Orsi Carolina, Davis Tyler, Swindall Rebecca, Wadle Carly, Cook Alan, Ismael Hishaam
Department of Graduate Medical Education, General Surgery, The University of Texas at Tyler Health Science Center, Tyler, TX, USA.
Department of Surgery, The University of Texas Health Science Center at Tyler, Tyler, TX, USA.
Ann Surg Oncol. 2025 Jul;32(7):4883-4889. doi: 10.1245/s10434-025-17291-z. Epub 2025 Apr 17.
Evidence-based benchmarks have been established to assess the quality of breast cancer care, as delays in treatment correlate with poor clinical outcomes. Our aim was to identify factors influencing the timeliness of care within a rural East Texas healthcare system.
Patients diagnosed with invasive breast cancer were identified and monitored from January 2015 to October 2022. Timeliness of care was assessed retrospectively across three intervals: diagnostic imaging to biopsy, biopsy to surgical treatment, and mammogram to surgical treatment. We analyzed correlations between demographic and clinical factors influencing timely initiation of treatment in our population against recommendations from the National Consortium of Breast Centers (NCBC).
A total of 278 cases were included over the 5-year study period. Nearly half met the recommended timeline from diagnostic imaging to biopsy, 13.3% from mammogram to surgical treatment, and 10.3% from biopsy to surgical treatment. A delay in the "diagnostic imaging to biopsy" interval or "biopsy to surgical treatment" interval predicted delays in the mammogram to treatment interval. Hispanics were more likely to present with stage 3 cancer and had a 4.5 times higher likelihood of mortality compared with Non-Hispanic whites.
Delay in one phase of care predicted delays in subsequent phases. Timeliness of treatment also influenced survival rates among Hispanic patients. Understanding factors influencing the timeliness of breast cancer treatment may guide targeted interventions in the future for patients at greater risk of care delays.
鉴于治疗延迟与不良临床结果相关，已建立循证基准来评估乳腺癌护理质量。我们的目的是确定影响东德克萨斯州农村医疗系统内护理及时性的因素。
对2015年1月至2022年10月期间确诊为浸润性乳腺癌的患者进行识别和监测。通过回顾性分析评估三个阶段的护理及时性：诊断性成像至活检、活检至手术治疗以及乳房X线摄影至手术治疗。我们根据国家乳腺中心联盟（NCBC）的建议，分析了影响我们研究人群中及时开始治疗的人口统计学和临床因素之间的相关性。
在5年的研究期间共纳入278例病例。近一半患者符合从诊断性成像到活检的推荐时间线，13.3%符合从乳房X线摄影到手术治疗的时间线，10.3%符合从活检到手术治疗的时间线。“诊断性成像至活检”阶段或“活检至手术治疗”阶段的延迟预示着乳房X线摄影至治疗阶段的延迟。西班牙裔患者更有可能出现3期癌症，其死亡率是非西班牙裔白人的4.5倍。
一个护理阶段的延迟预示着后续阶段的延迟。治疗的及时性也影响西班牙裔患者的生存率。了解影响乳腺癌治疗及时性的因素可能会为未来对护理延迟风险更高的患者进行有针对性的干预提供指导。
