The diagnosis or treatment of breast cancer is sometimes delayed. A lengthy delay may have a negative psychological impact on patients. Our study aim is 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. MethodThis 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. ResultsOver 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. ConclusionsCertain 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.

HighlightsLa ecografía clínica es una herramienta que complementa la anamnesis y exploración física, lo que facilita y agiliza la toma de decisiones en cualquier entorno de atención médicaEl médico de familia es el especialista que más se puede beneficiar del empleo de la ecografía porque debe ser competente en todos los terrenos de la patologíaLa ecografía musculoesquelética, por su fiabilidad, seguridad, reproducibilidad y bajo coste debe estar accesible para su empleo en atención primariaLa ecografía clínica musculoesquelética, aplicada en escenarios concretos, y con una técnica de estudio definida, confirma o descarta patología con elevada fiabilidadEste artículo revisa la fiabilidad y utilidad de la ecografía clínica musculoesquelética

ResumenLa ecografía musculoesquelética (EME) es una técnica que se ha extendido en los últimos años a la práctica totalidad de las especialidades médicas que abarcan esta parte de la patología. El médico de familia (MF) no ha sido ajeno a este proceso por su amplísimo espectro de competencias, usándola en gran cantidad de situaciones de su práctica habitual en las cuales obtiene rentabilidad de ella de modo fiable, eficiente y eficaz.La dotación de ecografía en los centros de Atención Primaria (AP) es una realidad creciente, aportando elevadas cotas de accesibilidad, inmediatez y capacidad de manejo clínico, lo que, unido a la elevada prevalencia de problemas del aparato locomotor en este ámbito, convierten a la EME en una acción estratégica de mejora de la capacidad resolutiva y de la calidad de la atención sanitaria.Para asegurar la competencia de quienes la practican, se hace necesario definir los beneficios y los potenciales riesgos que su uso puede generar, así como sus escenarios de aplicación, evitar exploraciones innecesarias y optimizar la inversión que supone dotar de este recurso al nivel de AP. Este artículo pretende resumir el estado actual de la ecografía clínica musculoesquelética y su utilidad para el MF en aquellos escenarios en los que resulta fiable y eficaz.

Objective: To assess the natural evolution of low-grade squamous intraepithelial lesions (LSIL) in a retrospective study conducted in a specialized primary care setting of patients detected from the cervical cancer prevention program. Materials and Methods: A review of all cytological examinations between January and December 2002, with 24 months follow-up was conducted in LSIL patients. Follow-up with cytological testing and colposcopy were performed every 6 months, and a biopsy was performed in cases that were indicated by protocol. Patients were not systemically or topically treated in any case. Results: During the study period, 4,152 women received cytology testing, and 122 had LSIL (prevalence, 2.9%). One hundred eleven patients (91%) completed the follow-up, and the remaining patients were lost for various reasons. The age distribution was as follows: 3.2% (G20 years), 34.4% (20Y29 years), 25.4% (30Y39 years), 27.2% (40Y49 years), 9% (50Y59 years), and 0.8% (960 years). Spontaneous regression was observed in 79 (71.3%) of women who completed follow-up. Regression was observed in 51.8% of patients within 12Y18 months and in 48.2% of patients within 18Y24 months of cytological testing. Regression according to age group was as follows: 100% (G20 years), 79.5% (20Y29 years), 60.6% (30Y39 years), 81.8% (40Y49 years), 90.9% (50Y59 years), and 100% (960 years). Conclusions: The general tendency of natural regression in LSIL patients without any specific risk factors identified is supported by our results. 2007, American Society for Colposcopy and Cervical Pathology