Factors Associated with Standardized Diagnosis and Treatment of Breast Cancer: A Real-World Multicenter Study

Breast cancer remains one of the leading causes of cancer-related death among women, and its incidence in Xinjiang is significantly higher than the national average. However, the extent to which breast cancer diagnosis and treatment are standardized in this region remains unclear, particularly with respect to key clinical decision-making processes such as surgical approach, pathological confirmation, and systemic treatment selection. This study aimed to identify factors associated with standardized breast cancer care within the Xinjiang Production and Construction Corps (XPCC).

A total of 670 patients who received their first breast cancer diagnosis at 11 XPCC hospitals between January 1, 2021, and January 1, 2022, were retrospectively included. Clinical and pathological variables were collected. According to the Chinese Anti-Cancer Association Guidelines for Breast Cancer (2021 Edition) and the AJCC Cancer Staging Manual (8th Edition), patients were classified into standardized and non-standardized care groups. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with standardized diagnosis and treatment.

The median age at diagnosis was 53.27 years. The rate of standardized diagnosis was 76.12%. Multivariate analysis indicated that hospital location, ethnicity, and method of detection were independent predictors of standardized diagnosis (P < 0.05). Notably, low rates of preoperative core-needle biopsy and regional disparities in diagnostic capacity were observed. The rate of standardized treatment was 46.71%. Standardized diagnosis, hospital location, pathological type, and tumor stage were independently associated with standardized treatment (P < 0.05), with substantial variations in surgical modality selection, axillary management, neoadjuvant therapy use, and access to radiotherapy across hospitals.

The median age of breast cancer onset in the XPCC region is slightly younger than the national average. Significant disparities in standardized diagnosis and treatment exist between southern and northern Xinjiang, reflecting differences in healthcare infrastructure, availability of pathological testing, radiotherapy resources, and multidisciplinary decision-making capacity. Minority patients exhibited lower levels of disease awareness. These findings underscore the need to strengthen medical resources, optimize guideline-concordant clinical decision-making, and improve breast cancer management in this region.