Breast Cancer Treatment Delay-Associated Factors in Northern Minas Gerais

Abstract

Objective: Delay in breast cancer treatment can lead to advanced stages of the disease and higher associated mortality. The north of Minas Gerais is a transition area between the southeast and northeast of the country, has a vast territorial extension, and has a great social need, where there have been no previous studies on breast cancer diagnosis and treatment delay. Thus, the objective of this study was to analyze the time elapsed between detection, diagnosis, and treatment in patients with breast cancer treated at a High Complexity Care Unit in Oncology (UNACON) in the north of Minas Gerais, identifying breast cancer treatment delay-associated factors. Methods: This is a retrospective cohort study that evaluated secondary data, analyzing the total interval (defined as the time elapsed from the first symptom or mammographic abnormality to treatment initiation) and associated factors for treatment delay in breast cancer patients at an oncology referral center in the north of Minas Gerais. A logistic regression model was used to define the associated factors, assuming a significance of up to 5% in the final model. In all, 300 medical records were analyzed between 2016 and 2018. All ethical precepts for conducting the research were respected. Data collection was authorized by the health institution. The research project was approved by the Research Ethics Committee of the State University of Montes Claros (no 3.840.184/2020) as recommended by the guidelines of Resolution No. 466/2012 of the National Health Council of the Ministry of Health. Results: The median time of the total interval was 179.5 days, with 76.0% of patients presenting a delay in treatment initiation. The chances of delay in the total interval were greater in patients with lower education (odds ratio [OR]=2.01), with access to public cancer centers (OR=4.47), patients diagnosed by clinical examination (OR=2.24), and with brown and black skin color (OR=2.00). Conclusion: An important delay in treatment initiation for breast cancer patients was observed, and the associated variables highlight social inequalities. Therefore, it is recommended that more equitable strategies for women’s health care be adopted in northern Minas Gerais.