Abstract
BackgroundDespite recently implemented access to care programs, Mexican breast cancer (BC) mortality rates remain substantially above those in the US. We conducted a survey among Mexican Oncologists to determine whether practice patterns may be responsible for these differences.MethodsA web-based survey was sent to 851 oncologists across Mexico using the Vanderbilt University REDCap database. Analyses of outcomes are reported using exact and binomial confidence bounds and tests.Results138 participants (18.6% of those surveyed) from the National capital and 26 Mexican states, responded. Respondents reported that 58% of newly diagnosed BC patients present with stage III-IV disease; 63% undergo mastectomy, 52% axillary lymph node dissection (ALND) and 48% sentinel lymph node biopsy (SLNB). Chemotherapy is recommended for tumors > 1 cm (89%), positive nodes (86.5%), triple-negative (TN) (80%) and HER2 positive tumors (58%). Trastuzumab is prescribed in 54.3% and 77.5% for HER2 < 1 cm and > 1 cm tumors, respectively. Tamoxifen is indicated for premenopausal hormone receptor (HR) positive tumors in 86.5% of cases and aromatase inhibitors (AI’s) for postmenopausal in 86%. 24% of physicians reported treatment limitations, due to delayed or incomplete pathology reports and delayed or limited access to medications.ConclusionsEven though access to care programs have been recently applied nationwide, women commonly present with advanced BC, leading to increased rates of mastectomy and ALND. Mexican physicians are dissatisfied with access to appropriate medical care. Our survey detects specific barriers that may impact BC outcomes in Mexico and warrant further investigation.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-658) contains supplementary material, which is available to authorized users.
Highlights
Despite recently implemented access to care programs, Mexican breast cancer (BC) mortality rates remain substantially above those in the US
The survey consisted of 35 questions which were divided into sections that addressed: physician demographics; BC patient demographics and clinical presentation; details of pathology reports and; patterns of treatment for patients with early breast cancer (EBC) (Additional file 1: Figure S1)
Physicians reported that tumor size, tumor grade, vascular invasion, tumor margin status, lymph node analysis, estrogen receptor (ER 88.4%), progesterone receptor (PR 87.7%), and HER2 (87.7%) receptor results were standard elements of pathology reports (Table 2)
Summary
Despite recently implemented access to care programs, Mexican breast cancer (BC) mortality rates remain substantially above those in the US. In Mexico, BC incidence has been increasing in recent decades with 8,428 cases reported in 2009. This reflects a national incidence of 15 per 100,000 women compared with 76 per 100,000 women in the US, figures in Mexico are underreported due to a lack of a National Cancer Registry [3]. Since 2006 it has been the leading cause of cancer mortality in Mexican women, accounting for 14% of all female cancer-related deaths [4]. Recent changes in Mexican health care policies have incorporated programs addressing access to early breast cancer (EBC) diagnosis and treatment [6]. The SP program appears to have had a significant impact on access to BC care, there remains a paucity of data as to whether the program has yet impacted the incidence and mortality of BC [10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
