{"id":"https://openalex.org/W7211865751","doi":"https://doi.org/10.21203/rs.3.rs-10590047/v1","title":"Clinical presentation, diagnostic pathway, treatment patterns, and survival among women with cytologically diagnosed breast cancer in two national referral hospitals in Niger: A five- year retrospective multicenter cohort study","display_name":"Clinical presentation, diagnostic pathway, treatment patterns, and survival among women with cytologically diagnosed breast cancer in two national referral hospitals in Niger: A five- year retrospective multicenter cohort study","publication_year":2026,"publication_date":"2026-09-07","ids":{"openalex":"https://openalex.org/W7211865751","doi":"https://doi.org/10.21203/rs.3.rs-10590047/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-10590047/v1","doi":"https://doi.org/10.21203/rs.3.rs-10590047/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10590047/v1","pdf_url":"https://www.researchsquare.com/article/rs-10590047/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-10590047/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5017422878","display_name":"Maina Oumara","orcid":"https://orcid.org/0000-0002-7248-2024","observed_orcids":["https://orcid.org/0000-0002-7248-2024"]},"institutions":[{"id":"https://openalex.org/I130359222","display_name":"Universit\u00e9 Abdou Moumouni","ror":"https://ror.org/05tj8pb04","country_code":"NE","type":"education","lineage":["https://openalex.org/I130359222"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Maina Oumara","raw_affiliation_strings":["Abdou Moumouni University, Isska Gazoby Maternity"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abdou Moumouni University, Isska Gazoby Maternity","institution_ids":["https://openalex.org/I130359222"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5150683835","display_name":"Amina Oumarou Saidou","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I130359222","display_name":"Universit\u00e9 Abdou Moumouni","ror":"https://ror.org/05tj8pb04","country_code":"NE","type":"education","lineage":["https://openalex.org/I130359222"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Amina Oumarou Saidou","raw_affiliation_strings":["Abdou Moumouni University, Isska Gazoby Maternity"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abdou Moumouni University, Isska Gazoby Maternity","institution_ids":["https://openalex.org/I130359222"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5046325553","display_name":"Hamidou Soumana Diaouga","orcid":"https://orcid.org/0000-0001-6326-161X","observed_orcids":["https://orcid.org/0000-0001-6326-161X"]},"institutions":[{"id":"https://openalex.org/I130359222","display_name":"Universit\u00e9 Abdou Moumouni","ror":"https://ror.org/05tj8pb04","country_code":"NE","type":"education","lineage":["https://openalex.org/I130359222"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Hamidou Soumana Diaouga","raw_affiliation_strings":["Abdou Moumouni University, Isska Gazoby Maternity"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abdou Moumouni University, Isska Gazoby Maternity","institution_ids":["https://openalex.org/I130359222"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5150687197","display_name":"Ibrahima Idrissa Diakite","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ibrahima Idrissa Diakite","raw_affiliation_strings":["National Cancer Control Center"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"National Cancer Control Center","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5108152353","display_name":"Adama Ayouba","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I130359222","display_name":"Universit\u00e9 Abdou Moumouni","ror":"https://ror.org/05tj8pb04","country_code":"NE","type":"education","lineage":["https://openalex.org/I130359222"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Adama Ayouba","raw_affiliation_strings":["Abdou Moumouni University, Isska Gazoby Maternity"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abdou Moumouni University, Isska Gazoby Maternity","institution_ids":["https://openalex.org/I130359222"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114283682","display_name":"Zelika Lankonde Salifou","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210151218","display_name":"Universit\u00e9 Andr\u00e9 Salifou","ror":"https://ror.org/00yfma824","country_code":"NE","type":"education","lineage":["https://openalex.org/I4210151218"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Zelika Salifou Lankande","raw_affiliation_strings":["Andr\u00e9 Salifou University, Mother and Child Health Center"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Andr\u00e9 Salifou University, Mother and Child Health Center","institution_ids":["https://openalex.org/I4210151218"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064451224","display_name":"Amadou Issa Abdou","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Amadou Abdou Issa","raw_affiliation_strings":["Dan Dicko Dankoulodo University, Mother and Child Health Center"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Dan Dicko Dankoulodo University, Mother and Child Health Center","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110864169","display_name":"Rachid Sani","orcid":"https://orcid.org/0000-0003-4494-3804","observed_orcids":["https://orcid.org/0000-0003-4494-3804"]},"institutions":[{"id":"https://openalex.org/I130359222","display_name":"Universit\u00e9 Abdou Moumouni","ror":"https://ror.org/05tj8pb04","country_code":"NE","type":"education","lineage":["https://openalex.org/I130359222"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Rachid Sani","raw_affiliation_strings":["Abdou Moumouni University, National hospital of Niamey"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abdou Moumouni University, National hospital of Niamey","institution_ids":["https://openalex.org/I130359222"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5064877172","display_name":"Madi Nayama","orcid":"https://orcid.org/0009-0004-7372-8040","observed_orcids":["https://orcid.org/0009-0004-7372-8040","https://orcid.org/0000-0001-5899-6718"]},"institutions":[{"id":"https://openalex.org/I130359222","display_name":"Universit\u00e9 Abdou Moumouni","ror":"https://ror.org/05tj8pb04","country_code":"NE","type":"education","lineage":["https://openalex.org/I130359222"]}],"countries":["NE"],"is_corresponding":false,"raw_author_name":"Madi Nayama","raw_affiliation_strings":["Abdou Moumouni University, Isska Gazoby Maternity"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abdou Moumouni University, Isska Gazoby Maternity","institution_ids":["https://openalex.org/I130359222"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.576200008392334,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11134","display_name":"Breast Lesions and Carcinomas","score":0.576200008392334,"subfield":{"id":"https://openalex.org/subfields/2734","display_name":"Pathology and Forensic Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10183","display_name":"Breast Cancer Treatment Studies","score":0.302700012922287,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10556","display_name":"Global Cancer Incidence and Screening","score":0.09080000221729279,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/breast-cancer","display_name":"breast cancer","score":0.9980000257492065},{"id":"https://openalex.org/keywords/niger","display_name":"Niger","score":0.6299999952316284},{"id":"https://openalex.org/keywords/fine-needle-aspiration-cytology","display_name":"fine needle aspiration cytology","score":0.9419999718666077},{"id":"https://openalex.org/keywords/diagnostic-pathway","display_name":"diagnostic pathway","score":0.7829999923706055},{"id":"https://openalex.org/keywords/delayed-diagnosis","display_name":"delayed diagnosis","score":0.6729999780654907},{"id":"https://openalex.org/keywords/advanced-disease","display_name":"advanced disease","score":0.8240000009536743},{"id":"https://openalex.org/keywords/histological-confirmation","display_name":"histopathological confirmation","score":0.9419999718666077},{"id":"https://openalex.org/keywords/immunohistochemistry","display_name":"immunohistochemistry","score":0.7789999842643738},{"id":"https://openalex.org/keywords/modified-radical-mastectomy","display_name":"modified radical mastectomy","score":0.8809999823570251},{"id":"https://openalex.org/keywords/chemotherapy","display_name":"chemotherapy","score":0.8050000071525574},{"id":"https://openalex.org/keywords/radiotherapy","display_name":"radiotherapy","score":0.9679999947547913},{"id":"https://openalex.org/keywords/endocrine-therapy","display_name":"endocrine therapy","score":0.9909999966621399},{"id":"https://openalex.org/keywords/overall-survival","display_name":"overall survival","score":0.9760000109672546},{"id":"https://openalex.org/keywords/loss-to-follow-up","display_name":"loss to follow-up","score":0.753000020980835},{"id":"https://openalex.org/keywords/access-to-cancer-care","display_name":"access to cancer care","score":0.7099999785423279},{"id":"https://openalex.org/keywords/low-and-middle-income-countries","display_name":"low- and middle-income countries","score":0.8790000081062317},{"id":"https://openalex.org/keywords/guideline-concordant-care","display_name":"guideline-concordant care","score":0.6949999928474426},{"id":"https://openalex.org/keywords/continuity-of-care","display_name":"continuity of care","score":0.6940000057220459}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9287999868392944},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.7228999733924866},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.6844000220298767},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.6456000208854675},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.53329998254776},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.4887999892234802},{"id":"https://openalex.org/C2778527826","wikidata":"https://www.wikidata.org/wiki/Q1787017","display_name":"Cancer registry","level":3,"score":0.46560001373291016},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.4431999921798706},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.42149999737739563},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4050000011920929},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.36649999022483826},{"id":"https://openalex.org/C29374701","wikidata":"https://www.wikidata.org/wiki/Q1931388","display_name":"Cause of death","level":3,"score":0.3465999960899353},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3422999978065491},{"id":"https://openalex.org/C2777757722","wikidata":"https://www.wikidata.org/wiki/Q848318","display_name":"Mastectomy","level":4,"score":0.3327000141143799},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.32519999146461487},{"id":"https://openalex.org/C2776283816","wikidata":"https://www.wikidata.org/wiki/Q332823","display_name":"Survival rate","level":2,"score":0.3249000012874603},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.3199000060558319},{"id":"https://openalex.org/C2992435398","wikidata":"https://www.wikidata.org/wiki/Q6934595","display_name":"Multicenter study","level":3,"score":0.2793999910354614},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.2757999897003174},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.2752000093460083},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.2718999981880188},{"id":"https://openalex.org/C2910733956","wikidata":"https://www.wikidata.org/wiki/Q848318","display_name":"Modified Radical Mastectomy","level":5,"score":0.2685999870300293},{"id":"https://openalex.org/C10515644","wikidata":"https://www.wikidata.org/wiki/Q543310","display_name":"Survival analysis","level":2,"score":0.26460000872612}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-10590047/v1","doi":"https://doi.org/10.21203/rs.3.rs-10590047/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10590047/v1","pdf_url":"https://www.researchsquare.com/article/rs-10590047/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10590047/v1","doi":"https://doi.org/10.21203/rs.3.rs-10590047/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10590047/v1","pdf_url":"https://www.researchsquare.com/article/rs-10590047/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"},{"score":0.7307999730110168,"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7211865751.pdf","grobid_xml":"https://content.openalex.org/works/W7211865751.grobid-xml"},"referenced_works_count":33,"referenced_works":["https://openalex.org/W2102376559","https://openalex.org/W2125963399","https://openalex.org/W2555676011","https://openalex.org/W2597362699","https://openalex.org/W2946421024","https://openalex.org/W2999400187","https://openalex.org/W3003411676","https://openalex.org/W3042513605","https://openalex.org/W3042778401","https://openalex.org/W3061102166","https://openalex.org/W3124357144","https://openalex.org/W3158958446","https://openalex.org/W3160699365","https://openalex.org/W3188351301","https://openalex.org/W3208783624","https://openalex.org/W4229041225","https://openalex.org/W4229448188","https://openalex.org/W4309557984","https://openalex.org/W4324309230","https://openalex.org/W4379600909","https://openalex.org/W4387296842","https://openalex.org/W4388110996","https://openalex.org/W4388523759","https://openalex.org/W4389681263","https://openalex.org/W4393154153","https://openalex.org/W4393935425","https://openalex.org/W4396827322","https://openalex.org/W4405302020","https://openalex.org/W4406431707","https://openalex.org/W4413190431","https://openalex.org/W4416074848","https://openalex.org/W4416299858","https://openalex.org/W4417265040"],"related_works":["https://openalex.org/W7212594735","https://openalex.org/W2299612917","https://openalex.org/W2990400382","https://openalex.org/W2739148003","https://openalex.org/W4406087693","https://openalex.org/W1689234869","https://openalex.org/W2036482278","https://openalex.org/W2258016421","https://openalex.org/W3124357144","https://openalex.org/W3081543166"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Breast":[2,301],"cancer":[3,7,34,58,79,302,360],"is":[4,305],"the":[5,45,61,99,108,120,127,156,161,177,229,249],"leading":[6],"among":[8,290],"women":[9,55,76,198,291],"worldwide,":[10],"with":[11,56,77,86,213,293],"disproportionately":[12],"high":[13],"mortality":[14],"in":[15,36,60,231,303,315,362],"low-":[16],"and":[17,24,52,95,107,117,143,210,239,253,262,277,312,330,343,350,364],"middle-income":[18],"countries":[19],"due":[20],"to":[21,27,43,166,183,257,267,281,321],"delayed":[22,308],"diagnosis":[23,165,230,317],"limited":[25],"access":[26,320],"comprehensive":[28],"care.":[29,337],"Contemporary":[30],"data":[31,145],"describing":[32],"breast":[33,57,78,359],"management":[35],"Niger":[37,304,363],"remain":[38],"scarce.":[39],"This":[40],"study":[41,74],"aimed":[42],"describe":[44],"clinical":[46],"presentation,":[47,309],"diagnostic":[48,345],"pathway,":[49],"treatment":[50],"patterns,":[51],"survival":[53,152,289],"of":[54,105,163,196,223,271,326,335,353],"managed":[59],"country's":[62],"two":[63],"national":[64,122],"referral":[65],"hospitals.":[66],"Methods":[67],"We":[68],"conducted":[69],"a":[70,219],"retrospective":[71],"multicenter":[72],"cohort":[73],"including":[75],"diagnosed":[80],"by":[81,126,307],"fine-needle":[82],"aspiration":[83],"cytology":[84],"(FNAC),":[85],"or":[87,168,181],"without":[88],"subsequent":[89],"histopathological":[90,237],"confirmation,":[91,238],"between":[92],"January":[93],"2020":[94],"December":[96],"2024":[97],"at":[98,172,176,187],"National":[100,128],"Cancer":[101,129],"Control":[102,130],"Center":[103],"(CNLC)":[104],"Niamey":[106],"Issaka":[109],"Gazoby":[110],"Maternity":[111],"Hospital(MIG).":[112],"Duplicate":[113],"records":[114],"were":[115,146,185,199,279],"identified":[116],"merged":[118],"using":[119,155],"unique":[121],"identification":[123],"number":[124],"assigned":[125],"Center,":[131],"ensuring":[132],"that":[133],"each":[134],"patient":[135],"was":[136,153,204,248,255],"included":[137],"only":[138,234,268],"once.":[139],"Demographic,":[140],"clinicopathological,":[141],"treatment,":[142],"follow-up":[144,184,332],"extracted":[147],"from":[148,160],"medical":[149],"records.":[150],"Overall":[151],"estimated":[154],"Kaplan-Meier":[157,283],"product-limit":[158],"method":[159],"date":[162,191],"cytological":[164,322],"death":[167],"censoring.":[169],"Patients":[170],"alive":[171,175],"five":[173],"years,":[174],"last":[178,189],"documented":[179],"contact,":[180],"lost":[182,280],"censored":[186],"their":[188],"known":[190],"alive.":[192],"Results":[193],"A":[194],"total":[195],"674":[197],"included.":[200],"The":[201],"median":[202,220],"age":[203],"45":[205],"years":[206],"(interquartile":[207],"range:":[208],"35\u201353),":[209],"70.0%":[211],"presented":[212],"AJCC":[214],"Stage":[215],"III-IV":[216],"disease":[217,295],"after":[218],"consultation":[221],"delay":[222],"7":[224],"months.":[225],"Although":[226],"FNAC":[227],"established":[228],"all":[232],"patients,":[233,259],"25.5%":[235],"underwent":[236],"no":[240],"patients":[241],"received":[242],"immunohistochemical":[243],"characterization.":[244],"Modified":[245],"radical":[246],"mastectomy":[247],"predominant":[250],"surgical":[251],"procedure,":[252],"chemotherapy":[254],"administered":[256],"most":[258],"whereas":[260],"radiotherapy":[261],"endocrine":[263],"therapy":[264],"remained":[265],"available":[266],"about":[269],"one-third":[270],"women.":[272],"During":[273],"follow-up,":[274],"10.4%":[275],"died":[276],"28.5%":[278],"follow-up.":[282],"analysis":[284],"demonstrated":[285],"significantly":[286],"poorer":[287],"overall":[288],"presenting":[292],"advanced-stage":[294,310],"(log-rank":[296],"P":[297],"<":[298],"0.001).":[299],"Conclusions":[300],"characterized":[306],"disease,":[311],"major":[313],"deficiencies":[314],"pathological":[316],"despite":[318],"universal":[319],"confirmation.":[323],"Limited":[324],"availability":[325],"histopathology,":[327],"immunohistochemistry,":[328],"radiotherapy,":[329],"long-term":[331],"constrain":[333],"delivery":[334],"guideline-concordant":[336],"Strengthening":[338],"early":[339],"diagnosis,":[340],"expanding":[341],"pathology":[342],"molecular":[344],"services,":[346],"reducing":[347],"financial":[348],"barriers,":[349],"improving":[351],"continuity":[352],"care":[354],"should":[355],"be":[356],"priorities":[357],"for":[358],"control":[361],"similar":[365],"resource-constrained":[366],"settings.":[367]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-09-08T00:00:00"}
