Prognostic implications of emergency admission and delays in patients with breast cancer

Redondo, Maximino; Rodrigo, Isabel; Pereda, Teresa; Fúnez, Rafael; Acebal, M.; Perea-Milla, Emilio; Jimenez, E. Yakes

doi:10.1007/s00520-008-0513-2

Cited by 23 publications

(32 citation statements)

References 11 publications

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“…Patient's delay represents the time between symptoms' appearance and first consultation with the physician that exceeds 3 months (3,6). Diagnosis delay is the time between seeking medical advice and the date of final diagnosis based on histopathological examination (6).…”

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confidence: 99%

Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan

et al. 2015

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Breast cancer is the most common cancer, and one of the leading causes of death for females in Jordan and many countries in the world. Studies have shown that delay in symptoms presentation, diagnosis or treatment would result in poor prognosis. There has been no published study from Jordan on delays in patient presentation, delays in diagnosis, or delays in treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for breast cancer patients in Jordan. This project was a cross-sectional study on female breast cancer patients in Jordan. The total number of participants was 327. The proportion of patients with presentation delay, diagnosis delay, and treatment delay was 32.2%, 49.1%, or 32.4%, respectively. The main reported reasons for delay in presentation were ignorance of the nature of the problem (65.6%), limited/lack of knowledge that symptoms were suggestive of cancer diagnosis (16.7%), and misdiagnosis (16.7%). Predictors of delay and mean time for presentation, diagnosis, and treatment were identified. Our results reveal that breast cancer patients in Jordan are experiencing delays in presentation, diagnosis, and treatment. This could justify the advanced stages at diagnosis and poor outcomes for breast cancer patients in Jordan. We recommend revising the current early detection and down-staging programs in Jordan.

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Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan

et al. 2015

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“…Similarly, Redondo and colleagues showed a statistically significant association between delays to initiating treatment greater than 30 days and the ductal type, as well as signs or symptoms apart from feeling a nodule in the breast (p= <0.05). 10 The literature has shown an association between skin lesions and discharge from the nipple and a nine-fold increased risk of breast cancer, with a two-fold increased risk when pain is reported. It is important that health professionals identify and communicate possible risks associated with cancer to swiftly refer any patient with suspected disease to ensure continuity of care.…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…7 A meta-analysis of 87 studies showed convincing evidence that women who initiated treatment 3 to 6 months after the appearance of symptoms had a significantly lower five-year survival than those who waited <3 months. 8 Recent studies suggest that care delay does not adequately explain breast cancer survival, 9,10 because sicker patients could receive quicker medical care. 6,7,10 A meta-analysis published in 2013 showed that for every four weeks of delay between surgery and the initiation of chemotherapy, a statistically significant reduction of 15% in overall survival was observed.…”

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confidence: 99%

“…8 Recent studies suggest that care delay does not adequately explain breast cancer survival, 9,10 because sicker patients could receive quicker medical care. 6,7,10 A meta-analysis published in 2013 showed that for every four weeks of delay between surgery and the initiation of chemotherapy, a statistically significant reduction of 15% in overall survival was observed. 11 The so-called wait time paradox is in discussion, and it proposes that various factors (e.g., tumor biology, health infrastructure and patient behavior) aside from time influence survival.…”

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Effect of care-delivery delay on the survival of Mexican women with breast cancer

et al. 2016

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Efecto de la demora en la atención sobre la supervivencia de mujeres mexicanas con cáncer de mama. Salud Publica Mex 2016;58:237-250. ResumenObjetivo. Estimar el efecto del tiempo de atención sobre la supervivencia de mujeres con cáncer de mama. Material y métodos. Se realizó el análisis retrospectivo de 854 mujeres atendidas en 11 hospitales entre 2007 y 2009. Se emplearon estimadores de Kaplan-Meier y un modelo de riesgos proporcionales de Cox. Resultados. 10.5% se diagnosticó en etapa I, mientras que 82.1% demoró más de 67 días entre la percepción de un síntoma y el inicio del tratamiento. La mediana del tiempo desde la entrega de los resultados de la mastografía hasta la biopsia fue de 31 días (RIQ 14-56); en comparación con quienes se encontraron en el cuartil 1 (Q1), la supervivencia fue menor en aquellas que se encontraron en los Q3 y Q4 (HR=1.68, IC95% 0.94-3.00; HR=1.76, IC95% 1.04-2.98, respectivamente). Conclusiones. Se sugiere reducir el tiempo desde la entrega de los resultados de la mastografía a la biopsia diagnóstica para incrementar la supervivencia.Palabras clave: cáncer de mama; demora en la atención; supervivencia; México The median time from receipt of results of the mammography to biopsy was 31 days (IQR 14-56). Compared with those who were in quartile I (Q1), survival was lower among those in Q3 and Q4 (HR=1.68, 95%CI 0.94-3.00; HR=1.76, 95% CI 1.04-2.98, respectively). Conclusions. To increase survival, it is suggested that the time between receipt of the mammography results and diagnostic biopsy be reduced.

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“…[1] However, the evidence supporting a link between delay in diagnosis and poorer cancer outcome is weak. [14][15][16][17][18][19][20][21][22][23][24][25] The greatest number of studies examining diagnostic delays have been in patients with breast…”

Section: Delays In Diagnosismentioning

confidence: 99%

The “two-week wait” referral pathway allows prompt treatment but does not improve outcome for patients with oesophago-gastric cancer

Sharpe¹,

Williams²,

Ubhi³

et al. 2010

European Journal of Surgical Oncology (EJSO)

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Prognostic implications of emergency admission and delays in patients with breast cancer

Abstract: Brief diagnostic delays were significantly associated with advanced disease stage and poor survival rates (RR 2.04; CI 95% 1.08-3.82) probably because sicker patients receive prompt medical attention.

Cited by 23 publications

References 11 publications

Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan

Delay in Presentation, Diagnosis, and Treatment for Breast Cancer Patients in Jordan

Effect of care-delivery delay on the survival of Mexican women with breast cancer

The “two-week wait” referral pathway allows prompt treatment but does not improve outcome for patients with oesophago-gastric cancer

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