Browsing by Author "Sánchez, C."
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- ItemBreast cancer and pregnancy: A comparative analysis of a Chilean cohort(2014) Sánchez, C.; Acevedo Claros, Francisco Nicolás; Medina, L.; Ibáñez, C.; Razmilic Valdés, Dravna Nichi; Navarro Ortega, María Elena; Camus, M.Introduction: Recent reports show that pregnancy-associated breast cancer (PABC) survival is similar to that of non-pregnant young patients. We evaluate the characteristics and prognosis of PABC patients treated in our cancer centre. Patients and methods: We identified patients with invasive PABC who were treated between 1999 and May 2013 and compared their characteristics with a no PABC cohort of similar age. Results: The prevalence of PABC was 1% (n = 17). The median age was 35 years (range: 29– 42 years). The initial tumour was suspected clinically in 93% of the cases. Total mastectomy rates were higher in women with PABC (78.6% versus 40.5%, p = 0.02), and more tumours in the PABC group were triple negative, epidermal growth factor type 2 (HER2)–positive, and at advanced stages; however, these differences were not statistically significant. While estimated overall survival at ten years was higher in the non-PABC group (75.5% versus 80.5%, p = 0.043), disease-specific survival (DSS) rate at ten years was not statistically different between groups (83.9% for PABC and 75.5% for unrelated pregnancy BC, p = 0.37). Conclusions: PABC is a rare event. In our cohort, it tended to be more aggressive. Compared with a similar age cohort, the DSS was not worse.
- ItemBreast Cancer Screening in Latin America: The Challenge to Move from Opportunistic to Organized-Systematic Screening(2023) Puschel Illanes, Klaus; Paz, S.; Rioseco Castillo, Andrea; Fowler, M.; Vescovic, Z.; Fuentes, I.; Sánchez, C.; Acevedo Claros, Francisco NicolasBackground: Breast cancer is the leading cause of death from cancer among women in Latin America. Most Latin American countries started national mammogram screening programs a decade ago. The implementation level and effects of screening programs in Latin America have not been evaluated. Aim: To evaluate the association between screening programs implementation and breast cancer mortality in selected North American and European countries compared to a group of Latin American countries with national screening programs. Methods: The study applied an ecological design with secondary data from official national and international sources. Join point regression analysis was conducted to describe the trends in mortality rates in a group of five Latin American countries (Brazil, Chile, Colombia, Costa Rica and Mexico) with five Non-Latin American countries (Canada, Spain, Sweden, United Kingdom and the United States of America). The association between screening and mortality rates was explored using correlation and linear regression. National cancer plans were assessed to describe screening strategies among selected countries. Results: A significant reduction in standardized breast cancer mortality rates was observed in all Non-Latin American countries with an Average Annual Percent Change (AAPC) of -2.00 (p<.05, 95%CI [-3.33, -0.70]) for the period 2010-2020. In contrast, Latin American countries reported a significant increase in the AAPC of +1.38 (p<.05, 95%CI [0.86,1.76]) in breast cancer mortality rates for the period 2010-2020. For Latin American countries, with screening rates below 50%, there was no correlation between screening and mortality rates for the period 1985-2020 (r = -0.17, p = .78). For non-Latin American countries, with screening rates over 70%, the linear regression model explained significantly 55% of the variance in mortality rates (R2aj =.55, F (5,14) = 5.69, p = .005), with a negative and significant effect of mammogram screening on mortality rates (β = -0.14, p = .01). The National Plans analysis revealed an opportunistic screening model for Latin American countries and an organized-systematic model in Non-Latin American countries. Conclusion: There is an association between the level of implementation of screening programs and mortality rates from breast cancer. Latin American countries should transform their opportunistic strategy into an organized-systematic model.
- ItemPrevalence of emotional symptoms in Chilean oncology patients before the start of chemotherapy: Potential of the distress thermometer as an ultra-brief screening instrument(2014) Calderón, J.; Campla, C.; D'Aguzan, N.; Barraza, S.; Padilla, O.; Sánchez, C.; Palma, S.; González, M.Emotional distress (ED) is greater for oncology patients in comparison with the general population, and this has implications for the quality of life of the patient and his/her family, adherence to the treatment, and eventually, survivorship. In general, the detection of these symptoms is low, which explains the need for detection systems appropriate to the clinical reality of the oncology team. The objective of this study is to evaluate for the first time the usefulness of an ultra-brief screening instrument [distress thermometer (DT)], in a group of Chilean oncology patients. A total of 166 outpatients were evaluated at the Cancer Center of the Pontificia Universidad Católica de Chile, before starting chemotherapy. Two screening instruments were applied: Hospital Anxiety and Depression Scale (HADS) and DT. The application of HADS resulted in a prevalence of 32.7% of anxiety symptoms (HADS-A ≥ 8), 15.7% of depression symptoms (HADS-D ≥ 8), and 39.8% had a total score of HADS-T ≥ 11. The DT resulted in the prevalence of 32.5% of distress or ED (DT ≥ 5). The validity of the DT was evaluated as a screening tool in comparison with HADS, observing, in relation to the anxiety scale (HADS-A), a sensitivity of 88.9% and specificity of 78.4% (DT ≥ 4); depression (HADS-D), a sensitivity of 69.2% and specificity of 74.3% (DT ≥ 5); and in relation to the total scale (HADS-T), a sensitivity of 68.2% and specificity of 73.0% (DT ≥ 4). This study demonstrates the elevated prevalence of emotional symptoms in Chilean oncology patients, before the start of chemotherapy, and confirms the potential of the DT as a brief screening instrument with easy application. The DT will allow the clinician to increase the detection threshold in the Chilean oncology population, intervene in a timely manner, and contribute to the comprehensive handling of the oncology patient without affecting the time needed for assistance.
- ItemUltrathin Bronchoscopy with and without Virtual Bronchoscopic Navigation : Influence of Segmentation on Diagnostic Yield(2019) Diez Ferrer, M.; Morales, Arturo; Tebe, C.; Cubero, N.; López Lisbona, R.; Padrones, S.; Aso, S.; Dorca, J.; Gil, D.; Rosell, A.; Minchole, E.; Zaccour, A. B.; Tazi, R.; Sánchez, C.; Borras, A.; Esteban-Lansaque, A.