title: [Delays in treatment of breast cancer: experience of an expert center of the Assistance Publique-Hôpitaux de Paris (AP-HP)].
abstract: OBJECTIVE
  The National Institute of the Cancer (INCA) recently published a study over the deadlines of medical care of breast cancers. We compared our delay within the framework of our expert center with their results.
  
  
  METHODS
  Our work is a retrospective unicentric non-interventional study. We included all the patients taken care for a breast cancer to the hospital Tenon in Paris. The criteria of inclusion were a primitive breast cancer, having accepted a care for a first cancer operated over a period of three months. We recovered 9 key deadlines to study the care of our patients.
  
  
  RESULTS
  Sixty-six patients were included. The mean age was of 55.6 years. The deadline of access to the hospital Tenon was 8.7 ± 7.7 days for the meetings of gynecology and 4.3 ± 4 days for those of radiology. The deadline of access to the diagnosis was 31.8 ± 26 days. The deadlines of access to the meeting of multidisciplinary dialogue pre-therapeutic was 13 ± 11 days. The access to the first management time was 18.5 days for the neoadjuvant chemotherapy and 13.5 days for surgery. The deadline of access to the postoperative therapeutic proposal was on average 20 ± 8 days. The deadline of access to the postoperative radiotherapy was of 197 days in case of postoperative chemotherapy vs 47.5 days without chemotherapy. The global deadline mammography-radiotherapy was of 188 days.
  
  
  CONCLUSIONS
  The deadline of access to the diagnosis, to the postoperative therapeutic proposal and the global deadline mammography-radiotherapy with adjuvant chemotherapy or neoadjuvant were longer in our center compared with the results of the INCA. The deadlines of access to the surgery and access to the radiotherapy without postoperative chemotherapy were shorter on the other hand. The contribution of the diagnosis in one day for breast cancer is probably going to allow us to improve the deadlines of care in our structure.
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France. Electronic address: aurelie.revaux@tnn.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Revaux
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Laas
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de radiologie, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Chopier
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de radiologie, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service d'oncologie radiothérapie, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Touboul
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service d'anatomo-pathologie, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Antoine
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service d'oncologie médicale, université Pierre-et-Marie-Curie, Paris 6, institut universitaire de cancérologie, hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Gligorov
authors.affiliation: Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Unité Inserm UMRS 938, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France. Electronic address: emile.darai@tnn.aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Darai
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010297:Paris; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013997:Time Factors
keywords: Breast cancer; Cancer du sein; Delay; Délai; Prise en charge; Target wait time