Abdel-Razeq Hikmat, Mansour Asem, Edaily Sarah, Dayyat Abdulmajeed
Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan.
Department of Internal Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.
J Clin Med. 2023 Jul 5;12(13):4502. doi: 10.3390/jcm12134502.
Breast cancer is the most commonly diagnosed cancer among women worldwide, and is a leading cause of cancer-related deaths. When diagnosed at an early stage, appropriate and timely treatment results in a high cure rate and better quality of life. Delays in initiating anti-cancer therapy, including surgical resection, adjuvant/neoadjuvant chemotherapy and radiation therapy are commonly encountered, even in developed health care systems. Existing comorbidities that mandate referral to other services, genetic counseling and testing that may dictate the extent and type of anti-cancer therapy and insurance coverage, are among the most commonly cited factors. However, delays can be unavoidable; for over three years, health care systems across the globe were busy dealing with the unprecedented COVID-19 pandemic. War across hot zones around the globe resulted in millions of refugees; most of them have no access to cancer care, and when/where available, there may be significant delays. Thus, cancer patients across the globe will probably continue to suffer from significant delays in diagnosis and appropriate treatment. Many retrospective reports showed significant negative impacts on different aspects of treatment outcomes and on patients' psychosocial wellbeing and productivity. In this paper, we review the available data on the impact of delays in initiating appropriate treatment on the outcomes of patients with early-stage breast cancer.
乳腺癌是全球女性中最常被诊断出的癌症，也是癌症相关死亡的主要原因。早期诊断时，恰当及时的治疗可带来高治愈率和更好的生活质量。即便在发达的医疗体系中，启动抗癌治疗（包括手术切除、辅助/新辅助化疗和放疗）的延迟也很常见。需要转诊至其他科室的现有合并症、可能决定抗癌治疗范围和类型的遗传咨询与检测以及保险覆盖情况，是最常被提及的因素。然而，延迟可能不可避免；三年多来，全球医疗体系都忙于应对前所未有的新冠疫情。全球热点地区的战争导致数百万难民；他们大多无法获得癌症治疗，即便有治疗机会，也可能会有显著延迟。因此，全球癌症患者可能会继续面临诊断和恰当治疗的严重延迟。许多回顾性报告显示，这对治疗结果的不同方面以及患者的心理社会福祉和生产力都有重大负面影响。在本文中，我们回顾了关于启动恰当治疗的延迟对早期乳腺癌患者预后影响的现有数据。
