Browsing by Author "Villarreal-Garza, C"

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Barriers in Latin America for the management of locally advanced breast cancer
(Cancer Intellilgence, 2019) Pinto, JA; Pinillos, L; Villarreal-Garza, C; Morante, Z; Villarán, MV; Mejía, G; Caglevic, C; Aguilar, A; Fajardo, W; Usuga, F; Carrasco, M; Rebaza, P; Posada, AM; Tirado-Hurtado, I; Flores, C; Vallejos-Sologuren, CS
Breast cancer (BC) is a highly prevalent malignancy in Latin American women, most cases being diagnosed at locally advanced or metastatic stages when options for cancer care are limited. Despite its label as a public health problem in the region, Latin American BC patients face several barriers in accessing standard of care treatment when compared with patients from developed countries. In this review, we analyse the landscape of the four main identified barriers in the region: i) high burden of locally advanced/advanced BC; ii) inadequate access to medical resources; iii) deficient access to specialised cancer care and iv) insufficient BC research in Latin America. Unfortunately, these barriers represent the main factors associated with the BC poor outcomes seen in the region. Targeted actions should be conducted independently by each country and as a region to overcome these limitations and create an enhanced model of BC care.
Effect of receiving a customizable brochure on breast cancer patients' knowledge about their diagnosis and treatment: A randomized clinical trial
(John Wiley and Sons Inc, 2023) Villarreal-Garza, C; Ferrigno, AS; De-la-Garza-Ramos, C; Vazquez-Juarez, D; Moreno-Jaime, B; Remolina-Bonilla, Y; Segura-Gonzalez, M; Mariscal-Ramirez, I; Perazzo, F; Garnica-Jaliffe, G; Neciosup-Delgado, S; Conde-Flores, E; Mysler, S; Hernandez-Ayala, A; Barajas-Sanchez, A; Rios-Mercado, MDS; Noh-Vazquez, NM; Garcia-Rodriguez, R; Platas, A; Tamez-Salazar, J; Mireles-Aguilar, T; Platas, A
Background: Patients' lack of knowledge about their own disease may function as a barrier to shared decision-making and well-being. This study aimed to evaluate the impact of written educational materials on breast cancer patients. Methods: This multicenter, parallel, unblinded, randomized trial included Latin American women aged ≥18 years with a recent breast cancer diagnosis yet to start systemic therapy. Participants underwent randomization in a 1:1 ratio to receive a customizable or standard educational brochure. The primary objective was accurate identification of molecular subtype. Secondary objectives included identification of clinical stage, treatment options, participation in decision-making, perceived quality of information received, and illness uncertainty. Follow-up occurred at 7–21 and 30–51 days post-randomization. ClinicalTrials.gov identifier: NCT05798312. Results: One hundred sixty-five breast cancer patients with a median age of 53 years and 61 days from diagnosis were included (customizable: 82; standard: 83). At first available assessment, 52%, 48%, and 30% identified their molecular subtype, disease stage, and guideline-endorsed systemic treatment strategy, respectively. Accurate molecular subtype and stage identification were similar between groups. Per multivariate analysis, customizable brochure recipients were more likely to identify their guideline-recommended treatment modalities (OR: 4.20,p = 0.001). There were no differences between groups in the perceived quality of information received or illness uncertainty. Customizable brochure recipients reported increased participation in decision-making (p = 0.042). Conclusions: Over one third of recently diagnosed breast cancer patients are incognizant of their disease characteristics and treatment options. This study demonstrates a need to improve patient education and shows that customizable educational materials increase patients' understanding of recommended systemic therapies according to individual breast cancer characteristics.
Latin America and the Caribbean Code Against Cancer 1st Edition: Medical interventions including hormone replacement therapy and cancer screening
(Elsevier Ltd, 2023) Baena, A; Paolino, M; Villarreal-Garza, C; Torres, G; Delgado, L; Ruiz, R; Canelo-Aybar, C; Song, Y; Feliu, A; Maza, M; Jeronimo, J; Espina, C; Almonte, M
Prostate, breast, colorectal, cervical, and lung cancers are the leading cause of cancer in Latin America and the Caribbean (LAC) accounting for nearly 50% of cancer cases and cancer deaths in the region. Following the IARC Code Against Cancer methodology, a group of Latin American experts evaluated the evidence on several medical interventions to reduce cancer incidence and mortality considering the cancer burden in the region. A recommendation to limit the use of HRT was issued based on the risk associated to develop breast, endometrial, and ovarian cancer and on growing concerns related to the over-the-counter and without prescription sales, which in turn bias estimations on current use in LAC. In alignment with WHO breast and cervical cancer initiatives, biennial screening by clinical breast examination (performed by trained health professionals) from the age of 40 years and biennial screening by mammography from the age of 50 years to 74, as well as cervical screening by HPV testing (either self-sampling or provider-sampling) every 5–10 years for women aged 30–64 years, were recommended. The steadily increasing rates of colorectal cancer in LAC also led to recommend colorectal screening by occult blood testing every two years or by endoscopic examination of the colorectum every 10 years for both men and women aged 50–74 years. After evaluating the evidence, the experts decided not to issue recommendations for prostate and lung cancer screening; while there was insufficient evidence on prostate cancer mortality reduction by prostate-specific antigen (PSA) testing, there was evidence of mortality reduction by low-dose computed tomography (LDCT) targeting high-risk individuals (mainly heavy and/or long-term smokers) but not individuals with average risk to whom recommendations of this Code are directed. Finally, the group of experts adapted the gathered evidence to develop a competency-based online microlearning program for building cancer prevention capacity of primary care health professionals.
Status of breast cancer in Latin American: Results of the breast cancer revealed initiative
(Elsevier Ireland Ltd, 2023) Ayala, N; Barchuk, S; Inurrigarro, G; Celano, C; Soriano-García, JL; Bolaños, P; Mohs-Alfaro, M; Tapia-González, H; Perez-Martinez, R; Samtani, S; Alvarado-Cabrero, I; Villarreal-Garza, C; Tamez-Salazar, J; Magallanes-Garza, GI; Vazquez, D; Castro, J; Gómez-Macías, GS; Ferrigno, A; Morante, Z; Vilchez, S; Cotrina, JM; Doimi, F; Santander, G; Acevedo, C; Ortega, V; Lavista, F; Richter, L; Gianella, M; Paredes ,M; Flores-Balcázar, CH; Pinto, JA; Gomez, HL
The Breast Cancer Revealed initiative was designed and conducted to know the status of breast cancer at each point of breast cancer care, through i) prevention, ii) detection, iii) diagnosis, iv) treatment, and iv) the capacity of our health systems. The expert panel from 11 Latin American countries identified several strategies and proposed high impact priorities, including implementation of prevention policies, improve primary healthcare capacity for breast cancer screening, have adequate infrastructure to make effective and timely diagnoses, have a multidisciplinary team in the treatment process, access to a variety of treatments for all types of patients, have a coordinated and articulated system from primary care to specialized hospital. In a region with limited resources, prioritization in high-impact strategies for breast cancer control could lead to improved clinical outcomes and quality of life for our patients.
Uptake of Risk-Reducing Surgeries in an International Real-World Cohort of Hispanic Women
(Lippincott Williams and Wilkins, 2024) Chavarri-Guerra, Y; Ferrigno-Guajardo, A; Villarreal-Garza, C; Martinez-Cannon, BA; Abugattas-Saba, J; Fontaine, AC; Horcasitas, DJ; Mora-Alferez, P; Unzeitig, GW; Brown, S; Mohar-Betancourt, A; Nehoray, B; Del, Toro-Valero, A; Daneri-Navarro, A; Ganschow, P; Komenaka, I; Rodriguez, Y; Gutierrez, Seymour, G; Valdez, L; Blazer, KR; Ellis, S; Weitzel, JN
PURPOSE Women with pathogenic variants (PVs) in breast cancer (BC) and ovarian cancer (OC) associated genes are candidates for cancer risk-reducing strategies. Limited information is available regarding risk-reducing surgeries (RRS) among Hispanics. The aim of this study was to describe the uptake of RRS in an international real-world experience of Hispanic women referred for genetic cancer risk assessment (GCRA) and to identify factors affecting uptake. METHODS Between July 1997 and December 2019, Hispanic women, living in the United States or in Latin America, enrolled in the Clinical Cancer Genomics Community Research Network registry were prospectively included. Demographic characteristics and data regarding RRS were obtained from chart reviews and patient-reported follow-up questionnaires. Median follow-up was 41 months. RESULTS Among 1,736 Hispanic women referred for GCRA, 27.2% women underwent risk-reducing mastectomy (RRM), 25.5% risk-reducing salpingo-oophorectomy (RRSO) and, 10.7% both surgeries. Among BRCA carriers, rates of RRM and RRSO were 47.6% and 56.7%, respectively. In the multivariate analyses, being a carrier of a BC susceptibility gene (odds ratio [OR], 3.44), personal history of BC (OR, 6.22), living in the US (OR, 3.90), age ≤50 years (OR, 1.68) and, family history of BC (OR, 1.56) were associated with a higher likelihood of undergoing RRM. Carrying an OC susceptibility gene (OR, 6.72) was associated with a higher likelihood of undergoing RRSO. CONCLUSION The rate of RRS among Hispanic women is suboptimal. PV carriers, women with personal history of cancer, and those with a family history of cancer were more likely to have RRS, with less uptake outside the US. Understanding personal and systemic factors influencing uptake may enable interventions to increase risk appropriate uptake of RRS.