Ethical issues surrounding breast cancer screening in Brazil

Gonçalves, Rodrigo; Soares-Jr, José Maria; Baracat, Edmund Chada; Filassi, José Roberto

doi:10.6061/clinics/2019/e1573

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…Although the prediction of patients that will achieve longer disease-free and overall survival after NAC facilitates patient management, NAC may increase the ipsilateral tumor recurrence rate compared with adjuvant therapy. In addition, the existence of healthcare access barriers and socioeconomic inequalities are the main reasons for late-stage diagnosis in developing countries and delaying surgery may result in decreased overall survival 11,12 .…”

Section: Discussionmentioning

confidence: 99%

Effects of enhancer of zeste homolog 2 and mucin 1 expressions on treatment response in breast cancer

Yetisir

Paydaş

Büyükşimşek

et al. 2023

Rev. Assoc. Med. Bras.

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OBJECTIVE: Breast cancer is the most common malignancy in women. In the treatment of these patients, pathological complete response is defined as the absence of invasive cancer in breast or lymph node tissue after the completion of neoadjuvant chemotherapy. In this study, we aimed to investigate the relationship of enhancer of zeste homolog 2 and mucin 1 expressions with pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy. METHODS: A total of 151 patients were included in the study. Enhancer of zeste homolog 2 and mucin 1 expressions were evaluated in the biopsy materials pre-neoadjuvant chemotherapy and post-neoadjuvant chemotherapy surgical material, and their relationship with pathological complete response was investigated. RESULTS: The pathological complete response rates were significantly higher among the hormone receptor-negative patients, those with a high Ki-67 score, and patients with HER2-positive. Higher pathological complete response rates were obtained from patients with enhancer of zeste homolog 2 expression positivity pre-neoadjuvant chemotherapy. In addition, after neoadjuvant chemotherapy, enhancer of zeste homolog 2 expression was found to be completely negative in materials with pathological complete response; that is, in breast tissues considered to be tumor-free. While there was no significant relationship between mucin 1 expression and pathological complete response pre-neoadjuvant chemotherapy, mucin 1 expression was determined to significantly differ between the tissues with and without pathological complete response among the surgical materials examined. CONCLUSION: In our study investigating the relationship between enhancer of zeste homolog 2 and mucin 1 expression and pathological complete response in patients who received neoadjuvant chemotherapy, we found that enhancer of zeste homolog 2 expression could be used as a predictive marker for pathological complete response. However, mucin 1 expression was not associated with pathological complete response.

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Section: Discussionmentioning

confidence: 99%

Effects of enhancer of zeste homolog 2 and mucin 1 expressions on treatment response in breast cancer

Yetisir

Paydaş

Büyükşimşek

et al. 2023

Rev. Assoc. Med. Bras.

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“…Most operable cases are diagnosed in later stages (53.5% stage 2 and 23.2% stage 3) 17 . Some authors advocate that the best strategy for Brazil is prompt care for symptomatic patients 18 . However, a recent study found that, when diagnosed at early stages, survival rates in Brazil are greater than 90% 19 .…”

Section: Discussionmentioning

confidence: 99%

Breast imaging hindered during covid-19 pandemic, in Brazil

Bessa¹

2021

Rev. saúde pública

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OBJECTIVE: To report the decrease in breast imaging after covid-19 pandemic, obtaining the number of mammograms performed in 2019 and 2020. Additionally, to investigate if there was an increase in the proportion of women undergoing mammography for diagnostic purposes, with palpable lesions. METHOD: This is a cross-sectional study, based on the number of mammograms performed by the Brazilian public health services, provided by DATASUS, an open access database. Mammograms from private institutions were not included. This study compares the number of mammograms performed in 2019 and 2020, in women aged 50–69 years, stratified by month, in each federal state, and the presence of palpable lumps (physician-reported). RESULTS: In total, 1,948,471 mammograms were performed in 2019 and 1,126,688 in 2020, for the population studied. These values represent a 42% decline. Monthly, a significant decreased is observed after April 2020. The results varied slightly according to federal state; yet the entire country was affected. Rondônia was the most affected state, with 67% decline. The proportion of women presenting palpable lumps increased from 7.06% on average in 2019 to 7.94% in 2020 (OR = 1.135, 95%CI 1.125–1.145, p = 0,001). DISCUSSION: The number of mammograms performed in 2020 declined considerably. Out of the women who presented for mammogram, the proportion of palpable lumps was significantly higher in 2020. Considering the detection rate of digital mammography, the loss of 800,000 exams means 4,000 undiagnosed breast cancer cases, by the end of 2020.

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