Incidence, stage and survival rate of breast cancer patients treated at the clinical oncology service of the Clementino Fraga Filho University Hospital (HUCFF), Rio de Janeiro, Brazil, from January 2022 to September 2023

Keywords

breast cancer - survival rate - public health system

Patients accessing the public health system often present with more advanced stages of breast cancer at diagnosis and appear to have a worse prognosis. The present study aimed to identify the profile of breast cancer patients accessing the Unified Health System (Sistema Unico de Saude; SUS) Oncology Service in Rio de Janeiro, Brazil, as well as their histopathological and immunohistochemical characteristics, access to treatment, and percentage of deaths during the evaluated period. Patients with a diagnosis of breast cancer confirmed by histopathology and immunohistochemistry between January 2022 and September 2023 were included in the study. Patient data were recorded in Microsoft Excel spreadsheets and analyzed for the frequency of observed variables. The percentage of deaths that occurred during the studied period was recorded in February 2024. The study included 106 patients with confirmed breast cancer diagnoses, 105 of which were females with mean age of 59 years. Most patients (52.83%) were at stage III (p < 0.0001), followed by stage II (27.3%), stage IV (12.26%), and stage 0 (4.7%). The most common type of breast cancer was invasive carcinoma of no special type (73.6%), followed by lobular (10.5%), micropapillary (6.6%), mucinous (2.8%), cribriform (0.9%), and metaplastic (0.9%). The remaining patients had in situ carcinoma (4.7%). Half of the patients had luminal B subtype (p < 0.0001), followed by luminal A (22.7%), triple-negative (11.3%), triple-positive (9.4%), and HER2-enriched (6.6%). The majority of patients (53.7%) received neoadjuvant or adjuvant chemotherapy, whereas 13.2% received palliative chemotherapy and 33% did not receive any chemotherapy. All luminal patients received hormonal treatment, except those at stage 0 (in situ). All ten triple-positive patients and four of the seven HER2-enriched patients were treated with HER2 blockers. Five patients died (4.7%) during the studied period, four of which were stage IV and receiving palliative chemotherapy. Most patients had luminal B and stage III breast cancer, indicative of a worse prognosis in terms of response to therapies. Nonetheless, access to the hormonal and anti-HER2 drug therapies available through SUS likely had a positive impact on the short- and medium-term follow-up of these patients. Early diagnosis of breast cancer and facilitated access to specialized public health services can result in long-term benefits and cost reductions for the country.

Corresponding author: Ana Lúcia Crissiuma de Azevedo Juppa (e-mail: [e-mail]).