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Subedi R, Houssami N, Nickson C, Dhimal M, David M, Yu XQ. Factors Influencing Time From Diagnosis to Treatment of Breast Cancer and the Impact of Longer Waiting Time on Survival in Kathmandu Valley, Nepal: A Population-Based Study. JCO Glob Oncol 2024; 10:e2400095. [PMID: 39088778 DOI: 10.1200/go.24.00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/24/2024] [Accepted: 06/11/2024] [Indexed: 08/03/2024] Open
Abstract
PURPOSE Longer time between breast cancer (BC) diagnosis and treatment initiation is associated with poorer survival, and this may be a factor behind disparities in global survival rates. We assessed time to BC treatment in the Kathmandu Valley, Nepal, including factors associated with longer waiting times and their impact on survival. METHODS We conducted a retrospective population-based study of BC cases recorded in the Kathmandu Valley Population-Based Cancer Registry between 2018 and 2019. Fieldwork survey through telephone was undertaken to collect additional sociodemographic and clinical information. Logistic regression was performed to identify factors associated with longer time to treatment, and Kaplan-Meier and Cox proportional hazard regression was used to examine survival time and evaluate the association between longer time to treatment and survival. RESULTS Among the 385 patients with BC, one third waited >4 weeks from diagnosis to initial treatment. Lower education was associated with longer time to treatment (adjusted odds ratio, 1.63 [95% CI, 1.03 to 2.60]). The overall 3-year survival rate was 88.6% and survival was not associated with time to treatment (P = .50). However, advanced stage at diagnosis was associated with poorer survival (adjusted hazard ratio, 4.09 [95% CI, 1.27 to 13.23]). There was some indication that longer time to treatment was associated with poorer survival for advanced-stage patients, but data quality limited that analysis. CONCLUSION In the Kathmandu Valley, Nepal, women with a lower education tend to wait longer from BC diagnosis to treatment. Patients with advanced-stage BC had poorer survival, and longer waiting time may be associated with poorer survival for women diagnosed with advanced-stage disease.
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Affiliation(s)
- Ranjeeta Subedi
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- The Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Nehmat Houssami
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- The Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Carolyn Nickson
- The Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Meghnath Dhimal
- Nepal Health Research Council, Government of Nepal, Kathmandu, Nepal
| | - Michael David
- The Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Xue Qin Yu
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- The Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
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Bahrami M, Sebzari AR, Nasiri A. Caregivers' demands: caring atmosphere expected by cancer patients' caregivers-a qualitative content analysis. Support Care Cancer 2024; 32:389. [PMID: 38802620 DOI: 10.1007/s00520-024-08575-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Family caregivers play a critical role in providing care for patients with cancer. However, the quality of their caregiving can be greatly impacted if the demands and expectations they experience are not identified. Therefore, this study aimed to explore the demands and perceived expectations of caregivers while caring for cancer patients. METHODS This qualitative study was conducted from June 2022 to September 2023. Face-to-face and in-depth semi-structured interviews were conducted to collect the experiences of 19 Iranian family caregivers of patients with cancer. Purposive sampling was used to select the participants. The interviews were analyzed using conventional content analysis and the rigor of the study was ensured by employing Lincoln and Guba's criteria. RESULTS Three main themes and six subthemes were identified through data analysis. The themes that emerged from the caregivers' experiences included the following: (1) ambiguity in the healthcare system, (2) need for empathetic communication, and (3) forgotten caregivers in the healthcare system. CONCLUSION Caregivers often feel overlooked, resulting in unfulfilled needs and expectations. It is imperative to explore potential solutions that provide caregivers information, empathetic communication, and support. Nurses, as key members of the healthcare team, should play a significant role in addressing this problem.
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Affiliation(s)
- Mahnaz Bahrami
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Reza Sebzari
- Department of Internal Medicine, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Nasiri
- Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Birjand University of Medical Sciences, Birjand, Iran.
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Pearson SA, Taylor S, Marsden A, O'Reilly JD, Krishan A, Howell S, Yorke J. Geographic and sociodemographic access to systemic anticancer therapies for secondary breast cancer: a systematic review. Syst Rev 2024; 13:35. [PMID: 38238821 PMCID: PMC10795363 DOI: 10.1186/s13643-023-02382-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 11/03/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The review aimed to investigate geographic and sociodemographic factors associated with receipt of systemic anticancer therapies (SACT) for women with secondary (metastatic) breast cancer (SBC). METHODS Included studies reported geographic and sociodemographic factors associated with receipt of treatment with SACT for women > 18 years with an SBC diagnosis. Information sources searched were Ovid CINAHL, Ovid MEDLINE, Ovid Embase and Ovid PsychINFO. Assessment of methodological quality was undertaken using the Joanna Briggs Institute method. Findings were synthesised using a narrative synthesis approach. RESULTS Nineteen studies published between 2009 and 2023 were included in the review. Overall methodological quality was assessed as low to moderate. Outcomes were reported for treatment receipt and time to treatment. Overall treatment receipt ranged from 4% for immunotherapy treatment in one study to 83% for systemic anticancer therapies (unspecified). Time to treatment ranged from median 54 days to 95 days with 81% of patients who received treatment < 60 days. Younger women, women of White origin, and those women with a higher socioeconomic status had an increased likelihood of timely treatment receipt. Treatment receipt varied by geographical region, and place of care was associated with variation in timely receipt of treatment with women treated at teaching, research and private institutions being more likely to receive treatment in a timely manner. CONCLUSIONS Treatment receipt varied depending upon type of SACT. A number of factors were associated with treatment receipt. Barriers included older age, non-White race, lower socioeconomic status, significant comorbidities, hospital setting and geographical location. Findings should however be interpreted with caution given the limitations in overall methodological quality of included studies and significant heterogeneity in measures of exposure and outcome. Generalisability was limited due to included study populations. Findings have practical implications for the development and piloting of targeted interventions to address specific barriers in a socioculturally sensitive manner. Addressing geographical variation and place of care may require intervention at a commissioning policy level. Further qualitative research is required to understand the experience and of women and clinicians. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020196490.
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Affiliation(s)
- Sally Anne Pearson
- Division of Nursing, Midwifery and Social Work, The Christie NHS Foundation Trust, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
| | - Sally Taylor
- Christie Patient Centred Research, The Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester, M20 4BX, UK
| | - Antonia Marsden
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Jessica Dalton O'Reilly
- Christie Patient Centred Research, The Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester, M20 4BX, UK
| | - Ashma Krishan
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Sacha Howell
- Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
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Hanafi I, Alsalkini M, Husein S, Salamoon M. The delay of breast cancer diagnosis and management during the Syrian war. Cancer Epidemiol 2023; 82:102290. [PMID: 36384074 DOI: 10.1016/j.canep.2022.102290] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early detection of breast cancer (BC) is crucial for better prognosis especially in low-income countries, where advanced cancer stages are common. The Syrian war severely affected the healthcare system restraining the proper timely management of BC cases. We aimed to investigate the prevalence of patient- and system-related delays in BC diagnosis and management in Syria in addition to their predisposing characteristics and impact on the staging. METHODS This is a cross-sectional retrospective cohort study on patients followed by the BC unit at Al-Bairouni main cancer center in Syria. The data were collected through personal interviews and retrospective revision of patients' records. RESULTS A total number of 519 patients were recruited; A quarter of them (n = 126) reported more than three months intervals between symptoms recognition and presentation to a physician. Additionally, 72 (13.9 %) patients received a confirmed diagnosis more than three months after presentation, and 12 (2.3 %) started treatment at least three months after the diagnosis. Patients who suffered from war-related inaccessibility to healthcare were 2.55 [1.58-4.11] times more likely to report significant delays. Additionally, the most common self-reported reasons for patient delay were the lack of awareness, which was more evident for less common symptoms like the change in breasts size, and shyness. Patients who reported significant delays were more likely to receive an advanced-stage diagnosis. CONCLUSION War-related inaccessibility to healthcare rendered a significant group of BC patient susceptible to evident delay. This combined with significant system delays because of the overwhelmed hospitals, high costs, and insufficient personnel, equipment, medications, and training. However, personal factors, which might not be directly related to the war, like the inadequate awareness of rare symptoms and shyness still necessitate urgent interventions on the public knowledge and performed screening practices. These delays associated with receiving advanced-stage diagnoses and minimizing them can return better prognoses.
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Affiliation(s)
- Ibrahem Hanafi
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syria.
| | | | - Sara Husein
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Maher Salamoon
- Department of Oncology, Faculty of Medicine, Damascus University, Damascus, Syria
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İlgün AS, Özmen V. The Impact of the COVID-19 Pandemic on Breast Cancer Patients. Eur J Breast Health 2022; 18:85-90. [DOI: 10.4274/ejbh.galenos.2021.2021-11-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/26/2021] [Indexed: 12/01/2022]
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Factors Related to Delayed Diagnosis and Treatment of Breast Cancer Among Moroccan Women in Casablanca. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2022. [DOI: 10.1007/s40944-022-00668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mert T. Evaluation of knowledge and practice regarding mammography among a group of Turkish women attending a tertiary hospital. Turk J Surg 2022; 38:230-236. [PMID: 36846069 PMCID: PMC9948670 DOI: 10.47717/turkjsurg.2022.5672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/17/2022] [Indexed: 03/01/2023]
Abstract
Objectives Early detection is the most important cornerstone of breast cancer in determining treatment outcome and survival. In this study, it was aimed to investigate the level of knowledge, attitude, and practice of mammography in the early diagnosis of breast cancer in a group of women. Material and Methods Data of this descriptive study were collected under observation with the help of a questionnaire. Female patients over 40 years of age or over 30 years of age with a family history of breast cancer admitted to our general surgery outpatient clinic for a health problem other than breast were included. Results A total of 300 female patients with a mean age of 48.7 ± 10.9 years (min-max, 33-83 years) were included. Median frequency of correct answers among the women participating in the study was 83.7% (76.0-92.0). Mean score obtained by the participants from the questionnaire was 75.7 ± 15.8 (the median score 80; 25th-75th centiles, 73.3-86.7). Slightly more than half of the patients (159 patients, 53%) had at least one mammography scan before. The level of mammography knowledge was negatively correlated with age and the number of previous mammographies, and positively correlated with education level (r= -0.700, p <0.001; r= -0.419, p <0.001 and r= 0.643, p <0.001, respectively). Conclusion Although the level of knowledge about breast cancer and early diagnosis methods in women was at a satisfactory level, it is obvious that mammography screening practice of women without any breast symptoms is very low. Therefore, it should be aimed to increase women's awareness of cancer prevention and compliance with early diagnosis methods and to promote participation in mammography screening.
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Affiliation(s)
- Tuba Mert
- Department of General Surgery, Pendik Medipol University Faculty of Medicine, İstanbul, Türkiye
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Hutajulu SH, Prabandari YS, Bintoro BS, Wiranata JA, Widiastuti M, Suryani ND, Saptari RG, Taroeno-Hariadi KW, Kurnianda J, Purwanto I, Hardianti MS, Allsop MJ. Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study. PLoS One 2022; 17:e0262468. [PMID: 35025941 PMCID: PMC8757982 DOI: 10.1371/journal.pone.0262468] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/23/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose
To investigate factors associated with delays in presentation and diagnosis of women with confirmed breast cancer (BC).
Methods
A cross-sectional study nested in an ongoing prospective cohort study of breast cancer patients at Dr Sardjito Hospital, Yogyakarta, Indonesia, was employed. Participants (n = 150) from the main study were recruited, with secondary information on demographic, clinical, and tumor variables collected from the study database. A questionnaire was used to gather data on other socioeconomic variables, herbal consumption, number of healthcare visits, knowledge-attitude-practice of BC, and open-ended questions relating to initial presentation. Presentation delay (time between initial symptom and first consultation) was defined as ≥3 months. Diagnosis delay was defined as ≥1 month between presentation and diagnosis confirmation. Impact on disease stage and determinants of both delays were examined. A Kruskal-Wallis test was used to assess the length and distribution of delays by disease stage. A multivariable logistic regression analysis was conducted to explore the association between delays, cancer stage and factors.
Results
Sixty-five (43.3%) patients had a ≥3-month presentation delay and 97 (64.7%) had a diagnosis confirmation by ≥1 month. Both presentation and diagnosis delays increased the risk of being diagnosed with cancer stage III-IV (odds ratio/OR 2.21, 95% CI 0.97–5.01, p = 0.059 and OR 3.03, 95% CI 1.28–7.19, p = 0.012). Visit to providers ≤3 times was significantly attributed to a reduced diagnosis delay (OR 0.15, 95% CI 0.06–0.37, p <0.001), while having a family history of cancer was significantly associated with increased diagnosis delay (OR 2.28, 95% CI 1.03–5.04, p = 0.042). The most frequent reasons for delaying presentation were lack of awareness of the cause of symptoms (41.5%), low perceived severity (27.7%) and fear of surgery intervention (26.2%).
Conclusions
Almost half of BC patients in our setting had a delay in presentation and 64.7% experienced a delay in diagnosis. These delays increased the likelihood of presentation with a more advanced stage of disease. Future research is required in Indonesia to explore the feasibility of evidence-based approaches to reducing delays at both levels, including educational interventions to increase awareness of BC symptoms and reducing existing complex and convoluted referral pathways for patients suspected of having cancer.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Yayi Suryo Prabandari
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bagas Suryo Bintoro
- Department of Health Behaviour, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Juan Adrian Wiranata
- Medical Internship Program, Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mentari Widiastuti
- Center of Health Behaviour and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Norma Dewi Suryani
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Rorenz Geraldi Saptari
- Medicine Study Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Kartika Widayati Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mardiah Suci Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Matthew John Allsop
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Cantürk NZ, Güllüoğlu BM. Value-Based Quality Care for Breast Cancer: More Than Guidelines. Eur J Breast Health 2021; 17:297-301. [PMID: 34651106 PMCID: PMC8496118 DOI: 10.4274/ejbh.galenos.2021.6333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/16/2021] [Indexed: 12/01/2022]
Abstract
Although guidelines recommend some of the most expensive diagnostic methods and therapies, some patients do have the opportunity to use them, but some others have overused or misused such methods. The cost of cancer care is increasing, but the satisfaction levels of patients and healthcare workers have not increased in line with this rise. Value-based care for cancer, especially breast cancer, should be implemented. For this reason, all unnecessary screening, tests, treatments, and follow-up parameters should be avoided.
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Affiliation(s)
- Nuh Zafer Cantürk
- Department of General Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Bahadır M. Güllüoğlu
- Department of General Surgery, Marmara University Faculty of Medicine, İstanbul, Turkey
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Miraj S, Saeed H, Jabeen S, Rasool F, Islam M, Zeeshan Danish, Imran I, Hashmi FK, Majeed A, Yasmeen S. Association of breast cancer reporting delays and care intervals with tumor size in patients with advanced disease. Women Health 2021; 61:832-844. [PMID: 34538224 DOI: 10.1080/03630242.2021.1976357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In Pakistan, breast cancer (BC) is frequently diagnosed with advanced disease. We aimed to examine the association of breast tumor size with reasons of reporting delays, care intervals in patients with advanced disease. This cross-sectional study enrolled 392 BC patients from tertiary care hospitals. Data were collected from August 2018-March 2019. Chi-square for significance and logistic regression for association were used. Patients between 31 and 45 years of age (51%), rural residents (39%), lower-class (88.4%), no family history (17.1%), at stage-IV (36%) and patient interval >90 days (70%, p = .034) presented with large tumor size (>5 cm). Tumor size was significantly associated with area of residence (p = .043), social-class (p = .027), family history (p = .004), smoking (p = .021), nipple discharge (p = .004), recurrence (p = .024), and metastasis (p = .007). Patient-interval was associated with poor knowledge (OR;4.3,p = .0001), influence of traditional healers (OR;2.3,p = .05), religion (OR;3.9,p = .0001), finances (OR;2.4,p = .045), and competing life priorities (OR;2.9,p = .026). In-adjusted linear regression model, area of residences, education, social-class, family-history, recurrence, cancer type, and patient interval (β;0.110,p = .030) were found to be independent predictors of tumor size. In conclusion, education, family history, area of residence, social class, recurrence, cancer stage and patient interval, co-influenced by religion, finances, life priorities, traditional healers, and poor knowledge, were independent predictors of tumor size in BC patients.
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Affiliation(s)
- Shumaila Miraj
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Hamid Saeed
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Sumaira Jabeen
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Islam
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Zeeshan Danish
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Abdul Majeed
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Sadia Yasmeen
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
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11
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Çakmak GK, Emiroğlu S, Sezer A, Canturk NZ, Yeniay L, Kuru B, Karanlık H, Soyder A, Gökgöz Ş, Sakman G, Ucuncu M, Akcay MN, Girgin S, Gurdal SO, Emiroglu M, Ozbas S, Öz AB, Arici C, Toktas O, Demircan O, Çalık A, Polat AK, Maralcan G, Demirer S, Ozmen V. Surgical Trends in Breast Cancer in Turkey: An Increase in Breast-Conserving Surgery. JCO Glob Oncol 2021; 6:285-292. [PMID: 32109157 PMCID: PMC7051798 DOI: 10.1200/jgo.19.00275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Breast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018. PATIENTS AND METHODS Between January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients’ choices, surgical approaches, and academic institutions. RESULTS All surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia (P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery. CONCLUSION Increasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey.
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Affiliation(s)
- Güldeniz Karadeniz Çakmak
- Department of Surgery, The School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Selman Emiroğlu
- Department of Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Atakan Sezer
- Department of Surgery, The School of Medicine, Trakya University, Edirne, Turkey
| | - Nuh Zafer Canturk
- Department of Surgery, The School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Levent Yeniay
- Department of Surgery, The School of Medicine, Ege University, Izmir, Turkey
| | - Bekir Kuru
- Department of Surgery, The School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Hasan Karanlık
- Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Aykut Soyder
- Department of Surgery, The School of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Şehsuvar Gökgöz
- Department of Surgery, The School of Medicine, Uludag University, Bursa, Turkey
| | - Gürhan Sakman
- Department of Surgery, The School of Medicine, Cukurova University, Adana, Turkey
| | | | - Mufide Nuran Akcay
- Department of Surgery, The School of Medicine, Ataturk University, Erzurum, Turkey
| | - Sadullah Girgin
- Department of Surgery, The School of Medicine, Dicle University, Diyarbakır, Turkey
| | - Sibel Ozkan Gurdal
- Department of Surgery, The School of Medicine, Namık Kemal University, Tekirdag, Turkey
| | | | | | - Abdullah Bahadir Öz
- Department of Surgery, The School of Medicine, Erciyes University, Kayseri, Turkey
| | - Cumhur Arici
- Department of Surgery, The School of Medicine, Akdeniz University, Antalya, Turkey
| | - Osman Toktas
- Department of Surgery, The School of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | | | - Adnan Çalık
- Department of Surgery, The School of Medicine, Karadeniz Teknik University, Trabzon, Turkey
| | - Ayfer Kamali Polat
- Department of Surgery, The School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Gokturk Maralcan
- Department of Surgery, The School of Medicine, Sanko University, Gaziantep, Turkey
| | - Seher Demirer
- Department of Surgery, The School of Medicine, Ankara University, Ankara, Turkey
| | - Vahit Ozmen
- Department of Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
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Sanchez JA, Portillo S, Zarka MA, Snedden D, Pyle D, Goodman H, Hayes DF. Improving Oncology-Pathology Collaboration in Resource-Limited Settings: An American Society of Clinical Oncology/College of American Pathologists Initiative. Am Soc Clin Oncol Educ Book 2021; 41:199-220. [PMID: 34010051 DOI: 10.1200/edbk_320037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Accurate pathologic evaluation is essential for proper diagnosis and treatment of patients with cancer. ASCO and the College of American Pathologists have successfully collaborated over the last 15 years to improve collaboration between clinical oncologists and pathologists and to standardize pathologic assay techniques. Cancer is an increasingly recognized societal burden in low- and middle-income countries. In 2015, ASCO and the College of American Pathologists implemented an initiative to identify countries that could benefit from peer insights by jointly convening an international workshop among members of both organizations and pathologists and clinical oncologists from Haiti, Honduras, Vietnam, and Uganda. Honduras was chosen as a pilot site, and representatives of ASCO, the College of American Pathologists, and the Honduras pathology and clinical oncology communities have identified areas in which collaboration might be productive. Multiple barriers, including high poverty levels, poor cancer awareness educational programs, lack of human resources, and delayed diagnosis and treatment, have resulted in a higher cancer mortality rate in Honduras compared with high/moderate-income countries and are shared by other low-income countries. ASCO and the College of American Pathologists member faculty supported a symposium led by Honduras colleagues for interested Honduran pathologists and oncologists. The Honduran communities are now working to establish national resource-appropriate guidelines for both pathology and clinical oncology. Taken together, these efforts indicate that barriers to meet the needs of the clinical oncologists in a low-income country such as Honduras are challenging but not insurmountable.
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Affiliation(s)
| | - Silvia Portillo
- National Institute for Cardio Pulmonary Diseases, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Matthew A Zarka
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ
| | | | - Doug Pyle
- American Society of Clinical Oncology, Alexandria, VA
| | - Harris Goodman
- Alameda Health System, College of American Pathologists, Oakland, CA
| | - Daniel F Hayes
- University of Michigan Rogel Cancer Center, Ann Arbor MI
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13
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Barros ÂF, Murta-Nascimento C, Abdon CHD, Nogueira DN, Lopes ELC, Dias A. Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer. CAD SAUDE PUBLICA 2020; 36:e00011919. [PMID: 32022172 DOI: 10.1590/0102-311x00011919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/25/2019] [Indexed: 01/07/2023] Open
Abstract
Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether > 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the > 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.
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Affiliation(s)
- Ângela Ferreira Barros
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil.,Escola Superior de Ciências da Saúde, Brasília, Brasil
| | - Cristiane Murta-Nascimento
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil
| | | | | | | | - Adriano Dias
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil
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14
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System Delay in Breast Cancer Diagnosis in Gaza Strip, Palestine. JOURNAL OF ONCOLOGY 2019; 2019:5690938. [PMID: 31885578 PMCID: PMC6927013 DOI: 10.1155/2019/5690938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/05/2019] [Accepted: 07/22/2019] [Indexed: 01/18/2023]
Abstract
Background Breast cancer is a major public health problem and the first leading cause of cancer deaths among females in Palestine. Early diagnosis of breast cancer contributes to reduction of morbidity and mortality rates. This study aimed to explore system-related factors affecting the timely diagnosis of breast cancer in the Gaza Strip. Method and Materials A mixed method, sequential explanatory design was employed. A quantitative study was conducted first, and it was cross-sectional in nature, followed by a qualitative study. An interviewed questionnaire and an abstraction sheet were used to collect necessary quantitative data among 122 females diagnosed with breast cancer. A purposive sample of five medical specialists were selected for in-depth interview. Descriptive and inferential analyses were used to find differences between variables. Odds ratio and confidence interval at 95% were presented, and P < 0.05 was considered statistically significant. Results Around 12.3% of women experienced diagnostic delay for 3 months and more, and 6.6% reported a delay in referral for more than 2 weeks. Regarding imaging delay, around 8.2% and 2.7% of women had reported a delay in performing mammography and ultrasound, respectively. Moreover, one-fourth reported delay in performing biopsy for more than 14 days, and 46.3% reported delay more than 14 days in getting histopathology report. In addition, 9% missed the follow-up after benign findings of the previous breast imaging and no national protocols are available for the diagnosis of breast cancer in the Gaza strip. Conclusion There is a long appointment time for diagnostic tools especially in biopsy. The nonmalignant findings from mammography or ultrasound could affect diagnosis time. It is an urgent need to have a national protocol for diagnosis and management of breast cancer and to adopt screening, diagnostic, and follow-up programs under the supervision of the Ministry of Health.
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15
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Özmen V, Özmen T, Doğru V. Breast Cancer in Turkey; An Analysis of 20.000 Patients with Breast Cancer. Eur J Breast Health 2019; 15:141-146. [PMID: 31312788 DOI: 10.5152/ejbh.2019.4890] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/08/2019] [Indexed: 01/22/2023]
Abstract
Objective Breast cancer is the most common type of cancer and the leading cause of cancer-related deaths in women in Turkey. This study presents the characteristics of patients registered in National Breast Cancer Registry Program of Turkish Federation of Breast Diseases Societies. Materials and Methods The registry contains 242 variables under 10 categories and 699 questions. Patients were recorded (online and offline) from nationwide breast centers around Turkey. Results Twenty-thousand patients were registered between May 2005 and April 2017 at 36 centers. After data cleaning, 19,503 women were included in the study. The median age at diagnosis was 51 [14-97]; 17.2% were younger than 40 and 37.2% were premenopausal; 13.6% were nulliparous. Breast conserving surgery rate was 39.3%. Histopathology was invasive ductal cancer in 77%. Majority of patients had stage II cancer (48.3%). Estrogen, progesterone and HER-2 receptor positivity rates in invasive breast cancer were 72.5%, 62.5% and 21.8%, respectively. The mean tumor diameter was 2.5±1.7 cm. During the mean 51.6 months of follow-up, the local/regional and systemic recurrence rates were 3.7% and 5.2%, respectively; five and 10-year overall survival rates were 86% and 76%. Conclusion Despite increasing number of screening centers and free-of-charge mammography (ages 40 to 69) and mobile screening systems in recent years, a significant portion of patients were diagnosed at advanced stage due to lack of breast cancer awareness. In contrast with the study published 5 years ago, there was a decrease in the rate of pre-menopausal women and an increase in the breast conserving surgery.
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Affiliation(s)
- Vahit Özmen
- Department of Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Tolga Özmen
- Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Florida, USA
| | - Volkan Doğru
- Department of Surgery, Akdeniz University School of Medicine, Antalya, Turkey
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16
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Sánchez JA, Handal MG, Vílchez Rodriguez JF, Mejía SI, Pagoaga AP. Time Intervals From Onset of Clinical Manifestations to Treatment in Patients With Cancer at Hospital General San Felipe, Tegucigalpa, Honduras. J Glob Oncol 2019; 5:1-7. [PMID: 31162986 PMCID: PMC6613713 DOI: 10.1200/jgo.19.00107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE In cancer, clinical staging is related to outcomes, and this is linked to the evolution of the disease over time. In Honduras, cancer mortality is high, and time intervals from onset of symptoms to treatment of cancer are not known. We conducted a cross-sectional study to determine these intervals. PATIENTS AND METHODS This investigation was carried out from April 25 to August 30, 2018, and included 202 patients at the main cancer referral center in Honduras. For the purposes of the study, information was obtained from patients, their caregiver, medical records, or treatment cards. Patients older than age 18 years were included after informed consent was signed. RESULTS The mean time interval from onset of symptoms to cancer treatment was 232 days. Different intervals of time were identified, and the mean of these intervals was calculated in days as follows: 68 days from onset of symptoms to first medical evaluation; 146 days from first evaluation to oncologist consultation; 26 days from cancer specialist to the pathology report; and 86 days from the histopathologic diagnosis to the beginning of treatment. Once diagnosis was established, the average elapsed times to chemotherapy, radiotherapy, surgery, and chemoradiotherapy were 88, 102, 76, and 154 days, respectively (P < .05, when surgery is compared against chemotherapy and radiotherapy). CONCLUSION The mean time interval from symptom presentation to treatment in patients with cancer is more than 7 months. This could explain the advanced stages of disease seen at the time of treatment in Honduras, which decrease chance of cure and increase the mortality rate of cancer). Appropriate intervention to decrease these intervals must be taken to reduce mortality.
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Affiliation(s)
- José A Sánchez
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Mayra G Handal
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | | | - Sinthia I Mejía
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Annye P Pagoaga
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
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17
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Fouladi N, Pourfarzi F, Daneshian A, Alimohammadi S. Mediating Factors in Early Diagnosis of Breast Cancer: from Initial Changes in Health to Breast Cancer Detection. Asian Pac J Cancer Prev 2018; 19:2751-2755. [PMID: 30360602 PMCID: PMC6291050 DOI: 10.22034/apjcp.2018.19.10.2751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Breast cancer is one of the most frequently occurring cancers in women throughout the world. In Iran, according to available reports, 70% of patients with breast cancer are detected at the advanced stages of the disease. Materials and Methods: This study is of descriptive-analytic cross-sectional type.160 female patients was selected. The data in this study was collected via face to face interview using a questionnaire based on the Anderson’s delay model. Data were analyzed using SPSS 22 and the significance level was considered to be 0.05. Results: The results showed that presence of mass was the first symptom in many of women, i.e., 76 cases (47.5%). not only the presence of mass in the breast, but also any other symptom, hadn’t been taken as a serious problem initially by women. Non-improvement of the symptoms and exacerbation of the symptoms was considered as a symptom of illness by patients. After considering the changes as the symptoms of illness, patients had tried to treat the disease through different methods of self-treatment. The failure of the self-treatment in controlling the symptoms, had directed the patients toward seeking for medical services. Out of 160 patients, 49 patients (39.6%) changed the time of their appointment with doctor. 110 cases (68%) out of 160 patients, rather than initiating relevant diagnostic procedure related to the disease, had received non-specific and non-related therapeutic measures. Conclusion: Pondering on the results yields that patient-related delays, resulting from their lack of awareness of the disease, cultural factors, and fear, can only play an important role in postponement of visiting a physician, but in the diagnosis of disease it is the inability of general practitioners in performing differential diagnoses, and making request for related diagnostic measures which can significantly increase the lag time until the onset of the main treatment.
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Affiliation(s)
- Nasrin Fouladi
- Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.,Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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18
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Ustbas B, Kilic D, Bozkurt A, Aribal ME, Akbulut O. Silicone-based composite materials simulate breast tissue to be used as ultrasonography training phantoms. ULTRASONICS 2018. [PMID: 29525227 DOI: 10.1016/j.ultras.2018.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A silicone-based composite breast phantom is fabricated to be used as an education model in ultrasonography training. A matrix of silicone formulations is tracked to mimic the ultrasonography and tactile response of human breast tissue. The performance of two different additives: (i) silicone oil and (ii) vinyl-terminated poly (dimethylsiloxane) (PDMS) are monitored by a home-made acoustic setup. Through the use of 75 wt% vinyl-terminated PDMS in two-component silicone elastomer mixture, a sound velocity of 1.29 ± 0.09 × 103 m/s and an attenuation coefficient of 12.99 ± 0.08 dB/cm-values those match closely to the human breast tissue-are measured with 5 MHz probe. This model can also be used for needle biopsy as well as for self-exam trainings. Herein, we highlight the fabrication of a realistic, durable, accessible, and cost-effective training platform that contains skin layer, inner breast tissue, and tumor masses.
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Affiliation(s)
- Burcin Ustbas
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Deniz Kilic
- Surgitate Medikal Arge Sanayi ve Ticaret A.Ş., Kocaeli, Turkey
| | - Ayhan Bozkurt
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Mustafa Erkin Aribal
- Marmara University Pendik Research and Application Hospital, Radiology Department, Istanbul, Turkey
| | - Ozge Akbulut
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey.
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19
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Unger-Saldaña K, Ventosa-Santaulària D, Miranda A, Verduzco-Bustos G. Barriers and Explanatory Mechanisms of Delays in the Patient and Diagnosis Intervals of Care for Breast Cancer in Mexico. Oncologist 2018; 23:440-453. [PMID: 29284758 PMCID: PMC5896704 DOI: 10.1634/theoncologist.2017-0431] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/02/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Most breast cancer patients in low- and middle-income settings are diagnosed at advanced stages due to lengthy intervals of care. This study aimed to understand the mechanisms through which delays occur in the patient interval and diagnosis interval of care. MATERIALS AND METHODS We conducted a cross-sectional survey including 886 patients referred to four major public cancer hospitals in Mexico City. Based in a conceptual model of help-seeking behavior, a path analysis strategy was used to identify the relationships between explanatory factors of patient delay and diagnosis delay. RESULTS The patient and the diagnosis intervals were greater than 3 months in 20% and 65% of participants, respectively. We present explanatory models for each interval and the interrelationship between the associated factors. The patient interval was longer among women who were single, interpreted their symptoms as not worrisome, concealed symptoms, and perceived a lack of financial resources and the difficulty of missing a day of work as barriers to seek care. These barriers were more commonly perceived among patients who were younger, had lower socioeconomic status, and lived outside of Mexico City. The diagnosis interval was longer among those who used several different health services prior to the cancer hospital and perceived medical errors in these services. More health services were used among those who perceived errors and long waiting times for appointments, and who first consulted private services. CONCLUSION Our findings support the relevance of strengthening early cancer diagnosis strategies, especially the improvement of quality of primary care and expedited referral routes to cancer services. IMPLICATIONS FOR PRACTICE This study's findings suggest that policy in low- and middle-income countries (LMICs) should be directed toward reducing delays in diagnosis, before the implementation of mammography screening programs. The results suggest several factors susceptible to early diagnosis interventions. To reduce patient delays, the usually proposed intervention of awareness promotion could better work in LMIC contexts if the message goes beyond the advertising of screening mammography to encourage the recognition of potential cancer symptoms and sharing of symptoms with significant others. To reduce diagnosis delay, efforts should focus on strengthening the quality of public primary care services and improving referral routes to cancer care centers.
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Affiliation(s)
- Karla Unger-Saldaña
- National Council of Science and Technology (CONACYT) - Mexican National Cancer Institute, Epidemiology Unit, Mexico City, Mexico
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20
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Özmen V. A Patient Advocacy Group Summit, Cancer Care in Turkey and The Society of Breast Health. Eur J Breast Health 2018; 14:1-4. [PMID: 29322111 DOI: 10.5152/ejbh.2017.1213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Vahit Özmen
- Department of Surgery, Istanbul University, Istanbul School of Medicine, İstanbul, Turkey
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21
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Yılmaz TU, Trabzonlu L, Güler SA, Baran MA, Pösteki G, Erçin C, Utkan Z. Characteristics of Special Type Breast Tumors in Our Center. Eur J Breast Health 2018; 14:17-22. [PMID: 29322114 DOI: 10.5152/ejbh.2017.3219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 07/06/2017] [Indexed: 01/06/2023]
Abstract
Objective Breast cancer is a heterogeneous disease with different histological types. Ductal breast cancer constitutes the vast majority of the breast cancers. However limited data are present in the rest of breast cancers called special or rare type breast cancers. Here in this study, we tried to describe the clinical features of special type breast cancers in our center. Materials and Methods Retrospective descriptive study was performed in Kocaeli University School of Medicine, Department of General Surgery between January 2000 and January 2016. Women diagnosed with primary breast cancer other than ductal carcinoma were included to the study. In total, 101 patients were evaluated according to histologic types, molecular types, Tumor Node Metastasis (TNM) stages, and grades. Survival of the patients was also evaluated. Results Medullary and metaplastic types showed basal type; tubular, mucinous, micropapillary carcinoma, cribriform, lobular and apocrine tumors showed luminal type molecular pattern. Neither the existence of ductal carcinoma nor any histologic types had any effects on survival. Apocrine tumors were presented in younger ages. Conclusion Histologic types of breast cancer are closely related with the molecular types of the breast cancer. Tumor size, grade, stage of the disease can show differences among histological types which might be due to the genetic background, late onset or limited number of patients. In order to achieve more significant results, multicenter national studies are needed.
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Affiliation(s)
- Tonguç Utku Yılmaz
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Levent Trabzonlu
- Department of Pathology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Sertaç Ata Güler
- Department of Pathology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Mehmet Ali Baran
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Gökhan Pösteki
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Cengiz Erçin
- Department of Pathology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Zafer Utkan
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
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22
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Stamatovic L, Vasovic S, Trifunovic J, Boskov N, Gajic Z, Parezanovic A, Icevic M, Cirkovic A, Milic N. Factors influencing time to seeking medical advice and onset of treatment in women who are diagnosed with breast cancer in Serbia. Psychooncology 2017; 27:576-582. [PMID: 28857314 DOI: 10.1002/pon.4551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 08/21/2017] [Accepted: 08/24/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Streamlining the diagnosis is a key factor in improving the treatment outcomes for breast cancer. The aim of this study was to determine factors influencing time to seeking medical advice and treatment onset in women who are diagnosed with breast cancer in Serbia. METHODS The study was a multicenter, cross-sectional national survey, performed at 10 oncology centers in Serbia. Time intervals spent throughout the complex diagnostic pathway were evaluated using a validated questionnaire administered to women with breast cancer (n = 800). Total interval (TI) was determined using predefined time scales, including one referring to patient interval (PI), and several related to health care system interval (SI). RESULTS Mean PI, SI, and TI were 4.5, 9.2, and 12.9 weeks, respectively; 20% of patients had a PI>12 weeks. Based on the multivariate regression model, longer PI was associated with perceived lack of time and personal disregard or trivialization of detected symptoms and signs. Women who were supported by family members or friends and had at least a secondary level education tended to have a shorter PI. Longer PI was correlated with a longer SI, while regular self-examination, having been diagnosed by an oncologist, and living in a major city were associated with shorter SI. CONCLUSIONS Several factors, related to psychological, demographic, behavioral, and health system characteristics, determined both the time to seeking medical advice and treatment onset for breast cancer. These findings support review and refining of national strategies and policies to promote early detection, diagnosis, and treatment of breast cancer.
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Affiliation(s)
- L Stamatovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - S Vasovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - J Trifunovic
- Oncology Institute of Vojvodina, Novi Sad, Serbia
| | - N Boskov
- General Hospital Zrenjanin, Zrenjanin, Serbia
| | - Z Gajic
- General Hospital Kruševac, Kruševac, Serbia
| | | | | | - A Cirkovic
- Institute for Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia
| | - N Milic
- Institute for Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia.,Department for Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Özmen V, Gürdal SÖ, Cabioğlu N, Özcinar B, Özaydın AN, Kayhan A, Arıbal E, Sahin C, Saip P, Alagöz O. Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project. Eur J Breast Health 2017; 13:117-122. [PMID: 28894850 DOI: 10.5152/ejbh.2017.3528] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 05/28/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We used the results from the first three screening rounds of Bahcesehir Mammography Screening Project (BMSP), a 10-year (2009-2019) and the first organized population-based screening program implemented in a county of Istanbul, Turkey, to assess the potential cost-effectiveness of a population-based mammography screening program in Turkey. MATERIALS AND METHODS Two screening strategies were compared: BMSP (includes three biennial screens for women between 40-69) and Turkish National Breast Cancer Registry Program (TNBCRP) which includes no organized population-based screening. Costs were estimated using direct data from the BMSP project and the reimbursement rates of Turkish Social Security Administration. The life-years saved by BMSP were estimated using the stage distribution observed with BMSP and TNBCRP. RESULTS A total of 67 women (out of 7234 screened women) were diagnosed with breast cancer in BMSP. The stage distribution for AJCC stages O, I, II, III, IV was 19.4%, 50.8%, 20.9%, 7.5%, 1.5% and 4.9%, 26.6%, 44.9%, 20.8%, 2.8% with BMSP and TNBCRP, respectively. The BMSP program is expected to save 279.46 life years over TNBCRP with an additional cost of $677.171, which implies an incremental cost-effectiveness ratio (ICER) of $2.423 per saved life year. Since the ICER is smaller than the Gross Demostic Product (GDP) per capita in Turkey ($10.515 in 2014), BMSP program is highly cost-effective and remains cost-effective in the sensitivity analysis. CONCLUSION Mammography screening may change the stage distribution of breast cancer in Turkey. Furthermore, an organized population-based screening program may be cost-effective in Turkey and in other developing countries. More research is needed to better estimate life-years saved with screening and further validate the findings of our study.
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Affiliation(s)
- Vahit Özmen
- Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Sibel Ö Gürdal
- Departments of Surgery, Namık Kemal University School of Medicine, Tekirdağ, Turkey
| | - Neslihan Cabioğlu
- Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Beyza Özcinar
- Department of Surgery, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - A Nilüfer Özaydın
- Department of Public Health, Marmara University School of Medicine, İstanbul, Turkey
| | - Arda Kayhan
- Departments of Radiology, University Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
| | - Erkin Arıbal
- Department of Radiology, Marmara University School of Medicine, İstanbul, Turkey
| | - Cennet Sahin
- Department of Radiology, University Health Sciences, İstanbul Şisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Pınar Saip
- Department of Medical Oncology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Oğuzhan Alagöz
- Department of Industrial & Systems Engineering and Population Health Sciences, UW Carbone Cancer Center, University of Wisconsin Hospital and Clinics, Madison, WI, USA
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Setyowibowo H, Sijbrandij M, Iskandarsyah A, Hunfeld JAM, Sadarjoen SS, Badudu DF, Suardi DR, Passchier J. A protocol for a cluster-randomized controlled trial of a self-help psycho-education programme to reduce diagnosis delay in women with breast cancer symptoms in Indonesia. BMC Cancer 2017; 17:284. [PMID: 28427373 PMCID: PMC5399390 DOI: 10.1186/s12885-017-3268-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/05/2017] [Indexed: 11/30/2022] Open
Abstract
Background Breast cancer (BC) is the most frequent cancer occurring in women across the world. Its mortality rate in low-middle income countries (LMICs) is higher than in high-income countries (HICs), and in Indonesia BC is the leading cause of cancer deaths among women. Delay in breast cancer diagnosis negatively impacts cancer prognosis. Only about 30% of patients who come to the hospital to check on their breast abnormalities, continue thorough examination to biopsy to get a diagnosis based on the results of anatomical pathology. Many Indonesian women with breast cancer were already in an advanced stage when starting treatment. Therefore, delay in diagnosis is a serious problem that needs to be addressed. The present study will investigate whether our newly developed self-help psycho-educational programme, “PERANTARA”, for women with breast cancer symptoms is effective to reduce patient diagnosis delay in Indonesia. Methods A cluster-randomized controlled trial will be conducted in 106 patients in four hospitals in Bandung, West Java, Indonesia. Data will be collected at baseline (pre-assessment), 7 days after the intervention (post-assessment), and at 3 months (follow-up assessments). The primary outcome is delay in diagnosis and treatment. Secondary outcomes are breast cancer knowledge, anxiety and depression, and quality of life. Exploratively, adherence with treatment will be measured too. Data will be analysed by hierarchical linear modelling (HLM) to assess differential change over time. Discussion If proven effective, PERANTARA will be evaluated and implemented in a diversity of settings for local cares (such as in POSYANDU, PUSKESMAS) that provide health education/psycho-education for women with breast symptoms. Trial registration ISRCTN12570738. Date: November 19th, 2016. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3268-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hari Setyowibowo
- Department of Educational Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia. .,Clinical, Neuro-and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, the Netherlands.
| | - Marit Sijbrandij
- Clinical, Neuro-and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, the Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | - Joke A M Hunfeld
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sawitri S Sadarjoen
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Drajat R Suardi
- Department of Surgical Oncology, Hasan Sadikin Hospital, Bandung, Indonesia
| | - Jan Passchier
- Clinical, Neuro-and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, the Netherlands
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Koçan S, Gürsoy A. Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research. THE JOURNAL OF BREAST HEALTH 2016; 12:145-150. [PMID: 28331752 DOI: 10.5152/tjbh.2016.2913] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/09/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To gain a holistic and deep understanding about how mastectomy effects the body image of women who have breast cancer. MATERIALS AND METHODS The sample of this qualitative descriptive study consisted of twenty patients who underwent mastectomy procedures. Semi-structured interviews were conducted during the second week after mastectomy. Each interview was transcribed verbatim, and a thematic analysis was performed. RESULTS After the mastectomy, the findings related to the women's body image and their experiences were specified as four main themes and seven sub-themes. The main themes were: meaning of the breast, mastectomy and me, my body image and body image changes, and social life. Most of the participants in this study stated that the breast meant femininity, beauty, and motherhood. It was found that the meaning of mastectomy varied according to individuals. Women used quite negative statements about their appearances. The participants also said that they felt that half themselves was missing, as individuals and women. The women stated that they preferred clothes that hid their lack of breast. Some of the participants mentioned that relations with their husbands were not like before, and they abstained from social interaction. CONCLUSION Our findings suggest that mastectomy as a surgical treatment for breast cancer may negatively affect a woman's body image and her self-image.
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Affiliation(s)
- Sema Koçan
- Vocational School of Health Services, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ayla Gürsoy
- Karadeniz Technical University, School of Health Sciences, Trabzon, Turkey
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Maghous A, Rais F, Ahid S, Benhmidou N, Bellahamou K, Loughlimi H, Marnouche E, Elmajjaoui S, Elkacemi H, Kebdani T, Benjaafar N. Factors influencing diagnosis delay of advanced breast cancer in Moroccan women. BMC Cancer 2016. [PMID: 27268201 DOI: 10.1186/s12885-016-2394-y.pmid:27268201freepmc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. METHODS A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. RESULTS In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p < 0.001). Also, a significantly higher risk of more than 6 months delay was found among rural women (P = 0.035) and women who live far away from specialized care center (P = 0.001). CONCLUSIONS Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.
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Affiliation(s)
- A Maghous
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco.
| | - F Rais
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - S Ahid
- Laboratory of epidemiology and clinical research, School of medicine and pharmacy of Rabat, Mohammed V University in Rabat, Rabat, Morocco
| | - N Benhmidou
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - K Bellahamou
- Department of Medical Oncology, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - H Loughlimi
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - E Marnouche
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - S Elmajjaoui
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - H Elkacemi
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - T Kebdani
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - N Benjaafar
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
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Maghous A, Rais F, Ahid S, Benhmidou N, Bellahamou K, Loughlimi H, Marnouche E, Elmajjaoui S, Elkacemi H, Kebdani T, Benjaafar N. Factors influencing diagnosis delay of advanced breast cancer in Moroccan women. BMC Cancer 2016; 16:356. [PMID: 27268201 PMCID: PMC4897875 DOI: 10.1186/s12885-016-2394-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 06/02/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Delay in the diagnosis of breast cancer in symptomatic women of 3 months or more is associated with advanced stage and low survival. We conducted this study to learn more about the extent and reasons behind diagnosis delay of advanced breast cancer in Moroccan women. METHODS A group of patients with advanced breast cancer were interviewed at the National Institute of Oncology in Rabat during the period from February to December 2014. Diagnosis delay was devised into patient delay and system delay. Patient delay was defined as time from first symptoms until first medical consultation. System delay was defined as time from first presentation to a health care provider until definite diagnosis or treatment. Prospective information and clinical data were collected on a form during an interview with each patient and from medical records. RESULTS In all, 137 patients were interviewed. The mean age of women was 48.3 ± 10.4 years. The median of consultation time was 6[4,12] months and the median of diagnosis time was 1[1,3] months. Diagnosis delay was associated to a personal reason in 96 (70.1 %) patients and to a medical reason in 19 (13.9 %) patients. A number of factors predicted diagnosis delay: symptoms were not considered serious in 66 (55.9 %) patients; traditional therapy was applied in 15 (12.7 %) patients and fear of cancer diagnosis and/or treatment in 14 (11.9 %) patients. A use of traditional methods was significantly associated with rural residence and far away from basic health center (p = 0.000). Paradoxically, a family history of breast cancer was significantly higher in who report a fear of cancer diagnosis and/or treatment to diagnosis delay (p < 0.001). Also, a significantly higher risk of more than 6 months delay was found among rural women (P = 0.035) and women who live far away from specialized care center (P = 0.001). CONCLUSIONS Diagnosis delay is very serious problem in Morocco. Diagnosis delay was associated with complex interactions between several factors and with advanced stages. There is a need for improving breast cancer information in our populations and training of general practitioners to reduce advanced breast cancer by promoting early detection.
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Affiliation(s)
- A Maghous
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco.
| | - F Rais
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - S Ahid
- Laboratory of epidemiology and clinical research, School of medicine and pharmacy of Rabat, Mohammed V University in Rabat, Rabat, Morocco
| | - N Benhmidou
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - K Bellahamou
- Department of Medical Oncology, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - H Loughlimi
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - E Marnouche
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - S Elmajjaoui
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - H Elkacemi
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - T Kebdani
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
| | - N Benjaafar
- Department of radiotherapy, National Institute of Oncology, Mohammed V University in Rabat, Rabat, Morocco
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Özmen V, Dağoğlu N, Dede İ, Akçakaya A, Kerem M, Göksel F, Özgür E, Başkan E, Yaylacı M, Ceydeli A, Baykara M, Kızıltan HŞ, Kömürcü Ş, Gümüş M, Türk HM, Demirhan R, Akgün A, Kadoglou N, Yatman E, Elbi CC, Güleç S, Soran A, Özet A, Keleştimur F. Turkish Ministry of Health, 2 nd Turkish Medical General Assembly Clinical Oncology Study Group Report. THE JOURNAL OF BREAST HEALTH 2016; 12:9-17. [PMID: 28331725 DOI: 10.5152/tjbh.2015.2869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 12/08/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE There is an increase in the incidence of cancer, and consequently in mortality rates, both in the world and in Turkey. The increase in the incidence and mortality rate of cancer are more prominent in our country as well as in other developing countries. The aim of this workshop was to determine the current status on prevention, screening, early diagnosis and treatment of cancer in our country, to identify related shortcomings, specify solutions and to share these with health system operators, and to aid in implementation of these systems. Developments on palliative care were also evaluated. MATERIALS AND METHODS The current situation in the practice of clinical oncology, related drawbacks, problems encountered during multidisciplinary approach and their solutions were discussed under several sub-headings during a 3-day meeting organized by the Turkish Ministry of Health (Türkiye Cumhuriyeti Sağlık Bakanlığı-TCSB) with participation of 16 scientists from Turkey and 6 from abroad, and the conclusions were reported. RESULTS It is expected that the newly established Turkish Health Institutes Association (Türkiye Sağlık Enstitüleri Başkanlığı-TÜSEB) and the National Cancer Institute (Ulusal Kanser Enstitüsü) will provide a new framework in the field of oncology. The current positive findings include the increase in the number of scientists who carry out successful trials in oncology both in Turkey and abroad, the implementation of the national cancer registry program by the Cancer Control Department and the breast cancer registry program by the Turkish Federation of Breast Diseases Societies (Türkiye Meme Hastalıkları Dernekleri Federasyonu-TMHDF), and introduction of Cancer Early Diagnosis, Screening, and Training Centers (Kanser Erken Tanı, Tarama ve Eğitim Merkezi-KETEM) for the application of community-based cancer screening programs. In addition to these, obvious shortcomings related to education, implementation, management and research issues were also determined, and policy and project proposals to address these issues were presented. Collaboration with relevant organizations in the implementation of these studies was supported. CONCLUSION Both the incidence and mortality rates of cancer are increasing in Turkey. The widespread deficiencies in population-based screening and in effective treatment lead to an increase in delay in diagnosis and mortality. Despite improvements in data recording, screening and treatment over the last 10 years, extensive, organized, population-based screening programs and fully equipped early diagnosis and treatment centers are required. Enhancement of basic cancer epidemiologic, translational, genetic and molecular research studies is essential in our country. Improvements on pain treatment and palliative care of patients with chronic and terminal cancer are also required.
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Affiliation(s)
- Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Nergiz Dağoğlu
- Department of Radiation Oncology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - İsmet Dede
- Cancer Surgeon General Office, İstanbul, Turkey
| | - Adem Akçakaya
- Department of General Surgery, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Mustafa Kerem
- Department of General Surgery, Gazi University Faculty of Medicine, İstanbul, Turkey
| | - Fatih Göksel
- Clinic of General Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Enver Özgür
- Department of Urology, Köln University Faculty of Medicine, Köln, Germany
| | - Emel Başkan
- Turkey Public Hospitals Institution, Ankara, Turkey
| | - Mustafa Yaylacı
- Clinic of Medical Oncology, İstanbul Bayındır Hospital, İstanbul, Turkey
| | | | - Meltem Baykara
- Clinic of Medical Oncology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Huriye Şenay Kızıltan
- Department of Radiation Oncology, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Şeref Kömürcü
- Clinic of Medical Oncology, Memorial Hospital, İstanbul, Turkey
| | - Mahmut Gümüş
- Department of Medical Oncology, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - H Mehmet Türk
- Department of Medical Oncology, Bezmialem University Faculty of Medicine, İstanbul, Turkey
| | - Recep Demirhan
- Clinic of Thoracic Surgery, Kartal Dr. Lütfü Kırdar Training and Research Hospital, İstanbul, Turkey
| | | | - Naim Kadoglou
- Department of General Surgery, National Health System-Konsultan, Pittsburgh, USA
| | - Emre Yatman
- Turkey Public Hospitals Institution, Ankara, Turkey
| | | | - Seza Güleç
- Department of General Surgery, Florida International University, Florida, USA
| | - Atilla Soran
- Department of General Surgery, Pittsburgh University Faculty of Medicine, Pittsburgh, USA
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Freitas AGQ, Weller M. Patient delays and system delays in breast cancer treatment in developed and developing countries. CIENCIA & SAUDE COLETIVA 2015; 20:3177-89. [DOI: 10.1590/1413-812320152010.19692014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 01/31/2015] [Indexed: 01/12/2023] Open
Abstract
AbstractDelays in treating breast cancer have been associated with a more advanced stage of the disease and a decrease in patient survival rates. The scope of this integrative review was to analyze the main causal factors and types of patient and system delays. The underlying causal factors of delays were compared among studies conducted in developing and developed countries. Of the 53 studies selected, 24 were carried out in developing countries and 29 in developed countries, respectively. Non-attribution of symptoms to cancer, fear of the disease and treatment and low educational level were the most frequent causes of patient delay. Less comprehensive health insurance coverage, older/younger age and false negative diagnosis tests were the three most common causal factors of system delay. The effects of factors such as age were not decisive per se and depended mainly on the social and cultural context. Some factors caused both patient delay and system delay. Studies conducted in developing countries identified more causal factors of patient delay and had a stronger focus on patient delay or the combination of both. Studies conducted in developed countries had a stronger focus on aspects of system delay during treatment and guidance of breast cancer patients in the health care system.
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Tolunay O, Celik U, Karaman SS, Celik T, Resitoglu S, Donmezer C, Aydin F, Baspinar H, Mert MK, Samsa H, Arli S. Awareness and Attitude Relating to the Human Papilloma Virus and its Vaccines Among Pediatrics, Obstetrics and Gynecology Specialists in Turkey. Asian Pac J Cancer Prev 2015; 15:10723-8. [DOI: 10.7314/apjcp.2014.15.24.10723] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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31
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Özmen V. Controversies on Mammography Screening in the World and Bahceşehir Population-Based Organized Mammography Screening Project in Turkey. THE JOURNAL OF BREAST HEALTH 2015; 11:152-154. [PMID: 28331713 DOI: 10.5152/tjbh.2015.0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Vahit Özmen
- Department of General Surgery, İstanbul University İstanbul Medical Faculty, İstanbul, Turkey
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