From diagnosis to beginning breast cancer treatment: A study about time in a reference private hospital in São Luís, MA, Brazil

Abstract

Objective: The objective of this study was to determine the time interval from diagnosis to initiation breast cancer treatment and to investigate factors associated with its delay. Methodology: This is an observational, descriptive, and retrospective study with analysis of medical records between January 2015 and December 2019, carried out in a private oncology referral hospital in São Luís, MA. Patients diagnosed with breast cancer (International Classification of Diseases-10
C50) were included. A total of 21 variables of epidemiological, clinical, and tumor characteristics were analyzed. The absolute and relative frequencies of categorical and numerical variables were calculated. The chi-square test was performed
to compare categorical variables, and the Student’s t-test was used to compare numerical variables. The significance level
was p<0.05. Results: There were 112 cases analyzed, 100% female, and 82.1% started treatment within 60 days of diagnosis. The mean time from diagnosis to treatment was 42.5 days (SD±24.3), and the median was 39 days. The year 2017 presented the majority of diagnosed cases (24.1%). The mean age at diagnosis was 51.9 years (SD±12.7), and most were 60 years
or older (29.7%). In 82.4% of the cases, the tumor was diagnosed at an early stage, and most were luminal A and B tumors
(52.8%). In 64.4% of the cases, the treatment was started with surgery. Factors related to the delay in starting treatment
were obesity and starting with surgery (p=0.007). Conclusion: Our results are similar to those of developed countries.
In the population studied, the factors related to delay were obesity and starting treatment with surgery. Possible factors
that contribute to these results would be the bureaucracy involved in the authorization of private health plans, the difficulty of navigating patients through the hospital system, and the comorbidities associated with obesity.