背景:叙利亚长达十年的战争严重影响了医疗保健系统,包括几乎消失的癌症筛查实践,被战争摧毁的医疗设施,缺乏持续的医学教育。这项研究旨在提供有关受影响的乳腺癌筛查实践的数据,诊断方法,在叙利亚分阶段分配。
方法:回顾性分析了2019年1月至2022年5月在Albairouni大学医院接受治疗的乳腺癌患者的病历。符合条件的患者为诊断为原发性乳腺癌的女性。排除标准包括接受新辅助化疗的女性和不完整的图表。有关患者年龄的数据,居住城市,婚姻状况,儿童数量,吸烟习惯,诊断方法,肿瘤大小(T),淋巴结(N),收集远端转移(M)。我们使用MicrosoftExcel和社会科学统计软件包(SPSS)来分析数据。描述性方法论(频率[n],百分比)被使用。
结果:审查的图表数量为4,500。应用排除标准后的剩余图表数量为2,367张。平均年龄为51.8(SD=11.3)。超过一半的患者(58.3%)来自大马士革以外的医院及其郊区。不到5%的人群通过筛查乳房X线照相术检测到癌症。只有32.4%的患者通过活检确诊,而外科手术(乳房肿瘤切除术和乳房切除术)用于诊断64.8%的人口。在诊断的时候,只有8%的患者出现局部阶段疾病(0期和I期),73%患有区域性疾病(II期和III期),19%患有转移性乳腺癌(IV期)。
结论:我们的回顾性图表回顾分析是叙利亚首次针对女性乳腺癌患者的综合综述。我们发现,根据筛查乳房X光检查确诊的患者比例明显较低,更高的手术活检,而不是简单的成像引导活检,远低于全国早期疾病的平均水平。我们令人震惊的发现可以作为未来战略的基础,以提高人们的健康意识,开展更严肃的全国性筛查活动,并对叙利亚的疾病采取多学科的方法。
BACKGROUND: The Syrian decade-long war has severely affected the healthcare system, including almost vanishing cancer screening practices, war-destroyed medical facilities, and lack of continuous medical education. This study aims to present data on the affected breast cancer screening practices, methods of diagnosis, and stages distribution in Syria.
METHODS: Medical charts of breast cancer patients treated at Albairouni University Hospital between January 2019 and May 2022 were retrospectively reviewed. Eligible patients were women diagnosed with primary breast cancer. Exclusion criteria included females receiving neoadjuvant chemotherapy and incomplete charts. Data regarding the patient\'s age, city of residence, marital status, number of children, smoking habits, method of diagnosis, tumor size (T), lymph nodes (N), and distal metastasis (M) were collected. We used Microsoft Excel and Statistical Package for the Social Sciences (SPSS) to analyze data. Descriptive methodology (frequency [n], percentage) was used.
RESULTS: The number of charts reviewed was 4,500. The number of remaining charts after applying the exclusion criteria was 2,367. The mean age was 51.8 (SD = 11.3). More than half of the patients (58.3%) came from outside Damascus -where the hospital is located- and its suburbs. Less than 5% of the population detected cancer by screening mammography. Only 32.4% of patients were diagnosed by a biopsy, while surgical procedures (lumpectomy and mastectomy) were used to diagnose 64.8% of the population. At the time of diagnosis, only 8% of patients presented with local-stage disease (stages 0 & I), 73% had a regional disease (stages II & III), and 19% had metastatic breast cancer (stage IV).
CONCLUSIONS: Our retrospective chart review analysis is the first comprehensive review in Syria for female breast cancer patients. We found a significant low percentage of patients diagnosed based on a screening mammogram, much higher surgical biopsies rather than a simple imaging-guided biopsy, and much lower than the national average of early-stage disease. Our alarming findings can serve as the base for future strategies to raise the population\'s health awareness, create more serious national screening campaigns, and adopt a multidisciplinary approach to the disease in Syria.