Patient-Attributable Delays in Breast Cancer Care Linked to Increased Risk for 2-Year Mortality

In In The News by Barbara Jacoby

Source This study was led by Desirée Martín-García, Hospital Universitario Costa del Sol, Marbella, Spain. I

From: medscape.com

TOPLINE:

Patient-attributable delays exceeding 90 days in breast cancer care were associated with a more than threefold higher risk for 2-year mortality. Living alone emerged as the only independent predictor of prolonged patient-attributable delay (PPAD), increasing the risk for delay by 88.2%.

METHODOLOGY:

  • This multicentre prospective cohort study included 543 symptomatic patients with breast cancer diagnosed between 2013 and 2015 across 10 hospitals in Spain’s National Health System.
  • PPAD was defined as a delay of more than 90 days between symptom onset and the first medical consultation; overall, 77 patients experienced a PPAD.
  • Researchers examined associations between PPADs and clinical outcomes, including 2-year mortality, while considering sociodemographic and clinical-pathological factors.
  • Diagnosis confirmation involved imaging techniques, including mammography and/or ultrasound, followed by biopsy.

TAKEAWAY:

  • Living alone emerged as the sole independent predictor of PPAD (odds ratio [OR], 1.882; 95% CI, 1.033-3.42; P = .039).
  • Among patients who sought medical care within 90 days, the mortality rate was 3.2%; however, among those who experienced delays exceeding 90 days, the rate was 11.7%.
  • In multivariate analysis, patient-attributable delays exceeding 90 days remained a significant risk factor for 2-year mortality (OR, 3.08; 95% CI, 1.05-9.07), and advanced disease stages (stages III-IV) demonstrated the highest risk for mortality (OR, 6.78; 95% CI, 2.51-18.3).
  • Age remained a significant predictor of mortality (OR, 1.04; 95% CI, 1.01-1.07).
  • The basal-like immunophenotype demonstrated the highest risk for mortality among subtypes (OR, 7.49; 95% CI, 2.68-20.9).

IN PRACTICE:

“Our findings highlight the need for targeted interventions to raise cancer symptom awareness and address barriers faced by vulnerable groups, such as the elderly and individuals living alone, to reduce delays, improve clinical outcomes, increase survival rates, and ultimately the quality of life for patients,” the authors of the study wrote.