1163 – Regional and therapeutic inequities in breast cancer treatment: an analysis of compliance with the 60-day law in Brazil

Abstract

Introduction: Breast cancer is the malignant neoplasm with the highest incidence among Brazilian women. The time
to treatment initiation is a crucial prognostic factor that impacts survival. To ensure agility within the Unified Health
System (SUS), Law 12.732/2012 mandates that the first specific oncological treatment must begin within sixty days after
the pathology report. The objective of this study is to evaluate the impact of the geographic macroregion and the first
therapeutic modality chosen on the non-compliance with this deadline for patients with breast cancer in Brazil.
Methods: A retrospective ecological study using secondary data from the Oncology Panel (DATASUS/TABNET) between
2023 and 2025. Records of patients diagnosed with breast neoplasm (ICD-10 C50) were analyzed and the proportions of
therapeutic delay were cross-referenced with the country’s five macroregions, as well as the two main first-line treatment
modalities: Surgery and Chemotherapy. The statistical significance of the associations was analyzed using Pearson’s Chisquare test.
Results: A statistically significant disparity in delay was identified according to the first treatment administered (p<0.0001).
Upfront surgery presented a lower rate of non-compliance with the law (31.2%) when compared to chemotherapy, which
showed a significant delay (59.4%). In the regional analysis of surgical access, the South region stood out with the lowest
delay (18.6%), contrasting with the critical rates in the North (43.3%) and Central-West (41.2%) regions, evidencing extreme
geographic inequity (p<0.0001).
Conclusion: Compliance with the 60-day Law in Brazil is heterogeneous, strongly influenced by geographic determinants
and the required initial therapeutic modality. The high rates of non-compliance for initiating chemotherapy, alongside
the profound regional disparities in surgical access, expose distinct bottlenecks within the public healthcare system. This
scenario requires the urgent development of public policies aimed at the decentralized allocation of oncological resources
and the optimization of patient care pathways.
Ethics: Public data.