Abstract

BackgroundBreast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983. In 2002 the urgency of the situation prompted Maharaj Nakorn Chiang Mai Hospital to initiate the Suandok Breast Cancer Network (SBCN).MethodsThe SBCN is a not-for-profit organization in the university hospital which serves as a training and education center and provides highly specialized medical care for patients in Chiang Mai and in 5 provinces of northern Thailand, with the key mission of improving breast cancer care. The short-term goal was to overcome the barriers to engagement with breast cancer and its treatment and the long-term goal was to increase the overall survival rate of breast cancer patients in our region.ResultsWe enrolled breast cancer patients treated at Maharaj Nakorn Chiang Mai Hospital between January 2006 and December 2015 and divided into 2 cohorts: 1485 patients who were diagnosed from 2006 to 2009 (cohort 1: early implementation of SBCN) and 2383 patients who were diagnosed from 2010 to 2015 (cohort 2: full implementation of SBCN). Criteria to measure improved cancer waiting time (CWT) would include: time to diagnosis, time to surgery, and time to radiotherapy. The 5-year overall survival (OS) of the cohort 2 was higher than that in cohort 1, at 73.8 (72.0–75.5) compared to 71.5 (69.2–73.7) (p-value = 0.03).ConclusionsReasons behind the success of project include the uniformity of care encouragement, service network development and timely access to each step of breast cancer management. The model used in SBCN could be adopted as a learning guide to improve healthcare access and outcome for breast cancer patients in low- to middle-income countries.

Highlights

  • Breast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983

  • Full list of author information is available at the end of the article

  • Trends of breast cancer were studied in Chiang Mai population and it was found that the incidence rates increased from an age-standardized incidence rate (ASR) of 14.8 per 100,000 women-years in 1989 to 32.9 cases per 100,000 women-years in 2013 and were projected to increase to 36.7 per 100,000 women-years in 2024 [3]

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Summary

Introduction

Breast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983. Chitapanarux et al BMC Cancer (2022) 22:26 in 2020, and there was an approximate mortality rate with ASR of 7.6 per 100,000 in 2016 [2]. This pattern is reflected in the Northern part of the country including Chiang Mai province. Trends of breast cancer were studied in Chiang Mai population and it was found that the incidence rates increased from an ASR of 14.8 per 100,000 women-years in 1989 to 32.9 cases per 100,000 women-years in 2013 and were projected to increase to 36.7 per 100,000 women-years in 2024 [3]. The difficulty lies in the fact that there are no definitive practice guidelines in the processes of surgery, radiotherapy and systemic medications in Northern Thailand

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