Breast cancer : do the current policies mean anything?

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dc.contributor.author Botha, Susan
dc.contributor.author Ledibane, Neo R.T.
dc.contributor.author Dreosti, Lydia M.
dc.date.accessioned 2024-11-04T10:27:46Z
dc.date.available 2024-11-04T10:27:46Z
dc.date.issued 2024-10
dc.description.abstract AIM : Breast cancer remains one of the most prevalent malignancies globally with a high mortality rate. South Africa has a number of policies in place designed to ensure that minimum delays are experienced by patients from first symptom to initial treatment. This study was initiated to determine where the longest delays occurred during the patient's journey, from the first symptom to the first treatment. This information, combined with the existing policy, identifies shortfalls in the breast cancer diagnostic and treatment pathways that must be addressed. METHODS : A cross-sectional study was undertaken in the Department of Medical Oncology, University of Pretoria/Steve Biko Academic Hospital between April 2020 and August 2021, analysing six timelines from first symptom to first treatment in patients with newly diagnosed breast cancer. Data was obtained by the researchers from the patients on their first visit relating to the delays experienced from first symptom to final biopsy. Clinical information was obtained from the patients' source records once a treatment decision had been reached and treatment started where applicable. RESULTS : The longest delays experienced were between the patients' first visit to any medical facility to date of diagnostic biopsy. Delays due to COVID-19 were in the minority with 13/79 (16.4%) patients reporting having experienced COVID-19 related delays. Key Area 2 of the Breast Cancer Prevention and Control Policy makes provision for patients to be referred directly to a regional/tertiary/quaternary medical facility for further screening, diagnosis and treatment within 21-60 days from the first visit. In the study's cohort, a mean of four months from first visit to diagnostic biopsy was recorded. Overall delays of longer than 12 months due to non-representative biopsies (range 1-3) were recorded in three patients. Twenty-nine patients (36.7%) presented to three medical facilities prior to diagnostic biopsy with 10/79 (12.6%) and 1/79 (1.2%) presenting to four and five institutions, respectively, before the diagnostic biopsy. CONCLUSIONS : The delays patients experienced highlights the lack of knowledge about the urgency and correct referral of suspected malignancy cases. Despite the number of promulgated policies relating to fast track systems via specialist breast units, fiscal and human capital deficiencies negatively impact the attempts to diagnose and treat patients timeously and increase survival. en_US
dc.description.department Medical Oncology en_US
dc.description.department School of Health Systems and Public Health (SHSPH) en_US
dc.description.librarian hj2024 en_US
dc.description.sdg SDG-03:Good heatlh and well-being en_US
dc.description.uri http://www.journals.co.za/content/journal/healthr en_US
dc.identifier.citation Botha, S., Ledibane, N.R.T. & Dreosti, L.M. Breast cancer: do the current policies mean anything? South African Health Review. 2024; 26. doi: 10.61473/001c.120241 en_US
dc.identifier.issn 1025-1715
dc.identifier.other 10.61473/001c.120241
dc.identifier.uri http://hdl.handle.net/2263/98902
dc.language.iso en en_US
dc.publisher Health Systems Trust en_US
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CCBY-NC-4.0). en_US
dc.subject Breast cancer en_US
dc.subject Diagnosis en_US
dc.subject Treatment en_US
dc.subject Delays en_US
dc.subject Policy en_US
dc.subject SDG-03: Good health and well-being en_US
dc.title Breast cancer : do the current policies mean anything? en_US
dc.type Article en_US


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