Clinical and Public Health Guidelines from the 2025 International symposium on breast diseases of inland São Paulo: strategies for early breast cancer detection and HER2-positive treatment within Brazil’s unified health system
DOI:
https://doi.org/10.29289/2594539420250024Keywords:
breast cancer, mammographic screening, unified health system, early diagnosis, HER2, neoadjuvant therapyAbstract
Objective: To disseminate the clinical and public health policy consensus established during the 2025 International Symposium on Breast Diseases of Inland São Paulo, based on the voting of 110 expert panelists in breast oncology. Methods: Four priority topics were presented through evidence-based lectures, followed by anonymous electronic voting using a validated Delphi-based methodology. Consensus was defined as ≥75% agreement among panelists. Results: Consensus was achieved on prioritizing mammography screening from age 40 (80% agreement) and on the positive impact of interdisciplinary integration in early diagnosis (95% agreement). No consensus was reached on optimizing São Paulo’s High Suspicion Law (67% agreement) or on the tumor size cutoff for neoadjuvant chemotherapy in human epidermal growth factor receptor 2 (HER2)-positive breast cancer, with the majority (53%) favoring tumors >20 mm (T2N0). Conclusion: The symposium’s guidelines provide evidence-based recommendations to enhance breast cancer screening, early diagnosis, and treatment within Brazil’s Unified Health System (SUS). While consensus was reached on earlier screening and interdisciplinary integration, further discussion is needed to optimize the High Suspicion Law and standardize neoadjuvant therapy criteria. These findings have significant potential to improve patient outcomes and resource allocation in the SUS.
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Copyright (c) 2026 Eduardo Carvalho Pessoa, Fabio Bagnoli, Marcelo Madeira, Joaquim Teodoro Araujo Neto, Giuliano Tosello, Beatriz Geronymo, Daniel de Araujo Buttros, André Mattar, Renato Torresan, João Bosco Ramos Borges, Gil Facina, Augusto Tufi Hassan, Fabricio Brenelli
This work is licensed under a Creative Commons Attribution 4.0 International License.
