https://orcid.org/0000-0002-7605-4676
![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Purpose
Breast cancer is a growing public health challenge in Thailand. Pathum Raksa project was launched in 2015, as a result of higher than expected rate of triple-negative breast cancers in Thai women. The purpose of this project was to identify the cause(s) and address the issue(s), hence improving the quality of breast cancer biomarker testing in Thailand.
Materials and Methods
Nineteen hospitals across the country, with 902 breast cancer patients were enrolled in this study during 2015–2020. The pre- and post-data from Pathum Raksa initiative was only available for Khon Kaen University (KKU) and Udonthani hospitals in Northeast Thailand. We developed a resource-stratified strategic plan that included designing a unique specimen container, forming multidisciplinary teams from the Surgery and Pathology Departments, and employing locally developed innovative technologies to optimize the entire process of breast cancer diagnostics and biomarker testing.
Results
The rate of triple-negative breast cancers in KKU and Udonthani decreased 52.8% (p = 0.02) and 28.9% (p = 0.48), respectively. The rate of ER+ breast cancers in both hospitals increased 5% post-Pathum Raksa implementation. The rate of HER2-neu+ (score 3+) also increased in both hospitals (particularly an increased 65% rate in KKU). Luminal A/B cancers were the most common subtype in both KKU and Udonthani hospitals.
Conclusion
Pathum Raksa project has significantly improved breast cancer biomarker testing in Thailand. As a result of this national innovation, false-negative rates of breast biomarkers have significantly decreased, resulting in improving prognosis, treatment, and survival of breast cancer women in Thailand.
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:
Acknowledgments
We would like to thank Prof. Vajarabhongsa Bhudhisawasdi, the former president of the Royal Committee of Surgeons of Thailand, Dr. Paiboon Pensuwan, Deputy Director of Roi Et hospital, Dr. Chanthit Phunlap, Head of Surgery Department, Roi Et hospital, and Dr. Thanasit Praipong, Deputy Director of Kalasin hospital, for their valuable support and assistance in managing the project since 2012.
Ethics Approval and Informed Consent
The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee for Human Research, Khon Kaen University (HE601284) and written informed consent was obtained from all patients.
Author Contributions
All authors contributed to data analysis, drafting and/or revising the article, gave final approval of the version to be published, agreed to the submitted journal, and agree to be accountable for all aspects of the work.
Disclosure
Dr Supinda Koonmee and Dr Krisada Prachumrasee report a Pretty Patent licensed to 9256 and a Pretty Patent licensed to 16424. Dr Sakkarn Sangkhamanon reports Pretty patent no. 9256 from the Department of intellectual property, Thailand, outside the submitted work; in addition, Dr Sakkarn Sangkhamanon reports Pretty patent no. 9256 with royalties paid to New Medical Technology company. The authors report no other potential conflicts of interest for this work.