ABSTRACT
Objetivo. Evaluar la calidad de la asistencia prestada a los pacientes con cáncer de mama en los hospitales públicos de Castilla y León (Sacyl). Material y métodos. La recogida de datos se realizó a través de una encuesta de criterios de calidad avalados por EUSOMA, enviada a hospitales del Sacyl, con un total de 1.235 pacientes diagnosticadas de cáncer de mama en el 2011. Resultados. El 81,81% de los criterios se cumplen. El 90% recibe tratamiento antes de 6 semanas del diagnóstico. En el tratamiento quirúrgico, radioterápico y sistémico, se cumplen criterios de calidad. Sin embargo, hay (se realizan) demasiadas exéresis quirúrgicas en afección benigna; el 87% de los casos se llevan a comité de tumores; excesivo seguimiento en pacientes asintomáticas y excesivo estudio de extensión. Conclusión. Aunque la asistencia prestada supera la mayoría de los criterios de calidad, se han identificado aspectos a mejorar para lograr un mejor rendimiento de nuestros recursos (AU)
Objectives. To assess the quality of care provided to breast cancer patients in the public hospitals of Castile-Leon. Material and methods. Data collection was carried out through a survey on quality criteria endorsed by the European Society of Breast Cancer Specialists (EUSOMA), which was sent to the public hospitals in Castile-Leon. A total of 1235 patients diagnosed with breast cancer in 2011 participated in the survey. Results. A total of 81.81% of criteria were achieved. Ninety percent of patients received treatment within 6 weeks of diagnosis. Surgical, radiotherapeutic, and systemic treatment complied with quality criteria. However, too many surgical excisions were performed in benign disease. The cases of 87% of cancer patients were discussed by a multidisciplinary team. There was excessive follow-up in asymptomatic patients and excessive study of tumoral extension. Conclusion. Although the healthcare provided exceeded most quality criteria, we identified areas that could be improved to achieve more efficient resource use (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Breast Neoplasms/epidemiology , Breast Neoplasms/prevention & control , Quality of Health Care/statistics & numerical data , Indicators of Quality of Life , Health Status Indicators , Hospitals, Public/organization & administration , Hospitals, Public/statistics & numerical data , Hospitals, PublicABSTRACT
Presentamos el caso de una mujer de 74 años con una lesión vulvar asociada a prurito vulvar, de 2 años de evolución. La paciente ha sido tratada con múltiples tratamiento tópicos y, por persistencia de la lesión y sintomatología, fue derivada a nuestra consulta. Se realiza una biopsia de la lesión y corresponde a una neoplasia vulvar intraepitelial diferenciada. El tratamiento inicial fue una escisión amplia, con el hallazgo anatomopatológico de carcinoma oculta escamoso de vulva. Posteriormente, se realiza una vulvectomía radical con biopsia selectiva de ganglio centinela, confirmando el diagnóstico de carcinoma epidermoide vulva estadio i B (AU)
We present the case of a 74-year-old woman with a 2-year history of a vulvar lesion associated with pruritus. The patient was treated with multiple topical treatments but, due to the persistence of the lesion and symptoms, she was referred to our clinic. The results of biopsy of the lesion corresponded to differentiated vulvar intraepithelial neoplasia. The initial treatment was wide local excision, with the pathological finding of occult differentiated squamous carcinoma of the vulva. The lesion was treated surgically through radical vulvectomy with sentinel node biopsy, which confirmed the diagnosis of stage IB squamous vulvar carcinoma (AU)
Subject(s)
Humans , Female , Aged , Vulvar Neoplasms/complications , Vulvar Neoplasms/diagnosis , Vulvar Neoplasms/surgery , Carcinoma/complications , Carcinoma/diagnosis , Carcinoma in Situ/complications , Carcinoma in Situ/diagnosis , Carcinoma in Situ/surgery , Carcinoma/surgery , Carcinoma , Carcinoma in Situ , Pruritus/complications , Pruritus/diagnosis , Pruritus/drug therapy , Biopsy , Informed Consent/standardsABSTRACT
Objetivos: Analizar si el programa de cribado del cáncer de mama en la provincia de Segovia ha supuesto una mejora en la supervivencia en la población afecta por este tumor. Objetivo secundario: analizar la magnitud de esta mejora a los 5, 10 y 15 años de seguimiento. Material y métodos: Estudio retrospectivo descriptivo, analiza la supervivencia de 253 pacientes diagnosticadas de cáncer de mama por el programa de cribado (desde 1992-2007) y la supervivencia de 312 diagnosticadas a través del marco asistencial habitual, todas ellas tratadas en el Hospital General de Segovia. Resultados: La supervivencia en el grupo de cribado es netamente superior a la del grupo de diagnóstico clínico, siendo la diferencia ma ́s marcada a medida que aumenta el seguimiento: 93% vs 78% a los 5 años; 89% vs 68% a los 10 años; 86% vs 56% a los 15 años. Conclusiones: Se ha conseguido mejorar la supervivencia desde la puesta en marcha del programa de cribado, especialmente se observa a los 15 años de seguimiento, una diferencia del 30% (AU)
Objectives: To analyze whether the program for breast cancer screening in the Spanish province of Segovia has increased the survival rate among the population with this disease. Secondary objective: to analyze the magnitude of this improvement at 5, 10 and 15 years of follow-up. Materials and methods: We performed a descriptive, retrospective study that analyzed the survival rates in 253 patients diagnosed with breast cancer by the breast cancer screening program (1992-2007), as well as survival in 312 patients, diagnosed in routine clinical practice. All patients were treated in the General Hospital of Segovia. Results: The survival rate in the screening group was clearly higher than that in the group diagnosed in routine clinical practice. This difference was more marked with increasing follow- up: 93% vs 78% at 5 years, 89% vs 68% at 10 years and 86% vs 56% at 15 years. Conclusions: Survival has improved since the start of the screening program. This increase was especially marked in the 15 years of follow-up, representing a difference of 30% (AU)
Subject(s)
Female , Humans , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Survivorship/psychology , Mass Screening/methods , Therapeutics/methods , Retrospective Studies , Breast Neoplasms/rehabilitation , Breast Neoplasms/therapy , Survivorship/physiology , Mass Screening/analysis , Kaplan-Meier Estimate , Therapeutics/instrumentation , Epidemiology, DescriptiveABSTRACT
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