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. 2022 Jan 3;22(1):26.
doi: 10.1186/s12885-021-09153-0.

Integration of breast cancer care in a middle-income country: learning from Suandok Breast Cancer Network (SBCN)

Imjai Chitapanarux  1   2   3 , Wimrak Onchan  4   5 , Panchaporn Wongmaneerung  4   6 , Areewan Somwangprasert  4   6 , Nongnuch Bunyoo  4 , Chagkrit Ditsatham  4   6 , Kirati Watcharachan  4   6 , Chaiyut Charoentum  4   7 , Patumrat Sripan  8 , Ausreeya Chumachote  4 , Puttachart Maneesai  4   8
Affiliations

Integration of breast cancer care in a middle-income country: learning from Suandok Breast Cancer Network (SBCN)

Imjai Chitapanarux et al. BMC Cancer. .

Abstract

Background: Breast cancer incidence in Northern Thailand has shown a continuous increase since records began in 1983. In 2002 the urgency of the situation prompted Maharaj Nakorn Chiang Mai Hospital to initiate the Suandok Breast Cancer Network (SBCN).

Methods: The SBCN is a not-for-profit organization in the university hospital which serves as a training and education center and provides highly specialized medical care for patients in Chiang Mai and in 5 provinces of northern Thailand, with the key mission of improving breast cancer care. The short-term goal was to overcome the barriers to engagement with breast cancer and its treatment and the long-term goal was to increase the overall survival rate of breast cancer patients in our region.

Results: We enrolled breast cancer patients treated at Maharaj Nakorn Chiang Mai Hospital between January 2006 and December 2015 and divided into 2 cohorts: 1485 patients who were diagnosed from 2006 to 2009 (cohort 1: early implementation of SBCN) and 2383 patients who were diagnosed from 2010 to 2015 (cohort 2: full implementation of SBCN). Criteria to measure improved cancer waiting time (CWT) would include: time to diagnosis, time to surgery, and time to radiotherapy. The 5-year overall survival (OS) of the cohort 2 was higher than that in cohort 1, at 73.8 (72.0-75.5) compared to 71.5 (69.2-73.7) (p-value = 0.03).

Conclusions: Reasons behind the success of project include the uniformity of care encouragement, service network development and timely access to each step of breast cancer management. The model used in SBCN could be adopted as a learning guide to improve healthcare access and outcome for breast cancer patients in low- to middle-income countries.

Keywords: Breast cancer care; Healthcare access; Overall survival; Service network.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Five-year overall survival (OS) over time at 2 year intervals between 2006 and 2015
Fig. 2
Fig. 2
Five-year overall survival (OS) comparing between two cohorts
See this image and copyright information in PMC

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