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To eradicate this critical barrier to care, we nested a novel breast specialty service platform inside a large public\u2010sector primary healthcare facility in Lusaka, Zambia to offer clinical breast examination, breast ultrasound, and ultrasound\u2010guided core needle biopsy in a one\u2010stop 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\u2010specific crude survival using the Kaplan\u2013Meier 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\u2010year survival was 73%. An increase in patients presenting with early breast cancer and improvements in their survival were observed. Women with early\u2010stage 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\u2010related 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.<\/jats:p>","DOI":"10.1002\/ijc.34920","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T09:56:18Z","timestamp":1711360578000},"page":"261-269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Three\u2010year survival of breast cancer patients attending a one\u2010stop breast care clinic nested within a primary care health facility in sub\u2010Saharan <scp>Africa\u2010Zambia<\/scp>"],"prefix":"10.1002","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4394-1583","authenticated-orcid":false,"given":"Mutumba","family":"Songiso","sequence":"first","affiliation":[{"name":"Department of Surgery Levy Mwanawasa University Teaching Hospital  Lusaka Zambia"},{"name":"Department of Surgery Levy Mwanawasa Medical University  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6651-8879","authenticated-orcid":false,"given":"Olivier","family":"Nu\u00f1ez","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiology National Center of Epidemiology (Pab,12) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Cabanes","sequence":"additional","affiliation":[{"name":"Division of Research and Advocacy Global Focus on Cancer  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpimpa","family":"Mutale","sequence":"additional","affiliation":[{"name":"Department of Physiological Sciences University of Lusaka  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jabulani","family":"Munalula","sequence":"additional","affiliation":[{"name":"Department of Surgery Medland Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Pupwe","sequence":"additional","affiliation":[{"name":"Department of radiation and clinical oncology Cancer Diseases Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronda","family":"Henry\u2010Tillman","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Arkansas for Medical Science  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Groesbeck P.","family":"Parham","sequence":"additional","affiliation":[{"name":"Department of Gynaecology University Teaching Hospital, Women and Newborn Hospital  Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(20)30261\u20108"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(16)30259\u20105"},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization.WHO Position Paper on Mammography Screening. 2014. Accessed December 2022.https:\/\/apps.who.int\/iris\/handle\/10665\/137339"},{"key":"e_1_2_10_6_1","volume-title":"Global Breast Cancer Initiative Implementation Framework: Assessing, Strengthening and Scaling\u2010up of Services for the Early Detection and Management of Breast Cancer","author":"World Health Organization","year":"2023"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/GO.20.00083"},{"key":"e_1_2_10_8_1","unstructured":"National Guidelines for Early Diagnosis of Breast Cancer in Zambia. December 2019. Accessed December 2022.https:\/\/www.moh.gov.zm\/?wpfb_dl=26"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29801"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u20109\u201083"},{"key":"e_1_2_10_11_1","unstructured":"Global Health Observatory Data Repository.Mortality and Global Health Estimates Life Tables by Zambia. 2020. Accessed December 2022.https:\/\/apps.who.int\/gho\/data\/view.main.61850"},{"key":"e_1_2_10_12_1","unstructured":"Ministry of Health Zambia.Zambia Population\u2010based HIV Impact Assessment (ZAMPHIA) 2021: Summary sheet. Accessed December 2022."},{"key":"e_1_2_10_13_1","volume-title":"Zambia Demographic and Health Survey 2018","author":"Zambia Statistics Agency, Ministry of Health (MOH) Zambia, and ICF","year":"2019"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2015.002675"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.08.520"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.006585"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27725"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2020.ed103"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.6583"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32871"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m4087"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201078517\u20106"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2014.08.014"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.34920","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T04:52:37Z","timestamp":1733115157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.34920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,25]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,7,15]]}},"alternative-id":["10.1002\/ijc.34920"],"URL":"https:\/\/doi.org\/10.1002\/ijc.34920","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,25]]},"assertion":[{"value":"2023-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}