Delay in diagnosis of breast cancer
Delay in diagnosis of breast cancer
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DOI：
10.1097/00000658-199901000-00012
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发表时间：
1999-01-01
影响因子：
9
通讯作者：
Bernstein, JL
中科院分区：
文献类型：
--
作者：
Tartter, PI;Pace, D;Bernstein, JL
目的通过比较延迟和不延迟患者的分期、治疗和结局，评估医生延迟诊断乳腺癌的后果，摘要背景信息乳腺癌诊断延迟是导致医疗事故诉讼的最常见的临床情况。方法回顾1014例患者的记录，在诊断之前进行了重建。606例患者可准确评估医生延误诊断，51例（8%）医生延误>3个月。延迟的患者在年龄，身高，体重，初潮年龄，怀孕，儿童，绝经比例，绝经年龄和乳腺癌家族史方面与未延迟的患者相当。结果36%的患者诊断延迟，乳房X线检查正常，而未延迟的患者仅为7%。延迟的患者的癌症显着大于平均比那些没有延迟，但有没有显着差异的病理，分化，淋巴结状态，TNM分期，治疗，或outcome.Conclusions医生延迟诊断乳腺癌是常见的，延迟的患者是类似的患者没有延迟，虽然他们更有可能有正常的乳房X线照片。医生延误在诊断、治疗和结局阶段的后果无统计学意义。
Objectives To assess the consequences of physician delay in the diagnosis of breast cancer by comparing stage, treatment, and outcome of patients with and without delay, and to identify patient characteristics that may make diagnosis more difficult.Summary Background Information Delay in diagnosis of breast cancer is the most common clinical scenario resulting in malpractice litigation.Methods The records of 1014 patients were reviewed and the events preceding the diagnosis were reconstructed. Accurate assessment of the physician delay in diagnosis could be made for 606 patients, 51 (8%) with physician delay >3 months. Patients with delay were comparable to patients without delay in terms of age, height, weight, age at menarche, pregnancies, children, proportion in menopause, age at menopause, and family history of breast cancer.Results Thirty-six percent of patients who had a delay in diagnosis had normal mammograms versus 7% of patients without delay. Cancers in patients with delay were significantly larger on average than in those without delay, but there were no significant differences in pathology, differentiation, nodal status, TNM stage, treatment, or outcome.Conclusions Physician delay in the diagnosis of breast cancer is common, and patients with delay are similar to patients without delay, although they are more likely to have normal mammograms. The consequences of physician delay in terms of stage at diagnosis, treatment, and outcome were not statistically significant.