Analysis of factors contributing to delayed initiation of treatment following definitive diagnosis of breast cancer at a University Hospital in Goiás, Brazil

Abstract

Objective: To describe a series of cases of patients treated at the Hospital das Clínicas of the Federal University of Goiás,
diagnosed with breast cancer, and identify the time elapsed from the date of definitive diagnosis to the initiation of specific treatment, while also exploring factors associated with the delays. Methods: This is a retrospective, descriptiveanalytical study involving patient record reviews from January 2017 to July 2019 at a university hospital in Goiás. Data on
sociodemographic characteristics, diagnosis dates, staging, and treatment initiation were collected. Factors associated
with therapeutic delays were analyzed, focusing on patient, physician, and health system-related aspects. Results: The
study reviewed 127 female patients, with a median age of 52.4 years. The median time from symptom onset to specialist consultation was five months. Notably, delays related to system factors were substantial, averaging 112 days from the
detection of abnormalities in initial exams to the beginning of treatment. These delays were fundamentally due to inefficiencies in primary care providers and the response times of pathology services. Furthermore, the educational level of
the patients demonstrated a statistically significant correlation with the stage of the disease at the time of presentation.
Conclusion: The time between diagnosis and treatment initiation significantly exceeds national guidelines. Factors such
as education level and the efficiency of primary health care and pathology services are directly related to treatment delays.
The quality of medical records and their management impact data acquisition for analysis and may influence treatment
delay. It can be concluded that delays in breast cancer treatment are multifactorial, with significant contributions from
primary healthcare and pathology services inefficiencies. Educational interventions for both healthcare providers and
patients, coupled with system-level reforms, are essential to ensure timely breast cancer treatment.