Breast Cancer, Invasive Breast Carcinoma
Conditions
Keywords
Breast cancer, Diagnostic delay, Time-to-treatment, Patient pathway, Behavioral economics
Brief summary
Women in the Hauts-de-France region show higher breast cancer mortality despite no overall higher incidence, suggesting differences in the care pathway. This multicenter study will describe the overall time from the first warning sign to initiation of the first treatment, and will break down this delay into three consecutive intervals (symptoms to mammography, mammography to biopsy, biopsy to first treatment). Participants will complete a one-time questionnaire (up to 1 hour, with assistance if needed), and clinical data will be extracted in a standardized way from medical records (key dates and tumor characteristics). A random sample of 10% of incident breast cancer cases identified by each hospital information department will be used to ensure balanced geographic representation across 38 centers. The study will also explore how individual and contextual factors (psychological, behavioral, socio-demographic, access to care, communication) are associated with each time interval, and exploratory analyses will assess links with severity (metastases and prognostic score).
Interventions
None listed
Sponsors
University Hospital, Lille
Université de Lille
Breast Cancer Research Foundation
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female, age ≥ 18 years. * Confirmed invasive breast carcinoma. * Diagnosis in 2024 (and/or \< 12 months at inclusion depending on center organization). * Affiliated with the French social security system. * Resident of Hauts-de-France since diagnosis. * Information provided and non-opposition documented (MR-003).
Exclusion criteria
* Male breast cancer. * Other histologies (phyllodes tumor, sarcoma, lymphoma). * Pure ductal carcinoma in situ (in situ only). * Personal history of breast cancer (including in situ). * Non-French-speaking. * Person deprived of liberty.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total time from first warning sign to initiation of first treatment. | One-time assessment using patient-reported dates and medical record dates at inclusion (single questionnaire session + record extraction). Questionnaire time : around 1 hour |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time from first warning sign to first mammography | At inclusion, one-time assessment using patient-reported dates and medical record dates. | — |
| Time from mammography to biopsy. | At inclusion, one-time assessment using patient-reported dates and medical record dates. | — |
| Time from biopsy to initiation of first treatment. | At inclusion, one-time assessment using patient-reported dates and medical record dates. | — |
| To evaluate breast cancer severity at diagnostic. Severity will be assessed by the presence of metastatic disease at diagnosis, recorded as a binary outcome (yes/no) indicating the rate of metastatic at diagnosis | At inclusion, assessed from medical record extraction. | — |
| To evaluate patients with localized breast cancer, by pronosis estimated using the PREDIC Breast tool. | At inclusion, calculated using clinical variables extracted from the medical record | Pronosis will be reported as 5-year and 10 year estimated survival probabilities, calculated from clinical variables extrected from the medical record at inclusion and expressed on a 0 to 100 % scale, with higher values indicating a better predicted outcome. |
Countries
France
Outcome results
None listed