Diagnosis-to-treatment intervals in breast cancer: analysis of the care pathway at an Amazonian referral center
DOI:
https://doi.org/10.29289/2594539420260017Palavras-chave:
breast neoplasms, time-to-treatment, health profileResumo
Objective: To evaluate the breast cancer care pathway for patients aged ≥18 years treated at the Amazonas State Oncology Control Center Foundation. Methods: A retrospective, descriptive, and observational study conducted between March 2022 and March 2024, based on the analysis of physical and electronic medical records. Results: A total of 397 patients were evaluated, with a predominance of the 50–59 age group (31.5%). The most common clinical staging was IIIA (20.7%), and the predominant immunohistochemical subtype was Luminal A (24.9%). A high proportion of patients received neoadjuvant chemotherapy (55.2%). The interval between diagnosis and the start of treatment was up to 60 days for 34.3% of patients and up to 90 days for 66%. Conclusion: Although 66% of patients began treatment within 90 days of diagnosis, only 34.3% received treatment within the legal 60-day deadline established by Law No. 12,732/2012, indicating that challenges remain in complying with the legislation.
Downloads
Referências
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660
2. International Agency for Research on Cancer. Global cancer observatory: cancer tomorrow [Internet]. Lyon: IARC; 2020 [cited 2026 Apr 11]. Available from: https://gco.iarc.fr/tomorrow
3. Instituto Nacional de Câncer. Estimativa 2026: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2026.
4. Lemos LLP, Souza MC, Moreira DP, Almeida PHRF, Godman B, Verguet S, et al. Stage at diagnosis and stage-specific survival of breast cancer in Latin America and the Caribbean: a systematic review and meta-analysis. PLoS One. 2019;14(10):e0224012. https://doi.org/10.1371/journal.pone.0224012
5. Hanna TP, King WD, Thibodeau S, Jalink M, Paulin GA, Harvey-Jones E, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020;371:m4087. https://doi.org/10.1136/bmj.m4087
6. Renna Junior NL, Silva GA. Late-Stage diagnosis of breast cancer in brazil: analysis of data from hospital-based cancer registries (2000–2012). Rev Bras Ginecol Obstet. 2018;40(3):127-36. https://doi.org/10.1055/s-0038-1624580
7. Brasil. Lei n. 12.732, de 22 de novembro de 2012. Dispõe sobre o primeiro tratamento de paciente com neoplasia maligna comprovada e estabelece prazo para seu início. Diário Oficial da União. 2012.
8. Brasil. Lei n. 13.896, de 30 de outubro de 2019. Garante à pessoa com suspeita de câncer a realização de exames no prazo máximo de 30 dias. Diário Oficial da União. 2019.
9. Garnelo L, Sousa ABL, Silva CO. Regionalização em Saúde no Amazonas: avanços e desafios. Ciênc Saúde Colet. 2017;22(4):1225-34. https://doi.org/10.1590/1413-81232017224.27082016
10. Cabral ALLV, Giatti L, Casale C, Cherchiglia ML. Social vulnerability and breast cancer: differentials in the interval between diagnosis and treatment of women with different sociodemographic profiles. Ciên Saúde Colet. 2019;24(2):613-22. https://doi.org/10.1590/1413-81232018242.31672016
11. Souza BC, Figueiredo FWS, Sousa LVA, Maciel ES, Adami F. Regional disparities in the flow of access to breast cancer hospitalizations in Brazil in 2004 and 2014. BMC Womens Health. 2020;20:137. https://doi.org/10.1186/s12905-020-00995-7
12. Santos ACB. Avaliação do fluxo assistencial do câncer de mama na Fundação Centro de Controle de Oncologia do Estado do Amazonas (FCECON): estudo retrospectivo [dissertation]. Manaus: FCECON; 2019.
13. Fundação Centro de Controle de Oncologia do Estado do Amazonas (FCECON). Relatório anual de gestão 2022–2023. Manaus: FCECON; 2023.
14. World Health Organization (WHO). Breast cancer: prevention and control. Geneva: WHO; 2021.
15. Carvalho FM, Bacchi LM, Pincerato KM, Van de Rijn M, Bacchi CE. Geographic differences in the distribution of molecular subtypes of breast cancer in Brazil. BMC Womens Health. 2014;14:102. https://doi.org/10.1186/1472-6874-14-102
16. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology: breast cancer. Version 2024. Plymouth Meeting: NCCN; 2024.
17. Rosa LM, Radünz V, Brüggemann OM. Tempo entre as etapas diagnósticas e terapêuticas do câncer de mama no SUS. Ciênc Cuid Saúde. 2013;12(1):104-11. https://doi.org/10.4025/cienccuidsaude.v12i1.18454
18. Medeiros GC, Thuler LCS, Bergmann A. Determinants of delay from cancer diagnosis to treatment initiation in a cohort of Brazilian women with breast cancer. Health Soc Care Community. 2021;29(6):1769-78. https://doi.org/10.1111/hsc.13284
19. Maschmann RM, Jesus RG, Werutsky G, Rebelatto TF, Queiroz G, Simon SD, et al. Time interval between diagnosis to treatment of breast cancer and the impact of health insurance coverage: a sub analysis of the AMAZONA III Study (GBECAM 0115). Breast Cancer Res Treat. 2023;198(1):123-30. https://doi.org/10.1007/s10549-022-06809-8
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Nicole Brandão Dourado, Camila Hak MonteiroMonteiro, Carla Emanuelle Nascimento de Medeiros, Débora Cristina Damasceno, Isabel de Melo Guerreiro, Yasmin Oliveira Soares, Yasmine Jurdi Jasserand, Hilka Flávia Barra Espírito Santo Alves Pereira
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
