The access rate to diagnosis and treatment modalities in breast cancer patients in Turkey; multicenter observational study.

PURPOSE: To determine the time elapsed between the first notification of the disease and the access to the diagnosis and treatment modalities and the associated factors in female patients with breast cancer in Turkey. METHODS: Data was acquired from a questionnaire involving 535 patients who applied to 14 various oncology clinics in Turkey between 1st and 28th of February 2010. Analyses were performed by the participating clinics and were divided into 3 groups: centers located in metropolitan areas formed group 1 (n=161), those located in Marmara and central Anatolia region formed group 2 (n=189), and centers located in Karadeniz and East-Southeast Anatolia region formed group 3 (n=185). The groups of these centers were formed according to the socioeconomic development of the provinces. RESULTS: The median patient age was 48 years, 56.1% of patients were less than 50 years of age. Eighty-five percent of the patients detected a mass in their breast by self examination and 27% of the patients older than 50 years never had breast imaging until the definite diagnosis was established. The median time elapsed between disease noticed by the patient and application to a health care center was 10 days, between application and biopsy 19 days, between biopsy and surgery 10 days, and between surgery and systemic therapy 31 days. The median time elapsed between patients applying for surgery in groups 1 and 2 centers was 11 and 21 days, respectively (p=0.01). The median time elapsed between biopsy and surgery in groups 1,2 and 3 centers was 14,1.5, and 12 days, respectively (p<0.05). CONCLUSION: A high level of awareness regarding breast cancer in our country is related with the time that is defined as 10 days between disease recognition and medical application. The time elapsed between the application and biopsy, surgery and systemic therapy was longer compared with the corresponding figures in developed countries.

The prognostic value of thrombocytosis in newly diagnosed lung cancer patients: a retrospective analysis.

PURPOSE: The importance of thrombocyte count as a prognostic factor has not been adequately investigated in patients with lung cancer. We retrospectively examined the value of thrombocytosis as a prognostic factor and investigated its relationship with other clinicopathologic factors and survival. METHODS: The medical records of 260 patients with lung cancer were reviewed. Pretreatment thrombocyte count, histopathological diagnosis, disease stage, gender, age, performance status (PS), thrombotic episodes, weight loss and paraneoplastic syndromes were recorded. Overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS) were evaluated in all patient subgroups. Thrombocytosis was defined as platelet count >400,000/µl. We assessed statistically the possible correlation between thrombocytosis, other clinicopathologic factors and survival parameters. A two-sided p value < 0.05 was considered significant. RESULTS: There were no statistically significant differences between histological subgroups (small cell/SCLC and non-small cell/NSCLC) according to age, disease stage and gender. Sixty-six (25.38%) patients had thrombocytosis before starting treatment. We found no relationship between thrombocytosis and disease stage, gender, age, PS and thrombotic episodes. Thrombocytosis was significantly correlated only with weight loss (p=0.011) and paraneoplastic syndromes (p=0.027). OS was shorter in the thrombocytosis group, but without statistical significance. PFS and DFS did not differ between thrombocytemic and non-thrombocytemic patients. CONCLUSION: Pretreatment thrombocytosis is not an independent prognostic factor of survival in lung cancer patients and is related with paraneoplastic syndromes.