Intervalos de tiempo para el diagnóstico y tratamiento en pacientes con cáncer de mama

Abstract

Objective

To describe the delay in the diagnosis of breast cancer in primary care and to identify the patient, care process and disease variables involved in the delay to diagnosis and treatment.

Design

Retrospective study with follow-up of a cohort of women with breast cancer, from the first symptoms to the start of treatment.

Site

In total 24 family medicine practices with information from both primary care and hospital settings.

Participants

446 women were evaluated (period 2014-2023).

Main measurements

Patient characteristics (age, history and comorbidity), care process (screening, consultation site and referral priority) and disease characteristics (stage, presentation and risk factors) were included. Time intervals considered included, among others, «primary care interval», «health system interval», «diagnosis interval» and «treatment interval».

Results

The mean value of the «primary care interval» was 24.7 days (median: 16); that of the «hospital care interval», 77.2 days (median: 68); and that of the «health system interval», 93.6 days (median: 83). Multiple linear regression showed a significantly shorter duration of the interval in women referred preferentially, in advanced stages, with a breast lump at presentation and with risk factors.

Conclusions

Most are diagnosed in early stages at the health centre. The duration of the «health system interval» is shorter in preferential referrals, when the form of presentation is a breast lump, with risk factors and in advanced stages.