In Zambia, women with breast symptoms travel through multiple levels of the healthcare system before obtaining a definitive diagnosis. To eradicate this critical barrier to care, we nested a novel breast specialty service platform inside a large public‐sector primary healthcare facility in Lusaka, Zambia to offer clinical breast examination, breast ultrasound, and ultrasound‐guided core needle biopsy in a one‐stop format, tightly linked to referral for treatment. The objective of the study was to determine the life expectancy and survival outcomes of a prospective cohort of women diagnosed with breast cancer who were attended to and followed up at the clinic. The effect of breast cancer stage on prognosis was determined by estimating stage‐specific crude survival using the Kaplan–Meier method. Survival analysis was used to estimate mean lifespan according to age and stage at diagnosis. We enrolled 302 women with histologically confirmed breast cancer. The overall 3‐year survival was 73%. An increase in patients presenting with early breast cancer and improvements in their survival were observed. Women with early‐stage breast cancer had a lifespan similar to the general population, while loss of life expectancy was significant at more advanced stages of disease. Our findings suggest that implementing efficient breast care services at the primary care level can avert a substantial proportion of breast cancer‐related deaths. The mitigating factor appears to be stage of disease at the time of diagnosis, the cause of which is multifactorial, with the most influential being delays in the referral process.

中文翻译：

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撒哈拉以南非洲赞比亚初级保健医疗机构内的一站式乳腺保健诊所就诊的乳腺癌患者的三年生存率

在赞比亚，有乳房症状的女性在获得明确诊断之前要经过多个级别的医疗保健系统。为了消除这一关键的护理障碍，我们在赞比亚卢萨卡的一家大型公共部门初级医疗机构内建立了一个新型乳腺专科服务平台，一站式提供临床乳腺检查、乳腺超声检查和超声引导的空心针活检格式，与转诊治疗紧密相关。该研究的目的是确定在诊所接受治疗和随访的被诊断患有乳腺癌的前瞻性女性群体的预期寿命和生存结果。乳腺癌分期对预后的影响是通过使用 Kaplan-Meier 方法估计分期特异性粗生存率来确定的。生存分析用于根据诊断时的年龄和阶段来估计平均寿命。我们招募了 302 名经组织学证实患有乳腺癌的女性。总体 3 年生存率为 73%。观察到早期乳腺癌患者的增加和生存率的提高。患有早期乳腺癌的女性的寿命与普通人群相似，而在疾病晚期，预期寿命的缩短则显着。我们的研究结果表明，在初级保健层面实施有效的乳房护理服务可以避免很大一部分乳腺癌相关死亡。缓解因素似乎是诊断时的疾病阶段，其原因是多因素的，其中影响最大的是转诊过程的延误。