In Mexico, women can wait between five and eight months to obtain a diagnosis of breast cancer, a time four times longer than the World Health Organization (WHO) standard, which recommends a maximum of 60 days, and a quality index seeks to reduce that time.
Shortening the period in question and guaranteeing quality diagnoses are the priorities of the Health sector in the country, said this Thursday Yanin Chávarri Guerra, medical oncologist and researcher at the Salvador Zubirán National Institute of Medical Sciences and Nutrition, belonging to the Ministry of Health.
During the meeting “Breast Cancer Quality Index: metrics that guide, voices that lead, action that happens”, at the close of the breast cancer awareness month, the specialist explained that delays are due to both personal and institutional barriers.
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“The most recent measurements, made by Dr. Karla Unger in different hospitals, show times of five to eight months. A third is due to the fear or lack of knowledge of the patients; the rest, to the saturation and fragmentation of the system. Many women go from one doctor to another, repeat studies or miss appointments due to administrative procedures,” the researcher explained.
Chávarri pointed out that the Breast Cancer Care Quality Index (BCCQI), promoted by the WHO, offers a concrete tool to reverse this panorama, by evaluating the entire process: early detection, timely diagnosis, adherence to treatment and resilience of the system. “What is measured can be improved; and measuring the quality of the process saves lives,” he said.
One of the goals of the BCCQI is for more than 80% of patients to complete their treatment, which requires addressing the daily factors that keep them away from hospitals.
“Transportation, childcare or lack of information are real barriers. Patient navigation programs – which accompany women from suspicion to recovery – have been shown to improve adherence,” explained the oncologist.
Chávarri also called for strengthening the quality of imaging studies. “It is not enough to have a mammogram or an ultrasound; we need good radiologists, accurate reports and clear communication to act in time,” he said.
Younger and more personalized diagnosis
Mexico faces a particular phenomenon: breast cancer is diagnosed a decade earlier than in high-income countries. “While in other regions the average is 60 years old, here it is 50 to 52. We have a younger population with more genetic alterations, so we must adapt our detection strategies,” said the specialist.
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In high-risk women, protocols change. “We start surveillance from the age of twenty-five with magnetic resonance imaging, and from age 30 or 35 we add mammography. There are also new mammograms with contrast that allow us to better see the tissue in dense breasts. It is not about doing more studies, but about doing the right ones,” Chávarri said.
Regarding hormonal factors, he warned that the use of combined contraceptives carries a slightly increased risk, although “the clearest effect is observed in prolonged hormone replacement therapies.” On the other hand, fertility treatments “do not show an association” with increased risk, according to international studies.
The specialist added that genetic tests should not be applied indiscriminately. “In Mexico, access is still limited, so we have to ask for them from those who benefit the most. We have alliances with institutions and the industry to bring them closer to eligible patients; they are few, but without them many women would not have access.”
With information from EFE.
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