scholarly journals Cancro de Mama: Valor em Saúde, Custos e Financiamento

2017 ◽  
Vol 30 (11) ◽  
pp. 762 ◽  
Author(s):  
Ana Harfouche ◽  
Silvia Silva ◽  
João Faria ◽  
Rui Araújo ◽  
António Gouveia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Healthcare Sector ◽  
Disease Stage ◽  
First Year ◽  
Study Cohort ◽  
New Disease ◽  
Activity Based Costing ◽  
Funding Programme ◽  
Disease Specific ◽  
Implementation Activity

Introduction: Breast cancer is the second most common oncological disease worldwide. To analyse the new disease specific funding programme (breast cancer) implemented at the Francisco Gentil Portuguese Institute of Oncology, Lisbon Center (Instituto Português de Oncologia de Lisboa Francisco Gentil), the actual costs of the patients were examined using activity-based costing as a costing methodology. This study addresses the following question: “How much does it cost to treat breast cancer per ‘patient-month’ compared to the monthly fixed ‘funding envelope’?”.Materials and Methods: The study cohort consisted of 807 patients, corresponding to all the patients eligible for the new disease specific funding programme and who were enrolled during the first year of implementation. Activity-based costing was used to calculate the total real costs per stage of disease and per ‘patient-month’ as well as the deviation from the monthly fixed ‘funding envelope’.Results: The total costs were 6.6 M€, whereas the total funding was 5.2 M€ for a total of 5648 ‘patient-months’. In 2014, the balance difference between the funding obtained and the actual costs was -1.4 €M for the cohort of 807 patients.Discussion: The extreme cases of differences in cost per ‘patient-month’ compared to the monthly fixed ‘funding envelope’ were (i) stage 0/Tis, with higher funding at 415.23 € per ‘patient-month’, and (ii) stage IIIC, with lower funding at 1062.79 € per ‘patient-month’.Conclusion: The ‘patient-month’ cost, regardless of disease stage was 1170.29 €. The median deviation per ‘patient-month’ was negative (241.21 €) compared to the monthly fixed ‘funding envelope’ of 929.08 € in the first year. Establishing activity-based costing - funding models will be crucial for the future sustainability of the healthcare sector.

scholarly journals Changes in Body Fat and Weight After a Breast Cancer Diagnosis: Influence of Demographic, Prognostic, and Lifestyle Factors

2005 ◽  
Vol 23 (4) ◽  
pp. 774-782 ◽  
Author(s):  
Melinda L. Irwin ◽  
Anne McTiernan ◽  
Richard N. Baumgartner ◽  
Kathy B. Baumgartner ◽  
Leslie Bernstein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Body Fat ◽  
Cancer Diagnosis ◽  
Breast Cancer Diagnosis ◽  
Lifestyle Factors ◽  
Analysis Of Covariance ◽  
Disease Stage ◽  
Future Research ◽  
First Year

Purpose Obese women and women who gain weight after a breast cancer diagnosis are at a greater risk for breast cancer recurrence and death compared with lean women and women who do not gain weight after diagnosis. In this population-based study, we assessed weight and body fat changes from during the first year of diagnosis to during the third year after diagnosis, and whether any changes in weight and body fat varied by demographic, prognostic, and lifestyle factors in 514 women with incident Stage 0-IIIA breast cancer. Methods Patients were participants in the Health, Eating, Activity, and Lifestyle (HEAL) study. Weight and body fat (via dual-energy x-ray absorptiometry scans) were measured during the baseline visit and 2 years later at a follow-up visit. Analysis of covariance methods were used to obtain mean weight and body fat changes adjusted for potential cofounders. Results Women increased their weight and percent body fat by 1.7 ± 4.7 kg and 2.1% ± 3.9%, respectively, from during their first year of diagnosis to during their third year of diagnosis. A total of 68% and 74% of patients gained weight and body fat, respectively. Greater increases in weight were observed among women diagnosed with a higher disease stage, younger age, being postmenopausal, and women who decreased their physical activity from diagnosis to up to 3 years after diagnosis (P for trend < .05). Conclusion Weight and body fat increased in the postdiagnosis period. Future research should focus on the effect of physical activity on weight and fat loss and breast cancer prognosis.

Breast cancer associated with pregnancy: a clinical case

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 102-108
Author(s):  
Yu E Dobrokhotova ◽  
S E Arakelov ◽  
S Zh Danelyan ◽  
E I Borovkova ◽  
A E Zykov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Clinical Case ◽  
First Trimester ◽  
First Year ◽  
Total Mastectomy ◽  
First Time

Associated with pregnancy is breast cancer, which was first detected during pregnancy, during the first year after childbirth or at any time against lactation. Diagnosis of the disease in the first trimester is an indication for abortion. The detection of the disease after 20 weeks and the desire of the woman to maintain pregnancy is the basis for conducting a total mastectomy followed by polychemotherapy with doxorubicin with cyclophosphamide or with fluorouracil. Radiation therapy during pregnancy is not applied. The timing and method of delivery are determined individually and depend on the stage of the process and the period of pregnancy, when it was identified. A clinical case of a patient with edematous-infiltrative form of breast cancer of the IV stage, diagnosed for the first time in 22 weeks of pregnancy, is presented.

Diagnostic Delay in Breast Cancer: Correlation with Disease Stage and Prognosis

1990 ◽  
Vol 76 (6) ◽  
pp. 559-562 ◽  
Author(s):  
Simonetta Rossi ◽  
Claudia Cinini ◽  
Cinzia Di Pietro ◽  
Celestino Pio Lombardi ◽  
Antonio Crucitti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Diagnostic Delay ◽  
Disease Stage

scholarly journals Plasma Level of MMP-10 May Be a Prognostic Marker in Early Stages of Breast Cancer

2020 ◽  
Vol 9 (12) ◽  
pp. 4122
Author(s):  
Barbara Maria Piskór ◽  
Andrzej Przylipiak ◽  
Emilia Dąbrowska ◽  
Iwona Sidorkiewicz ◽  
Marek Niczyporuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Area Under The Curve ◽  
Disease Stage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Early Stages ◽  
Potential Marker ◽  
Breast Cancer Biomarkers ◽  
Diagnostic Usefulness ◽  
Chemiluminescent Microparticle Immunoassay

Background: Stromelysins are potential breast cancer biomarkers. The aim of the study was to evaluate if plasma levels of selected metalloproteinases (MMPs) (stromelysin-1 (MMP-3) and stromelysin-10 (MMP-10)) and cancer antigen 15-3 (CA 15-3) used separately and in combination demonstrated diagnostic usefulness in breast cancer (BC). Methods: The study group consisted of 120 patients with BC, while the control group included 40 patients with benign breast cancer and 40 healthy individuals. Concentrations of MMP-3 and MMP-10 were determined by enzyme-linked immunosorbent assay; CA 15-3 was determined by chemiluminescent microparticle immunoassay. Results: In the group of patients with BC, the area under the curve (AUC) was significantly higher for all markers (except MMP-3) and all sets of markers. At the earliest disease stage, only MMP-10 had a significantly higher AUC (AUC = 0.8692, p < 0.001). Moreover, MMP-10 had the highest AUC (0.9166) among parameters tested separately. The highest AUC was observed for the combination of MMP-10 + CA 15-3 and MMP-3 + MMP-10 + CA 15-3 in line with disease progression (stage I 0.8884 and 0.8906, stage II 0.9244 and 0.9308, stages III + IV 0.9919 and 0.9944, respectively, p < 0.001 in all cases). Conclusions: The results suggest that MMP-10 could be a potential marker in early stages of BC. Moreover, plasma concentration of MMP-10 and MMP-3 in combination with CA 15-3 may improve diagnosis of this type of cancer.

scholarly journals Adjuvant Hormonotherapy and Cardiovascular Risk in Post-Menopausal Women with Breast Cancer: A Large Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2254
Author(s):  
Matteo Franchi ◽  
Roberta Tritto ◽  
Luigi Tarantini ◽  
Alessandro Navazio ◽  
Giovanni Corrao
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Adjuvant Therapy ◽  
Large Population ◽  
Positive Association ◽  
Population Based ◽  
Study Cohort ◽  
Increased Risk ◽  
Post Menopausal ◽  
New Diagnosis

Background: Whether aromatase inhibitors (AIs) increase the risk of cardiovascular (CV) events, compared to tamoxifen, in women with breast cancer is still debated. We evaluated the association between AI and CV outcomes in a large population-based cohort of breast cancer women. Methods: By using healthcare utilization databases of Lombardy (Italy), we identified women ≥50 years, with new diagnosis of breast cancer between 2009 and 2015, who started adjuvant therapy with either AI or tamoxifen. We estimated the association between exposure to AI and CV outcomes (including myocardial infarction, ischemic stroke, heart failure or any CV event) by a Cox proportional hazard model with inverse probability of treatment and censoring weighting. Results: The study cohort included 26,009 women starting treatment with AI and 7937 with tamoxifen. Over a median follow-up of 5.8 years, a positive association was found between AI and heart failure (Hazard Ratio = 1.20, 95% CI: 1.02 to 1.42) and any CV event (1.14, 1.00 to 1.29). The CV risk increased in women with previous CV risk factors, including hypertension, diabetes and dyslipidemia. Conclusions: Adjuvant therapy with AI in breast cancer women aged more than 50 years is associated with increased risk of heart failure and combined CV events.

scholarly journals The natural history of Canavan disease: 23 new cases and comparison with patients from literature

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Annette Bley ◽  
Jonas Denecke ◽  
Alfried Kohlschütter ◽  
Gerhard Schön ◽  
Sandra Hischke ◽  
...  
Keyword(s):  
Severity Score ◽  
Canavan Disease ◽  
Psychomotor Development ◽  
Rank Test ◽  
First Year ◽  
Study Cohort ◽  
Pooled Data ◽  
Kaplan Meier ◽  
History Of ◽  
First Year Of Life

Abstract Background Canavan disease (CD, MIM # 271900) is a rare and devastating leukodystrophy of early childhood. To identify clinical features that could serve as endpoints for treatment trials, the clinical course of CD was studied retrospectively and prospectively in 23 CD patients. Results were compared with data of CD patients reported in three prior large series. Kaplan Meier survival analysis including log rank test was performed for pooled data of 82 CD patients (study cohort and literature patients). Results Onset of symptoms was between 0 and 6 months. Psychomotor development of patients was limited to abilities that are usually gained within the first year of life. Macrocephaly became apparent between 4 and 18 months of age. Seizure frequency was highest towards the end of the first decade. Ethnic background was more diverse than in studies previously reported. A CD severity score with assessment of 11 symptoms and abilities was developed. Conclusions Early hallmarks of CD are severe psychomotor disability and macrocephaly that develop within the first 18 months of life. While rare in the first year of life, seizures increase in frequency over time in most patients. CD occurs more frequently outside Ashkenazi Jewish communities than previously reported. Concordance of phenotypes between siblings but not patients with identical ASPA mutations suggest the influence of yet unknown modifiers. A CD severity score may allow for assessment of CD disease severity both retrospectively and prospectively.

Patients With Invasive Breast Cancer Who Refuse Treatment: An Analysis of Associated Factors and Impact on Survival

2021 ◽  
pp. 000313482110241
Author(s):  
Jackelyn J. Moya ◽  
Ashkan Moazzez ◽  
Junko J. Ozao-Choy ◽  
Christine Dauphine
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Invasive Breast Cancer ◽  
Risk Groups ◽  
Breast Cancer Treatment ◽  
Study Cohort ◽  
National Cancer Database ◽  
Optimal Outcomes ◽  
Impact On Survival ◽  
The Impact

Background Completion of surgical resection and adjuvant/neoadjuvant treatments (chemotherapy, radiation, and endocrine therapy) is necessary to achieve optimal outcomes in invasive breast cancer. The objective of this study was to determine the characteristics of patients refusing treatment and to analyze the impact of refusal on survival. Study Design A retrospective cohort study of invasive breast cancer cases diagnosed 2004-2016 was performed utilizing the National Cancer Database. Results Of 2 058 568 cases comprising the study cohort, .6% refused recommended surgery, 14.1% refused chemotherapy, 5.5% refused radiation, and 6.3% refused endocrine therapy. Patients refusing therapy were older and more likely uninsured; they did not live farther from the treating hospital. Racial disparities were also associated with refusal. Surgery refusal had the highest hazard ratio for mortality (2.7; 95% CI: 2.5-3.0, P < .001) compared to chemotherapy (1.3; 95% CI: 1.3-1.4, P < .001), radiation (1.8; 95% CI: 1.7-1.9, P < .001), and endocrine therapy (1.5; 95% CI: 1.4-1.6, P < .001) independent of race, insurance, receptor status, and stage. Conclusion This study demonstrates significant associations with refusal of breast cancer treatment and quantifies the impact on mortality, which may help to identify at-risk groups for whom interventions could prevent increases in mortality associated with declining treatment.

Sign in / Sign up

Export Citation Format

Share Document