15P - Delays in breast cancer treatment in a tertiary hospital

Background

The burden of treatment delay in breast cancer is high, especially among developing countries. Despite adversely affecting morbidity and mortality, this burden still remains largely unexplored. This study aimed to determine treatment delays among breast cancer patients in a tertiary hospital during surgery, neoadjuvant chemotherapy, and adjuvant chemotherapy and to identify predictors of delay.

Methods

A retrospective cohort study was conducted among breast cancer patients seen between January 1, 2012 to December 31, 2018. The following outcomes were investigated: delay in neoadjuvant chemotherapy, delay in surgery, delay in adjuvant chemotherapy, and any form of delay. Summary statistics were reported as percent for categorical data and as mean for continuous data. The individual correlations were performed using Chi-square for qualitative data and t-test for quantitative data while predictors were determined through logistic regression.

Results

A total of 324 patients were included in this study. The majority of the patients were less than 65 years old living in rural areas. More than half of the patients were overweight or obese, hypertensive, and diabetic. A high prevalence of delays were observed: 61.1% (n = 198) with any type of delay, 23.8% (n = 53) with delay in surgery, 53.8% (n = 120) with delay in adjuvant chemotherapy, and 74.3% (n = 75) with delay in neoadjuvant chemotherapy. Patients from rural areas and those with hypertension were associated with any form of delay. The presence of coronary artery disease andN2 disease were associated with delay in surgery. The use of doxorubicin, cyclophosphamide, and docetaxel and the docetaxel-cyclophosphamide doublet regimens were both associated with delay in adjuvant chemotherapy. Moreover, T2-T3, N2-N3, and grade 1-2tumors, and the use of the doublet doxorubicin-cyclophosphamide with or without subsequent docetaxel were also associated with any form of delay.

Conclusions

The present study shows a high prevalence of treatment delay among breast cancer patients. Further studies may be done to identify factors affecting these delays and policy changes are recommended to address these gaps in treatment.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Rogelio Velasco Jr.

Funding

Philippine General Hospital - Expanded Hospital Research Office.

Disclosure

All authors have declared no conflicts of interest.