title: [Influence of clinical and biographical factors on the delay in starting adjuvant chemotherapy treatment among breast cancer patients].
abstract: OBJECTIVE
  Previous studies have related the delay in starting chemotherapy (>3 months from date of surgery) with worse survival. The study objective is to analyse the delay in the start of chemotherapy and associated biomedical, sociodemographic and cultural factors.
  
  
  METHODS
  A cohort of women operated on for breast cancer, candidates for receiving adjuvant chemotherapy and participants in a clinical trial of non-pharmacological intervention, were surveyed regarding the delay in starting their chemotherapy, measured by the number of days from date of surgery. Differences in function of the clinical and biographical variables were studied.
  
  
  RESULTS
  In 197 women, mean delay was 42.32 (15.29) days; this was associated with tumour stage (i, 40.06 days; ii, 44.76 days; iii, 38.7 days; P=.049), age (≤ 35, 37.36 days; 36-64, 41.49 days; ≥ 65, 52.61 days; P=.007) and occupational situation (active, 36.91 days; unemployed, 45.5 days; pensioner, 40.07 days; housewife, 43.17 days; P=.038). For patients older than 65 years, the delay in starting adjuvant chemotherapy was longer than for those in the 2 lower age groups -less than 35 years, and between 35 and 65 years- (P=.023 and P=.009 respectively). In the multivariate analysis, the variables associated independently with the delay in starting chemotherapy were again age (P=.019), tumour stage (P=.037) and occupational situation (P=.022).
  
  
  CONCLUSIONS
  Patients began receiving adjuvant chemotherapy within the time period (3 months from surgery) defined as appropriate, and during which no evidence exists of worse survival results. Length of delay varied according to age, tumour stage and occupational situation.
authors.affiliation: Servicio de Oncología Médica, Hospital Universitario Puerta del Mar, Cádiz, España. josem.baena.sspa@juntadeandalucia.es
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Baena-Cañada
authors.forename: Petra
authors.initials: P
authors.lastname: Rosado-Varela
authors.forename: Sara
authors.initials: S
authors.lastname: Estalella-Mendoza
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Expósito-Álvarez
authors.forename: Macarena
authors.initials: M
authors.lastname: González-Guerrero
authors.forename: Encarnación
authors.initials: E
authors.lastname: Benítez-Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D009790:Occupations; D010353:Patient Education as Topic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors; D013030:Spain; D013997:Time Factors; D055815:Young Adult