Breast Cancer Treatment Delay in SafetyNet Health Systems, Houston Versus Southeast Brazil.

Autor:	Shafaee MN; Baylor College of Medicine, Houston, TX, USA., Silva LR; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Ramalho S; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Doria MT; Department of Obstetrics and Gynecology, Clinical Hospital of Federal University of Paraná, Curitiba, Paraná, Brazil., De Andrade Natal R; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Cabello V; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Cons L; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Pavanello M; School of Women's and Children's Health, Lowy Cancer Research Centre, University of New South Wales, Sydney, Australia., Zeferino LC; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil., Mano MS; Hospital Sírio-Libanês, São Paulo, Brazil., Linck RDM; Hospital Sírio-Libanês, São Paulo, Brazil., Batista LS; Hospital Sírio-Libanês, São Paulo, Brazil., Pedro EP; Hospital Sírio-Libanês, São Paulo, Brazil., De Paula BH; Instituto Nacional Do Câncer (INCA - HCIII), Rio de Janeiro, Brazil., Zuca-Matthes G; Barretos Cancer Hospital, Barretos, Brazil., Podany E; Baylor College of Medicine, Houston, TX, USA., Makawita S; MD Anderson Cancer Center, Houston, TX, USA., Ann Stewart K; Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN, USA., Tsavachidis S; Baylor College of Medicine, Houston, TX, USA., Tamimi R; Department of Population Health Sciences, Weill Cornell Medicine, New York-Presbyterian, New York, NY, USA., Bondy M; Center for Population Health Sciences, Stanford Cancer Institute, Stanford, CA, USA., Debord L; Department of Dermatology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA., Ellis M; Baylor College of Medicine, Houston, TX, USA., Bines J; Instituto Nacional Do Câncer (INCA - HCIII), Rio de Janeiro, Brazil., Cabello C; Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2022 May 06; Vol. 27 (5), pp. 344-351.
DOI:	10.1093/oncolo/oyac050
Abstrakt:	Background: Breast cancer outcomes among patients who use safety-net hospitals in the highly populated Harris County, Texas and Southeast Brazil are poor. It is unknown whether treatment delay contributes to these outcomes. Methods: We conducted a retrospective cohort analysis of patients with non-metastatic breast cancer diagnosed between January 1, 2009 and December 31, 2011 at Harris Health Texas and Unicamp's Women's Hospital, Barretos Hospital, and Brazilian National Institute of Cancer, Brazil. We used Cox proportional hazards regression to evaluate association of time to treatment and risk of recurrence (ROR) or death. Results: One thousand one hundred ninety-one patients were included. Women in Brazil were more frequently diagnosed with stage III disease (32.3% vs. 21.1% Texas; P = .002). Majority of patients in both populations had symptom-detected disease (63% in Brazil vs. 59% in Texas). Recurrence within 5 years from diagnosis was similar 21% versus 23%. Median time from diagnosis to first treatment defined as either systemic therapy (chemotherapy or endocrine therapy) or surgery, were comparable, 9.9 weeks versus 9.4 weeks. Treatment delay was not associated with increased ROR or death. Higher stage at diagnosis was associated with both increased ROR and death. Conclusion: Time from symptoms to treatment was considerably long in both populations. Treatment delay did not affect outcomes. Impact: Access to timely screening and diagnosis of breast cancer are priorities in these populations. (© The Author(s) 2022. Published by Oxford University Press.)
Databáze:	MEDLINE
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