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Social determinants of health and disparities in cancer care for patients with metastatic breast cancer in Mexico.
(American Society of Clinical Oncology (ASCO), 2025)
Chavarri Guerra, Yanin
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Verduzco-Aguirre, Haydee Cristina
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Esparza-Orozco, Maria Fernanda
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Ramos Lopez, Wendy Alicia
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Alvarado, Montserrath
Background: Patients diagnosed with metastatic breast cancer (MBC) in low- and middle-income countries (LMICs) face poorer outcomes than their counterparts in high-income countries. Social determinants of health (SDH)—including housing, food security, employment, and education—have been increasingly recognized as critical non-medical factors influencing access to care and cancer-related outcomes. We aimed to describe SDH among Mexican patients with MBC and examine their association with treatment adherence, receipt of standard therapy, and survival. Methods: This was a prospective multicenter cohort study including patients from three public cancer centers in Mexico City. Eligible participants were adults with MBC receiving first- or second-line systemic therapy. A trained patient navigator conducted structured interviews at baseline and every three months over one year using validated questionnaires (SDH needs, SEAMS, FACT-G, and BPI). Treatments were categorized as standard or non-standard based on NCCN guidelines. Associations between SDH and clinical outcomes were explored using chi-square tests. Linear mixed models were used to assess longitudinal changes in health-related quality of life. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Results: A total of 324 patients were included (mean age 58.1 years; 99.7% female). At baseline, 92% reported at least one SDH-related need, most commonly employment (77.5%), housing (55.2%), and food (45.7%). The mean number of SDH needs at baseline was 3.1±1.8, remaining consistent across timepoints. Receipt of standard treatment was lower among those with needs in utilities (47.6% vs. 69.1%, p= 0.001) and education (58.0% vs. 69.0%, p= 0.046). Median SEAMS scores improved slightly over time (35 to 37). Median follow-up was 12.1 months (95% CI, 12.05-12.15). One-year overall survival was 85.0% (95% CI, 81.0–89.0), with no differences based on presence (p = 0.61) or number of SDH needs (p = 0.51) at baseline. The presence of any SDH need was significantly associated with FACT-G scores (p = 0.002) throughout the follow-up period. FACT-G scores were consistently lower in patients with any SDH need, and no significant interaction was observed between time and presence of any SDH need (p = 0.481). Conclusions: SDH needs were highly prevalent and persistent among patients with MBC in Mexico and were associated with lower likelihood of receiving guideline-concordant care and lower quality of life. Addressing these social barriers through targeted interventions may be critical to improving treatment equity and clinical outcomes in LMIC settings. ©The authors ©American Society of Clinical Oncology.
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Attitudes and knowledge towards breast cancer among non-healthcare workers at an educational institution
(American Society of Clinical Oncology (ASCO), 2025)
Esparza-Orozco, Maria Fernanda
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Esparza Orozco, Raúl Emiliano
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Cruz-Zermeño, Mayte
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Mendez-Bribiesca, Sofia Alejandra
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Lagunas-Medina, Alex
Background: Breast cancer (BC) is the leading cause of cancer-related death among Mexican women. Knowledge about BC is limited and often restricted to healthcare workers. Evaluating knowledge among non-healthcare workers (non-HCWs) allows us to depict a more realistic view of the general population's awareness. This study aimed to evaluate knowledge and attitudes towards BC among non-HCWs in a private educational institution. Methods: A validated and translated 32-item electronic questionnaire was administered to non-HCWs of an educational institution with or without personal/family history of cancer, teachers and medical staff were excluded. It assessed BC warning signs, breast self-examination (BSE), and screening practices. Sociodemographic data were collected. Descriptive statistics and Pearson’s test were used for analysis. Results: Of 119 eligible participants, 102 (60% women, median age 43 [range 21–62]) completed the survey; 47% were maintenance and 32% security staff. Most were married (44%) and had completed high school (31%); 13% had a university degree. 97% had no personal history of cancer, and 50% reported a family history of cancer. An average of 8.1 (SD ±2.2) out of 11. BC warning signs were identified. Women identified more than men (8.5 vs. 7.6, p = 0.02). The most recognized sign was a breast lump (85.2%); the least was nipple inversion (54.9%). Family (59%) and personal (57%) history of BC were the most commonly identified risk factors; late menopause was the least (9.8%). Regarding BSE, 38% rarely or never performed it, especially men (65%), individuals < 40 years (41%), and those without family history (41%). Women performed BSE more frequently, 30.6% reported weekly practice. BSE was more common among women (80%), > 40yo (65%), and those with family history (84%). While 86% felt confident detecting breast changes, confidence was lower in men and < 40yo (both 15%). Most (90.1%) would consult a physician when detecting a change. For BC screening, 81% were aware of screening tests, 43.3% knew the correct starting age and none knew the stopping age (p < 0.05). Misreporting the starting age was more common among men (80%), < 40yo (63%), and those without family history (60%). Women (58%), > 40yo (46%), and those with family history (47%) responded more accurately. 53.2% of women reported being invited to a BC detection program, and 74% had undergone screening. 10.7% of screening-eligible women had not yet started it. No other significant association was found. Conclusions: While BC signs were widely recognized, knowledge of risk factors and screening was limited, particularly among men and younger participants. Findings highlight the need for targeted education strategies to improve BC awareness among non-HCWs. ©The authors ©American Society of Clinical Oncology.
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Mental health-related, existential, and biological factors are associated with the desire to hasten death in Mexican cancer patients undergoing palliative care: A single-center study
(Public Library of Science (PLoS), 2025)
Rodríguez-Mayoral, Oscar
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Monreal-Carrillo, Edith
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Contreras-Yáñez, Irazú
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Allende-Pérez, Silvia
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Agazzi, Evandro
Introduction: The wish to hasten death (WTHD) is a clinically significant phenomenon that arises from complex suffering. It has been predominantly studied in Caucasian populations, emphasizing the importance of gaining more diverse cultural perspectives. This study explores the factors associated with the WTHD in Mexican cancer patients receiving palliative care from one academic center, with a specific focus on its connection to dignity.“. Patients and methods: The study, a cross-sectional research conducted between October 12, 2023, and August 30, 2024, involved patients with confirmed cancer diagnoses who were attending a palliative care service. Patients had applied the Patient Dignity Inventory (PDI), Schedule of Attitudes Toward Hastened Death (SAHD), Brief Edinburgh Depression Scale (BEDS), EORTC QLQ-C15-PAL to assess health-related quality of life, Karnofsky Performance Status Scale (KPSS) to assess functional capacity, and the Edmonton Symptom Assessment System. A PDI score ≥55 indicated a fractured sense of dignity (DPD), while a SAHD score ≥1 indicated the WTHD. Factors associated with the WTHD were identified using multiple logistic regression analysis. The study was approved by the IRB. Results: The study included 302 primarily middle-aged (54.5 [45–64]) females (225 [74.5%]), with 9 years of education. They reported high severity of well-being (7 [1–7]) and tiredness (3 [0–6]). Their median KPSS score showed independence (80 [70–80]), despite impacts across all EORTC QLQ-C15-PAL dimensions. DPD was noted in 110 patients (36.5%). The most frequent diagnoses were breast cancer (114 [38%]), lung cancer (33 [11%]), and gastrointestinal cancer (28 [9%]). The WTHD was found in 94 patients (31.1%). Factors significantly associated included tiredness score (OR: 1.147, 95% CI: 1.044–1.261, p = 0.004), BEDS score (1.181, 1.085–1.284, p ≤ 0.001) and a DPD (1.979, 1.038–3.772, p = 0.04). Conclusions: The WTHD was found in one out of every three Mexican cancer patients receiving palliative care and was linked to biological-, mental health-, and existential-related factors. ©The authors ©Public Library of Science (PLoS) ©PLOS one
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Correlación clínica, radiológica e histopatológica en lesiones de mama: experiencia a 10 años
(Federación Colombiana de Obstetricia y Ginecología, 2025)
Santiago Sanabria, Leopoldo
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Garza Arrieta, Julieta
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Contreras Estrada, Daniela
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Rochin Benoit, Adalberto
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Sánchez Alquicira, Bernardo
Introducción. El cáncer de mama continúa siendo un problema de salud pública a nivel global. Se estima que su incidencia incrementará en los próximos años. Es importante evaluar a través de indicadores los estudios de escrutinio de las clínicas de mastología con el fin de obtener una adecuada correlación clínica, imagenológica e histopatológica. Objetivos. Evaluar la correlación que existe entre la clínica, los estudios radiológicos e histopatológicos en mujeres que acudieron a exámenes de escrutinio para cáncer de mama en un periodo de 10 años. Métodos. Se realizó un estudio transversal, descriptivo de cohorte retrospectiva efectuado de los registros de un centro de referencia en el periodo de junio del 2013 a junio 2023, de mujeres quienes acudieron a tamizaje para cáncer de mama. En aquellas que se les realizó toma de biopsia, las muestras fueron analizadas en nuestra institución. Resultados. Se analizaron los registros de 6 754 mujeres que cumplieron los criterios de inclusión, en donde la edad promedio de la población de estudio fue de 50,7 años. Se registró que 73,2% de los estudios se categorizaron BI-RADS 2 y la mayoría de las participantes cursaba asintomática. De aquellas 551 mujeres que recibieron una mamografía BI-RADS >4, 226 (41%) obtuvieron un resultado de malignidad. Conclusiones. La mamografía ha demostrado ser la única herramienta de imagen que logrado tener un impacto sobre la mortalidad. Existen modalidades, como la tomosíntesis, que han incrementado el rendimiento de esta prueba. Es válido auxiliarse de nuevas tecnologías para mantener estándares de calidad en los estudios. © Los autores © Federación Colombiana de Obstetricia y Ginecología.
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Águeda de Catania: Santa patrona de las enfermedades de la glándula mamaria
(2011-09)
Ortíz Hidalgo, Carlos Federico
For those suffering from breast cancer, Agatha is their patron saint. She was a beautiful Christian maiden, from Catania, Sicily, who dedicated her life to God. As she rejected the love proposals of consul Quintiliano, she suffered cruel tortures. One of the tortures she suffered was to have her breast cut off, with iron shears, a detail that furnished to the Christian medieval iconography, the peculiar characteristic of Agatha. Catania honors Agatha as her patron saint and throughout the region around Mt. Etna. Saint Agatha’s feast day is February 5. All of those dedicated to the treatment and prevention of breast cancer are known as “the soldiers of Saint Agatha”.© Gaceta Médica de México.
Scopus© Citations 2 39 1
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In Vitro Evidence of Differential Immunoregulatory Response between MDA-MB-231 and BT-474 Breast Cancer Cells Induced by Bone Marrow-Derived Mesenchymal Stromal Cells Conditioned Medium
(2022)
Arenas Luna, Victor Manuel
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Montesinos, Juan José
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Cortés-Morales, Víctor A.
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Cisneros, Bulmaro
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Navarro Betancourt, Refugio
Inside tumors, cancer cells display several mechanisms to create an immunosuppressive environment. On the other hand, by migration processes, mesenchymal stromal cells (MSCs) can be recruited by different cancer tumor types from tissues as distant as bone marrow and contribute to tumor pathogenesis. However, the impact of the immunoregulatory role of MSCs associated with the aggressiveness of breast cancer cells by soluble molecules has not been fully elucidated. Therefore, this in vitro work aimed to study the effect of the conditioned medium of human bone marrow-derived-MSCs (hBM-MSC-cm) on the immunoregulatory capability of MDA-MB-231 and BT-474 breast cancer cells. The hBM-MSC-cm on MDA-MB-231 cells induced the overexpression of TGF-β, IDO, and IL-10 genes. Additionally, immunoregulation assays of mononuclear cells (MNCs) in co-culture with MDA-MB-231 and hBM-MSC-cm decreased lymphocyte proliferation, and increased proteins IL-10, TGF-β, and IDO while also reducing TNF levels, shooting the proportion of regulatory T cells. Conversely, the hBM-MSC-cm did not affect the immunomodulatory capacity of BT-474 cells. Thus, a differential immunoregulatory effect was observed between both representative breast cancer cell lines from different origins. Thus, understanding the immune response in a broader tumor context could help to design therapeutic strategies based on the aggressive behavior of tumor cells.
Scopus© Citations 2 20 1

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