Waiting Time between Breast Cancer Diagnosis and Treatment in Brazilian Women: An Analysis of Cases from 1998 to 2012

Brazilian law requires that treatment for breast cancer begin within 60 days of diagnosis. This waiting time is an indicator of accessibility to health services. The aim of this study was to analyze which factors are associated with waiting times between diagnosis and treatment of breast cancer in women in Brazil between 1998 and 2012. Information from Brazilian women diagnosed with breast cancer between 1998 and 2012 was collected through the Hospital Registry of Cancer (HRC), developed by the National Cancer Institute (INCA). We performed a secondary data analysis, and found that the majority of women (81.3%) waited for ≤60 days to start treatment after being diagnosed. Those referred by the public health system, aged ≥50 years, of nonwhite race, diagnosed at stage I or II, and with low levels of education waited longer for treatment to start. We observed that only 18.7% experienced a delay in starting treatment, which is a positive reflection of the quality of the care network for the diagnosis and treatment of breast cancer. We also observed inequalities in access to health services related to age, region of residence, stage of the disease, race, and origin of referral to the health service.

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Czas oczekiwania na postawienie diagnozy i rozpoczęcie leczenia w przypadku złośliwego nowotworu piersi oraz wpływ pomiaru na poprawę standardu realizowanych świadczeń

Zdrowie Publiczne i Zarządzanie ◽

10.4467/20842627oz.20.024.14141 ◽

2021 ◽

Vol 18 (3) ◽

pp. 227-235

Author(s):

Anna Andrzejczak ◽

Ewelina Żarłok ◽

Karolina Osowiecka ◽

Luiza Kańczuga-Koda ◽

Sergiusz Nawrocki

Keyword(s):

Breast Cancer ◽

Waiting Time ◽

Core Needle Biopsy ◽

Cancer Care ◽

Needle Biopsy ◽

Waiting Times ◽

Diagnosis And Treatment ◽

Core Needle ◽

Malignant Breast ◽

The Impact

Waiting Times for Diagnosis and Treatment in Breast Cancer and the Impact of Measurement on the Improvement of the Standard of Services Provided Mortality rates for malignant breast cancer are rising in Poland. This is a subject of growing concern and a focus of public debate about cancer care in Poland. The following paper presents a case study—an attempt to measure and analyze waiting times for diagnosis and treatment in breast cancer. The survey was carried out in one of the regional cancer care centers in Poland. The data were collected solely from hospital information systems. The overall waiting time (mammography to treatment) was median 35,5 days. Waiting time since diagnosis (results of core needle biopsy to treatment) was median 27,5 days. The analysis has been conducted twice. In between the center implemented several organizational changes. They resulted in shortening of waiting time for mammogram description—from 4 to 1 day (median) also the waiting times for core needle biopsy result has been shortened—from 6 to 4 days (median). However, the overall waiting time has not changed significantly.

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Have Standardised Referral Forms Reduced the Number of Inappropriate Referrals to Breast Clinic?

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363512x13189526438954 ◽

2012 ◽

Vol 94 (2) ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

V Lefemine ◽

G Osborn ◽

AM Mainwaring ◽

S Goyal

Keyword(s):

Breast Cancer ◽

Early Diagnosis ◽

Waiting Time ◽

Waiting Times ◽

Diagnosis And Treatment ◽

Breast Clinic ◽

Department Of Health ◽

National Breast ◽

Specialist Services ◽

The Uk

National breast referral guidelines in the UK were introduced in 1995 to create a framework for appropriate referral of patients to specialist breast clinics. In 1998, in an attempt to improve outcomes for patients with breast cancer, the Department of Health issued a circular entitled Breast Cancer Waiting Times – Achieving the Two Week Target. The aim of the two-week waiting time directive (Table 1) was to provide prompt access to specialist services for patients with suspected breast cancer to facilitate early diagnosis and treatment.

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Waiting time disparities in breast cancer diagnosis and treatment: A population-based study in France

The Breast ◽

10.1016/j.breast.2013.02.009 ◽

2013 ◽

Vol 22 (5) ◽

pp. 810-816 ◽

Cited By ~ 23

Author(s):

F. Molinié ◽

C. Leux ◽

P. Delafosse ◽

S. Ayrault-Piault ◽

P. Arveux ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Waiting Time ◽

Breast Cancer Diagnosis ◽

Population Based ◽

Diagnosis And Treatment ◽

Population Based Study

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The long-term course of fatigue following breast cancer diagnosis

Journal of Patient-Reported Outcomes ◽

10.1186/s41687-020-00187-9 ◽

2020 ◽

Vol 4 (1) ◽

Cited By ~ 1

Author(s):

Karin Biering ◽

Morten Frydenberg ◽

Helle Pappot ◽

Niels Henrik Hjollund

Keyword(s):

Breast Cancer ◽

Time Course ◽

Breast Cancer Diagnosis ◽

Patient Characteristics ◽

Repeated Measurements ◽

Diagnosis And Treatment ◽

Persistent Problem ◽

Treatment Regimens ◽

Long Time

Abstract Purpose Fatigue following breast cancer is a well-known problem, with both high and persistent prevalence. Previous studies suffer from lack of repeated measurements, late recruitment and short periods of follow-up. The course of fatigue from diagnosis and treatment to the long-time outcome status is unknown as well as differences in the level of fatigue between treatment regimens. The purpose of this study was to describe the long-time course of fatigue from the time of clinical suspicion of breast cancer, its dependence of patient characteristics and treatment regimens and the comparison with the course of fatigue among women with the same suspicion, but not diagnosed with breast cancer. Methods Three hundred thirty-two women referred to acute or subacute mammography was followed with questionnaires from before the mammography and up to 1500 days. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-20). The women reported their initial level of fatigue before the mammography and thus without knowledge of whether they had cancer or not. Both women with and without cancer were followed. Women with cancer were identified in the clinical database established by Danish Breast Cancer Cooperative Group (DBCG) to collect information on treatment regimen. Results Compared to fatigue scores before diagnosis, women with breast cancer reported a large increase of fatigue, especially in the first 6 months, followed by a slow decrease over time. Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography. Women without breast cancer, experienced a rapid decrease of fatigue after disproval of diagnosis followed by a steadier period. Conclusions Fatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment. The women with breast cancer were most affected by fatigue in the first 6 months after diagnosis.

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HER2 targeting as a two-sided strategy for breast cancer diagnosis and treatment: Outlook and recent implications in nanomedical approaches

Pharmacological Research ◽

10.1016/j.phrs.2010.01.013 ◽

2010 ◽

Vol 62 (2) ◽

pp. 150-165 ◽

Cited By ~ 50

Author(s):

Miriam Colombo ◽

Fabio Corsi ◽

Diego Foschi ◽

Elisa Mazzantini ◽

Serena Mazzucchelli ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Breast Cancer Diagnosis ◽

Diagnosis And Treatment

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900 Effects Of COVID-19 Pandemic Restrictions on the 2ww Breast Referrals in A UK Specialist Breast Service

British Journal of Surgery ◽

10.1093/bjs/znab259.213 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

O Tokode ◽

S Rastall

Keyword(s):

Breast Cancer ◽

Waiting Times ◽

Age Groups ◽

Breast Cancer Diagnosis ◽

Hospital Staff ◽

Breast Cancers ◽

Telephone Triage ◽

Telephone Consultation ◽

Mean Waiting Time ◽

Delays In Diagnosis

Abstract Aim Recommendations were issued to the hospital Trusts to configure service delivery to balance cancer care with patient and hospital staff safety during the COVID-19 pandemic. It was felt the service restrictions might lead to delays in diagnosis and treatment of cancer patients. We conducted an audit to compare 2ww breast referrals in our center between May to July of 2019 and 2020. Method We triaged all referrals to face-face consultation or telephone consultation in our center during the pandemic. Patients with suspicious symptoms were offered face-face consultation after the telephone triage. Results Data analysis showed that the referrals fell by 28.3% (N 1569 versus N 1125). The largest reduction was noted in May (34.4% versus 24.2%). Mean waiting time in 2019 was 19.86 (± 7.14) and 11.43 (± 3.48) in 2020. The proportion of patients referred for suspected breast cancers increased across all age groups in 2020 (range +10.4% to 16.2%). Significantly more breast cancers were diagnosed in 2020 (7.1% versus 5.1%). No breast cancer was diagnosed in under 25 patients. 29.1% of the 522 patients telephoned were discharged, and others were seen in the clinic. Conclusions The COVID-19 infection’s management caused a fall in 2ww referrals and shortened waiting times but increased breast cancer diagnosis. Many 2ww referrals during the COVID-19 infection were unnecessary. The telephone consultation reduced waiting times but may have deferred clinic visitation for most patients.

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