with breast cancer (primary diagnosis, relapse, or secondary malignancy) at the University Hospital Würzburg in 2019 and 2020. Data were retrieved from patients' records. Correlations and regression analyses were performed to detect potential risk factors for treatment delay.

RESULTS

Patients who received the histological confirmation of breast cancer at an external institution experienced a later therapy start than those patients who received the histological confirmation at the University Hospital Würzburg itself. (35.7 vs. 32.2 days). The interval between histological confirmation and the first consultation at the University Hospital Würzburg correlated statistically significant with age, distress and distance to the hospital.

CONCLUSION

Patients with an in-house diagnosis of breast cancer are treated more quickly than those whose diagnosis was confirmed in an external institution. We identified factors such as increased age, greater distance to the hospital as well as increased distress to prolong the time until start of oncological treatment. Intensified patient care should be offered to these subgroups.

摘要

目的

在全球范围内,乳腺癌的发病率不断上升。由于治疗的延误可能对预后产生负面影响,因此及时进行癌症治疗是一个重要的质量指标。通过在认证的乳腺癌中心接受治疗,患者有最好的机会按照指南进行治疗并获得最佳预后。确定治疗延误的风险因素至关重要,应成为乳腺癌中心不断优化治疗的基础。

方法

本回顾性研究纳入了 2019 年和 2020 年在维尔茨堡大学医院就诊的乳腺癌女性患者(初诊、复发或继发性恶性肿瘤)。数据来自患者记录。进行相关性和回归分析,以检测治疗延误的潜在风险因素。

结果

在外部机构获得乳腺癌组织学确诊的患者比在维尔茨堡大学医院获得组织学确诊的患者开始治疗的时间晚(35.7 天 vs. 32.2 天)。组织学确诊与在维尔茨堡大学医院首次就诊之间的间隔与年龄、痛苦和与医院的距离具有统计学显著相关性。

结论

在内部诊断为乳腺癌的患者比在外部机构确诊的患者接受治疗的速度更快。我们确定了一些因素,如年龄增加、与医院的距离增加以及痛苦增加,这些因素会延长开始肿瘤治疗的时间。应向这些亚组提供强化的患者护理。

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