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Padilla-Ruiz M, Zarcos-Pedrinaci I, Rivas-Ruiz F, Téllez T, García-Gutiérrez S, González N, Rivero A, Sarasqueta C, Serrano-Aguilar P, Castells X, Quintana JM, Sala M, Redondo M, Castells X, Comas M, Domingo L, Macià F, Roman M, Romero A, Sala M, Barata T, de la Lastra ID, de la Vega M, Bare M, Torà N, Ferrer J, Castanyer F, Carmona C, García S, Martín M, González N, Orive M, Valverde MA, Saez A, Barredo I, de Toro M, Ferreiro J, Quintana JM, Pérez J, Rivero A, Valcárcel C, Padilla M, Redondo M, Téllez T, Zarcos I, Churruca C, Perales A, Recio J, Ruiz I, Sarasqueta C, Urraca JM, Michelena MJ, Moreno J, Mallabiabarrena G, Cobos P, Otero B, Gorostiaga J, Troya I. Factors that Influence Treatment Delay for Patients with Breast Cancer. Ann Surg Oncol 2020; 28:3714-3721. [PMID: 33247362 DOI: 10.1245/s10434-020-09409-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/03/2020] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The diagnosis or treatment of breast cancer is sometimes delayed. A lengthy delay may have a negative psychological impact on patients. The aim of our study was to evaluate the sociodemographic, clinical and pathological factors associated with delay in the provision of surgical treatment for localised breast cancer, in a prospective cohort of patients. METHODS This observational, prospective, multicentre study was conducted in ten hospitals belonging to the Spanish national public health system, located in four Autonomous Communities (regions). The study included 1236 patients, diagnosed through a screening programme or found to be symptomatic, between April 2013 and May 2015. The study variables analysed included each patient's personal history, care situation, tumour history and data on the surgical intervention, pathological anatomy, hospital admission and follow-up. Treatment delay was defined as more than 30 days elapsed between biopsy and surgery. RESULTS Over half of the study population experienced surgical treatment delay. This delay was greater for patients with no formal education and among widows, persons not requiring assistance for usual activities, those experiencing anxiety or depression, those who had a high BMI or an above-average number of comorbidities, those who were symptomatic, who did not receive NMR spectroscopy, who presented a histology other than infiltrating ductal carcinoma or who had poorly differentiated carcinomas. CONCLUSIONS Certain sociodemographic and clinical variables are associated with surgical treatment delay. This study identifies factors that influence surgical delays, highlighting the importance of preventing these factors and of raising awareness among the population at risk and among health personnel.
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Affiliation(s)
- María Padilla-Ruiz
- Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Irene Zarcos-Pedrinaci
- Oncology Service, Hospital Costa del Sol, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Francisco Rivas-Ruiz
- Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Teresa Téllez
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Susana García-Gutiérrez
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Research Unit, Galdakao-Usansolo Hospital Osakidetza, Galdakao, Bizkaia, Spain
| | - Nerea González
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Research Unit, Galdakao-Usansolo Hospital Osakidetza, Galdakao, Bizkaia, Spain
| | - Amado Rivero
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Canary Islands Foundation for Health Care Research (FUNCANIS), Tenerife, Spain
| | - Cristina Sarasqueta
- Unidad de Investigación, Instituto de Investigación Sanitaria BioDonostia, Hospital Universitario Donostia - REDISSEC, Donostia, Gipuzkoa, Spain
| | - Pedro Serrano-Aguilar
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
| | - Xavier Castells
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Autonomous University of Barcelona, Barcelona, Spain
| | - José María Quintana
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Research Unit, Galdakao-Usansolo Hospital Osakidetza, Galdakao, Bizkaia, Spain
| | - María Sala
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Autonomous University of Barcelona, Barcelona, Spain
| | - Maximino Redondo
- Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain. .,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.
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Miret C, Domingo L, Louro J, Barata T, Baré M, Ferrer J, Carmona-García MC, Castells X, Sala M. Factors associated with readmissions in women participating in screening programs and treated for breast cancer: a retrospective cohort study. BMC Health Serv Res 2019; 19:940. [PMID: 31805926 PMCID: PMC6896282 DOI: 10.1186/s12913-019-4789-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/28/2019] [Indexed: 01/15/2023] Open
Abstract
Background We aimed to identify the risk factors associated with early, late and long-term readmissions in women diagnosed with breast cancer participating in screening programs. Methods We performed a multicenter cohort study of 1055 women aged 50–69 years participating in Spanish screening programs, diagnosed with breast cancer between 2000 and 2009, and followed up to 2014. Readmission was defined as a hospital admission related to the disease and/or treatment complications, and was classified as early (< 30 days), late (30 days-1 year), or long-term readmission (> 1 year). We used logistic regression to estimate the adjusted odds ratios (aOR), and 95% confidence intervals (95% CI) to explore the factors associated with early, late and long-term readmissions, adjusting by women’s and tumor characteristics, detection mode, treatments received, and surgical and medical complications. Results Among the women included, early readmission occurred in 76 (7.2%), late readmission in 87 (8.2%), long-term readmission in 71 (6.7%), and no readmission in 821 (77.8%). Surgical complications were associated with an increased risk of early readmissions (aOR = 3.62; 95%CI: 1.27–10.29), and medical complications with late readmissions (aOR = 8.72; 95%CI: 2.83–26.86) and long-term readmissions (aOR = 4.79; 95%CI: 1.41–16.31). Conclusion Our results suggest that the presence of surgical or medical complications increases readmission risk, taking into account the detection mode and treatments received. Identifying early complications related to an increased risk of readmission could be useful to adapt the management of patients and reduce further readmissions. Trial Registration ClinicalTrials.govIdentifier: NCT03165006. Registration date: May 22, 2017 (Retrospectively registered).
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Affiliation(s)
- Carme Miret
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, Pompeu Fabra University, Barcelona, Spain.,Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain.,Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain
| | - Laia Domingo
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain. .,Research Network on Health Services in Chronic Diseases (REDISSEC), Av. de Monforte de Lemos, 5, 28029, Madrid, Spain.
| | - Javier Louro
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Av. de Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Teresa Barata
- General Directorate of Health Care Programs, Canary Islands Health Service, C/ Juan XXIII,13, 35005, Las Palmas de Gran Canaria, Spain
| | - Marisa Baré
- Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Av. de Monforte de Lemos, 5, 28029, Madrid, Spain.,Cancer Screening and Clinical Epidemiology, Corporació Sanitària Parc Taulí, 08208, Sabadell, Spain
| | - Joana Ferrer
- Department of Radiology, Hospital de Santa Caterina, C/ Dr. Castany, s/n, 17190 Salt, Girona, Spain
| | - Maria Carmen Carmona-García
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Catalan Institute of Oncology, C/ Sol, 15, 17004, Girona, Spain.,Girona Biomedical Research Institute (IDIBGI), C/ Dr Castany s/n, 17190 Salt, Girona, Spain.,Department of Medical Oncology, Catalan Institute of Oncology, University Hospital Dr Josep Trueta, Av. França, S/N, 17007, Girona, Spain
| | - Xavier Castells
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain.,Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Av. de Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Maria Sala
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain.,Research Network on Health Services in Chronic Diseases (REDISSEC), Av. de Monforte de Lemos, 5, 28029, Madrid, Spain
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