906 – Optimizing breast cancer care: overcoming delays for better outcomes in Brazil

Abstract

Introduction: Breast cancer is the leading cause of cancer death among women in Brazil. Despite laws establishing a
60-day deadline for starting treatment, delays are still prevalent, compromising patient prognosis and increasing healthcare
costs, especially in more advanced stages. This study evaluates the quality of breast cancer care at Hospital Governador
Israel Pinheiro (HGIP) in Minas Gerais, focusing on compliance with legal timelines and identifying the causes of delays.
Methods: A descriptive, analytical, and retrospective study, utilizing electronic medical records of 197 patients diagnosed
with breast cancer at HGIP between 2020 and 2022. Quantitative analysis used negative binomial regression to identify
factors associated with the time between biopsy and surgery, while qualitative analysis, through thematic content analysis, categorized institutional, personal, and external factors impacting treatment delays. The study was approved by the
Research Ethics Committee (Approval No. 7,914,343).
Results: The average time between biopsy and surgery was 77 days, with 51.3% of treatments starting after the 60-day
legal limit. Age was a significant factor in delays. Institutional factors accounted for 78.9% of the delays, primarily due to
limitations in the surgical block and preoperative consultations.
Conclusion: Over half of the patients did not initiate treatment within the legal timeframe, highlighting institutional
failures that require urgent correction. Reorganizing care pathways at HGIP is crucial to ensuring compliance with legal
deadlines, improving clinical outcomes, and reducing costs associated with advanced-stage treatments. This study is a
call to action to optimize internal management, improve care quality, and create a more efficient and equitable healthcare system. Furthermore, the strategies identified hold great potential to be replicated in other hospitals across Brazil,
promoting improvements in breast cancer care nationwide.
Ethics: Research Ethics Committee Approval (CAAE 90438125.6.0000.5136).