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BMC women's health. 2025 Mar 29;25(1):149. doi: 10.1186/s12905-025-03667-6 Q32.42024

Real-world breast cancer treatment patterns and guideline-concordant treatment completion among Malawian women

马拉维妇女乳腺癌的实际治疗模式和指南一致的治疗完成情况 翻译改进

Jennifer Morgan  1, Shekinah Elmore  2, Takondwa Zuze  3, Lusayo Simwinga  3, Richard Nyasosela  4, Precious Makondi  4, Agnes Manda BSc  3, Chifundo Kajombo  4, Anthony Charles  5, Lisa A Carey  2, Maurice Mulenga  3, Katherine Reeder-Hayes  2, Tamiwe Tomoka  3  6

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作者单位

  • 1 Department of Medicine, University of Minnesota, 516 Delaware Street SE, PWB 14-148, Minneapolis, MN, 55455, USA. morg0524@umn.edu.
  • 2 University of North Carolina Lineberger Cancer Center, Chapel Hill, NC, USA.
  • 3 University of North Carolina Project Malawi, Lilongwe, Malawi.
  • 4 Kamuzu Central Hospital, Lilongwe, Malawi.
  • 5 University of North Carolina, Chapel Hill, NC, USA.
  • 6 Kamuzu University of Health Sciences, Blantyre, Malawi.
  • DOI: 10.1186/s12905-025-03667-6 PMID: 40158080

    摘要 Ai翻译

    Purpose: In Sub-Saharan Africa (SSA), resource-stratified guidelines for breast cancer treatment are increasingly recommended, but treatment receipt and outcomes according to these guidelines are underreported. Here, we describe breast cancer treatment patterns by stage and curative-intent guideline-concordant treatment (GCT) receipt among Malawian women.

    Methods: A prospective cohort of breast cancer patients were enrolled from December 2016 to October 2018 at Kamuzu Central Hospital with an assessment of demographics, stage, and treatment received, including neoadjuvant (NAC), adjuvant (AdC) and palliative chemotherapy and breast surgery. Curative-intent GCT was defined as having completed breast surgery and at least 4 cycles of chemotherapy. Overall survival (OS) was calculated using Kaplan Meier methods and odds ratios using logistic regression.

    Results: 91 patients were included, of whom 13 (14%) presented as stage II, 54 (59%) as stage III, and 24 (26%) as stage IV. Curative treatment was recommended for 65 of 91 (71%) patients, of whom 47 (72%) were initiated on NAC, 14 (22%) on upfront breast surgery, and 4 (6%) received no treatment. Only 63% (41/65) of patients received curative-intent GCT as recommended with non-GCT associated with stage III (vs. stage II) disease (OR 0.10 CI (0.01-0.89)), HIV positivity ((OR 0.25 CI (0.06-0.99)) and hormone receptor (HR) negative/HER2 positive subtype ((OR 0.07 CI (0.01-0.49)). Curative-intent GCT was associated with improved OS (44.1 vs. 23.2 months; p = 0.00) compared to non-GCT.

    Conclusion: While curative-intent GCT was associated with improved survival in this Malawian cohort, treatment completion rates were suboptimal. Resource-stratified guidelines must be paired with locally relevant, multilevel implementation strategies to target barriers to treatment completion.

    Keywords: Breast cancer; Malawi; Treatment.

    Keywords:breast cancer treatment; guideline-concordant treatment; Malawian women

    Copyright © BMC women's health. 中文内容为AI机器翻译,仅供参考!

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    期刊名:Bmc womens health

    缩写:BMC WOMENS HEALTH

    ISSN:1472-6874

    e-ISSN:

    IF/分区:2.4/Q3

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    Real-world breast cancer treatment patterns and guideline-concordant treatment completion among Malawian women