Compliance with Brazilian Law 12.732: assessing breast cancer treatment delays across different therapeutic modalities (2017-2022)

Authors

DOI:

https://doi.org/10.29289/2594539420250016

Keywords:

breast neoplasm, treatment, delay, 60-day rule

Abstract

Introduction: Breast cancer (BC) is the most common cancer among women in Brazil and worldwide, followed by non-melanoma skin cancer. Law No. 12,732, of November 22, 2012, stipulates that cancer treatment should begin within 60 days of the anatomopathological diagnosis. However, the time to start treatment is still variable in Brazil. Methods: A cross-sectional observational ecological study was conducted using data on breast cancer in Brazil between 2017 and 2022, obtained from the DATASUS-SISCAN database. Patients with a diagnosis of breast cancer (ICD C50), the federative unit (UF) of residence, and the treatment modality were considered. Five-time intervals were defined for the start of treatment. The χ² and Z tests of two proportions were used, considering a 95% confidence interval (p<0.05). Results: Of the 243,277 evaluated cases, the highest frequency of patients was in the interval of more than 120 days to start treatment (25.5%). Surgery as a modality had a predominance of treatment initiation within 30 days in Brazil and in all regions, with the Northeast and South presenting 63.3% and 66.9% of patients starting treatment within 30 days, respectively. The chemotherapy modality had a greater distribution of patients in the interval of 31 to 60 days in the Northeast (26.1%) and in the South (26.3%), with the remaining regions predominantly showing intervals of more than 120 days. For radiation therapy, the predominance of treatment was after 120 days from diagnosis in all segments. Conclusion: Most patients waited more than 120 days to start breast cancer treatment. Surgical treatment had the shortest waiting time, while radiation therapy showed the longest intervals. For chemotherapy, the time until initiation was variable. In the trend analysis, a decrease in the time to start treatment was evident.

Downloads

Download data is not yet available.

References

1. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer; 2022.

2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660

3. Heer E, Harper A, Escandor N, Sung H, McCormack V, Fidler-Benaoudia MM. Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. Lancet Glob Health 2020;8(8):e1027-37. https://doi.org/10.1016/S2214-109X(20)30215-1

4. Lei S, Zheng R, Zhang S, Wang S, Chen R, Sun K, et al. Global patterns of breast cancer incidence and mortality: A population-based cancer registry data analysis from 2000 to 2020. Cancer Commun (Lond). 2021;41(11):1183-94. https://doi.org/10.1002/cac2.12207

5. Rahib L, Wehner MR, Matrisian LM, Nead KT. Estimated Projection of US Cancer Incidence and Death to 2040. JAMA Netw Open. 2021;4(4):e214708. https://doi.org/10.1001/jamanetworkopen.2021.4708

6. Santos MO, Lima FCS, Martins LFL, Oliveira JFP, Almeida LM, Cancela MC, et al. Estimativa de Incidência de Câncer no Brasil, 2023-2025. Rev Bras Cancerol. 2023;69(1):e-213700. https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3700

7. Brasil. MInistério da Saúde. Sistema de Informação sobre Mortalidade. Brasília, DF: Ministério da Saúde; 2022.

8. Vieira RAC, Biller G, Uemura G, Ruiz CA, Curado MP. Breast cancer screening in developing countries. Clinics (Sao Paulo). 2017;72(4):244-53. https://doi.org/10.6061/clinics/2017(04)09

9. Brasil. Ministério da Saúde. Ordinance n. 876, from May 16, 2013. Approaches the implementation of Law No. 12,732, of November 22, 2012, which addresses the first treatment of patients with confirmed malignant neoplasms within the scope of the Unified Health System (SUS). Diário Oficial da União. 2013.

10. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806-8. https://doi.org/10.1136/bmj.39335.541782.AD

11. Nogueira MC, Atty ATM, Tomazelli J, Jardim BC, Bustamante-Teixeira MT, Silva GA. Frequency and factors associated with delay in breast cancer treatment in Brazil, according to data from the Oncology Panel, 2019-2020. Epidemiol Serv Saude. 2023;32(1):e2022563. https://doi.org/10.1590/S2237-96222023000300004

12. Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolution n. 510, from April 07, 2016. Approves the regulatory standards for research in social sciences, humanities, and other disciplines that utilize methodologies characteristic of these fields. Diário Oficial. 2016.

13. Monteiro SO. Atrasos no tratamento do câncer de mama: fatores associados em uma coorte de mulheres admitidas em um centro de referência do Rio de Janeiro. 2016.

14. Silva FPC, Souza MC, Bertoni N. Fatores associados ao atraso para o início do tratamento para câncer de mama em um centro oncológico de referência em Juiz de Fora, de 2010 a 2019: estudo de coorte. Epidemiol Serv Saude. 2024;33:e20231177. https://doi.org/10.1590/S2237-96222024v33e20231177.pt

15. Leite GC, Ruhnke BF, Valejo FAM. Correlação entre tempo de diagnóstico, tratamento e sobrevida em pacientes com câncer de mama: uma revisão de literatura. Colloquium Vitae. 2021;13(1):12-6.

16. Schubbe D, Yen RW, Durand MA. How Does Patient Socioeconomic Position Affect Breast Cancer Surgical Treatment and Mortality?: A Rapid Review. Breast Cancer (Dove Med Press). 2021;13:595-601. https://doi.org/10.2147/BCTT.S293635

17. Medeiros GC, Teodózio CGC, Fabro EAN, Aguiar SS, Lopes AHM, Conte BC, et al. Fatores Associados ao Atraso entre o Diagnóstico e o Início do Tratamento de Câncer de Mama: um Estudo de Coorte com 204.130 Casos no Brasil. Rev Bras Cancerol. 2020;66(3):e-09979. https://doi.org/10.32635/2176-9745.RBC.2020v66n3.979

18. Sousa SMMT, Carvalho MGM, Santos Júnior LA, Mariano SBC. Acesso ao tratamento da mulher com câncer de mama. Saúde em Debate. 2019;43(122):727-41. https://orcid.org/0000-0002-9611-7486

19. Saldanha RF, Xavier DR, Carnavalli KM, Lerner K, Barcellos C. [Analytical study of the breast cancer patient flow network in Brazil from 2014 to 2016]. Cad Saude Publica. 2019;35(7):e00090918. https://doi.org/10.1590/0102-311X00090918

20. Abreu AM, Amaral CS, Fraga DRS, Paz AA, Linch GFC, Waterkemper R. Radiotherapy services in the Brazilian scenario - Serviços de radioterapia no cenário brasileiro. 2019;9:21-5.

21. Oliveira EXG, Melo ECP, Pinheiro RS, Noronha CP, Carvalho MS. [Access to cancer care: mapping hospital admissions and high-complexity outpatient care flows. The case of breast cancer]. Cad Saude Publica. 2011;27(2):317-26. https://doi.org/10.1590/s0102-311x2011000200013

22. Sobral GS, Araújo YB, Kameo SY, Silva GM, Santos DKC, Carvalho LLM. Análise do Tempo para Início do Tratamento Oncológico no Brasil: Fatores Demográficos e Relacionados à Neoplasia. Rev Bras Cancerol. 2022;68(3):e-122354. https://orcid.org/0000-0002-3835-7916

23. Barros ÂF, Uemura G, Macedo JLS. [Interval for access to treatment for breast cancer in the Federal District, Brazil]. Rev Bras Ginecol Obstet. 2013;35(10):458-63. https://orcid.org/10.1590/s0100-72032013001000006

24. Medeiros GC, Bergmann A, Aguiar SS, Thuler LCS. [Determinants of the time between breast cancer diagnosis and initiation of treatment in Brazilian women]. Cad Saude Publica. 2015;31(6):1269-82. https://doi.org/10.1590/0102-311X00048514

Downloads

Published

2026-02-13

How to Cite

Antonini, M., Freitas, S. N. B., Mattar, A., Pinheiro, D. J. P. da C., Campos, R. C., Felix, L. X., … Freitas-Junior, R. (2026). Compliance with Brazilian Law 12.732: assessing breast cancer treatment delays across different therapeutic modalities (2017-2022). Mastology, 35. https://doi.org/10.29289/2594539420250016

Issue

Section

Original Articles