Isabel Torá-Rocamora1, Jaume Grau2, Blanca Oliver-Vall-Llosera3, Xavier Bargalló4, Marta Aldea2, Rosa Puigpinós-Riera5. 1. Servicio de Medicina Preventiva, Hospital Clínic de Barcelona, Barcelona, España. Electronic address: tora@clinic.cat. 2. Servicio de Medicina Preventiva, Hospital Clínic de Barcelona, Barcelona, España; Departament de Medicina, Facultat de Medicina y Ciències de la Salut, Universitat de Barcelona, Barcelona, España. 3. Servicio de Cirugía Pediátrica, Hospital Universitari Vall d'Hebron, Barcelona, España. 4. Departament de Medicina, Facultat de Medicina y Ciències de la Salut, Universitat de Barcelona, Barcelona, España; Servicio de Radiología, Hospital Clínic de Barcelona, Barcelona, España. 5. Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut de Recerca Biomèdica Sant Pau, Barcelona, España.
Abstract
OBJECTIVE: To describe and analyze the characteristics of breast cancer tumours according to the diagnostic pathway. We analyse the adverse effects of the treatments and the use of unconventional therapies in order to alleviate them. METHOD: Descriptive design nested in a mixed cohort (Cohort DAMA). The dependent variable was the route to diagnosis of breast cancer. The independent variables were age, body mass index, social class, disposable family income, type of tumour, histological degree, tumour stage, recurrences, treatment, adverse effects derived from treatments and unconventional therapies. Bivariate descriptive analyses were performed and univariate and multivariate regression models were adjusted; and graphic representations of the unconventional therapies. RESULTS: There are differences in the characteristics of the tumours, and the impact of the adverse effects derived from the treatments. The patients diagnosed by screening were older, from a high social class, had a higher percentage of tumours of grade I differentiation, initial stages, fewer recurrences and fewer adverse effects due to treatment, although this was not different in the screening group compared to the rest. There was also less use of unconventional therapies. CONCLUSIONS: The results indicate that the implementation of screening programmes increases the possibility of detecting tumours in initial stages and with therapies with fewer adverse effects. As a result, there is less need to resort to unconventional therapies.
OBJECTIVE: To describe and analyze the characteristics of breast cancer tumours according to the diagnostic pathway. We analyse the adverse effects of the treatments and the use of unconventional therapies in order to alleviate them. METHOD: Descriptive design nested in a mixed cohort (Cohort DAMA). The dependent variable was the route to diagnosis of breast cancer. The independent variables were age, body mass index, social class, disposable family income, type of tumour, histological degree, tumour stage, recurrences, treatment, adverse effects derived from treatments and unconventional therapies. Bivariate descriptive analyses were performed and univariate and multivariate regression models were adjusted; and graphic representations of the unconventional therapies. RESULTS: There are differences in the characteristics of the tumours, and the impact of the adverse effects derived from the treatments. The patients diagnosed by screening were older, from a high social class, had a higher percentage of tumours of grade I differentiation, initial stages, fewer recurrences and fewer adverse effects due to treatment, although this was not different in the screening group compared to the rest. There was also less use of unconventional therapies. CONCLUSIONS: The results indicate that the implementation of screening programmes increases the possibility of detecting tumours in initial stages and with therapies with fewer adverse effects. As a result, there is less need to resort to unconventional therapies.
Keywords:
Adverse effects; Breast cancer; Cancer screening; Cribado de cáncer; Cáncer de mama; Diagnostic route; Efectos adversos; Terapias no convencionales; Unconventional therapies; Vía diagnóstica