Overview of breast cancer in the Brazilian public health system

Introduction: Breast cancer is the most common neoplasm in women, being a public health problem due to its high incidence and morbimortality. The aim of the study is to provide an overview of breast cancer care in the SUS between 2015 and 2022.

Methods: Descriptive study with data from the SUS Information Systems and the INCA Cancer Hospital Registry for ICD-10 C50 between 2015 and 2022.

Results: Between 2015 and 2022, approximately 18 million screening mammograms were performed for women aged 50 to 69 by the SUS, with costs exceeding 800 million reais. During the Covid-19 pandemic, there was a significant reduction in the number of mammograms performed, with a 41.5% drop in 2020 and 18.9% in 2021 compared to 2019. In 2022, there was an increase of just over 1% in the number of mammograms compared to 2019. About 38% of breast cancer diagnoses occurred at advanced stages (3 and 4). Acre and Roraima had the worst staging outcomes (56%), while Rio Grande do Sul and São Paulo had the lowest percentages of diagnoses at stages 3 or 4. The average time between the first consultation and diagnosis was 34 days, with about 33% of cases taking more than 30 days for confirmation. Sergipe and Amazonas had the worst performances in the time to diagnosis. The average time between diagnosis and the start of treatment was 179 days, with Sergipe and Rondônia being the states with the worst performance. Between 2015 and 2022, nearly 532 thousand Hospitalization Authorizations were reported, with a total cost of over one billion reais. About 14 million high-complexity procedures for breast cancer treatment were performed, with about 400 thousand radiotherapy and the rest of chemotherapy, with total costs close to five billion reais. There was a significant reduction in the number of radiotherapy procedures over the period. The number of deaths from breast cancer reached 140,589. São Paulo recorded the highest number of deaths, followed by Rio de Janeiro.

Discussion and conclusion: Brazil faces challenges in the diagnosis and treatment of breast cancer, despite the 30 and 60-day laws and the National Policy for Cancer Prevention and Control. The Covid-19 pandemic worsened the situation, reducing the number of mammograms, hospital capacity, and diagnoses, highlighting the urgent need to improve access to health services and the prognosis of the disease.

Corresponding author: Catherine Moura da Fonseca Pinto (e-mail: catherine.moura@abrale.org.br).