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Ferreira ADSS, Cintra JRD, Fayer VA, Nogueira MC, Júnior CB, Bustamante-Teixeira MT, Chaoubah A, Cintra AD, Simão CM, Guerra MR. Breast cancer survival and the health system in Brazil: an analysis of public and private healthcare. Front Oncol 2023; 13:927748. [PMID: 37305573 PMCID: PMC10248159 DOI: 10.3389/fonc.2023.927748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/01/2023] [Indexed: 06/13/2023] Open
Abstract
Background The incidence of breast cancer is increasing globally; however, survival outcomes vary and are lower in developing countries. Methods We analyzed the 5- and 10-year survival rates for breast cancer according to the type of healthcare insurance (public vs. private) in a referral center for cancer care in the Brazilian southeast region. This hospital-based cohort study included 517 women diagnosed with invasive breast cancer between 2003 and 2005. The Kaplan-Meier method was used to estimate the probability of survival, and the Cox proportional hazards regression model was used to assess prognostic factors. Results The 5- and 10-year breast cancer survival rates were as follows: private healthcare service survival rate of 80.6% (95% CI 75.0-85.0) and 71.5% (95% CI 65.4-77.1), respectively, and public healthcare service survival rate of 68.5% (95% CI 62.5-73.8) and 58.5% (95% CI 52.1-64.4), respectively. The main factors associated with the worst prognosis were lymph node involvement in both healthcare services and tumor size >2 cm only in public health services. The use of hormone therapy (private) and radiotherapy (public) was associated with the best survival rates. Conclusions The survival discrepancies found between health services can be explained mainly by the difference in the stage of the disease at the time of diagnosis, indicating inequalities in access to the early detection of breast cancer.
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Affiliation(s)
- Adriana de Souza Sérgio Ferreira
- Instituto Oncológico de Juiz de Fora/Hospital 9 de Julho, Departamento de Oncologia Clínica, Juiz de Fora, Brazil
- Programa de Pós-Graduação em Saúde da Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Juiz de Fora, Brazil
| | - Jane Rocha Duarte Cintra
- Instituto Oncológico de Juiz de Fora/Hospital 9 de Julho, Departamento de Oncologia Clínica, Juiz de Fora, Brazil
| | - Vívian Assis Fayer
- Programa de Pós-Graduação em Saúde Coletiva da Universidade Federal de Juiz de Fora (UFJF), Departamento de Saúde Coletiva, Juiz de Fora, Brazil
| | - Mário Círio Nogueira
- Programa de Pós-Graduação em Saúde Coletiva da Universidade Federal de Juiz de Fora (UFJF), Departamento de Saúde Coletiva, Juiz de Fora, Brazil
| | | | - Maria Teresa Bustamante-Teixeira
- Programa de Pós-Graduação em Saúde da Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Juiz de Fora, Brazil
- Programa de Pós-Graduação em Saúde Coletiva da Universidade Federal de Juiz de Fora (UFJF), Departamento de Saúde Coletiva, Juiz de Fora, Brazil
| | - Alfredo Chaoubah
- Programa de Pós-Graduação em Saúde da Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Juiz de Fora, Brazil
- Programa de Pós-Graduação em Saúde Coletiva da Universidade Federal de Juiz de Fora (UFJF), Departamento de Saúde Coletiva, Juiz de Fora, Brazil
| | - Arthur Duarte Cintra
- Instituto Oncológico de Juiz de Fora/Hospital 9 de Julho, Departamento de Oncologia Clínica, Juiz de Fora, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Brazil
| | - Caroline Montes Simão
- Instituto Oncológico de Juiz de Fora/Hospital 9 de Julho, Departamento de Oncologia Clínica, Juiz de Fora, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Brazil
| | - Maximiliano Ribeiro Guerra
- Programa de Pós-Graduação em Saúde Coletiva da Universidade Federal de Juiz de Fora (UFJF), Departamento de Saúde Coletiva, Juiz de Fora, Brazil
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Campos AAL, Guerra MR, Fayer VA, Ervilha RR, Cintra JRD, Medeiros IRD, Silveira MCD, Bustamante-Teixeira MT. Time to diagnosis and treatment for breast cancer in public and private health services. Rev Gaucha Enferm 2022; 43:e20210103. [PMID: 35613242 DOI: 10.1590/1983-1447.2022.20210103.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze the time to diagnosis and treatment for breast cancer and the associated factors, according to the type of care (public vs. private). METHODOLOGY Retrospective cohort study with 477 women diagnosed with breast cancer between 2014 and 2016. Data were collected in an oncology service in a municipality in Minas Gerais, in the 2018-2019 period. Analyzes were performed using the Kaplan-Meier method and Cox's proportional regression model. RESULTS The median time to diagnosis was 70 days, being shorter for women who discovered the disease through screening tests and who were diagnosed in early stages of the disease. The median time for treatment was 32 days, which was shorter for women assisted by private health service, with a high level of education and who were diagnosed in early stages. CONCLUSIONS Private care and facilitators of access to breast cancer care were associated with shorter waiting times.
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Affiliation(s)
- Angélica Atala Lombelo Campos
- Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Programa de Pós-Graduação em Saúde Coletiva. Juiz de Fora, Minas Gerais, Brasil
| | - Maximiliano Ribeiro Guerra
- Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Programa de Pós-Graduação em Saúde Coletiva. Juiz de Fora, Minas Gerais, Brasil
| | - Vívian Assis Fayer
- Universidade Federal de Juiz de Fora (UFJF), Núcleo de Assessoria, Treinamentos e Estudos em Saúde. Juiz de Fora, Minas Gerais, Brasil
| | - Rafaela Russi Ervilha
- Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Programa de Pós-Graduação em Saúde Coletiva. Juiz de Fora, Minas Gerais, Brasil
| | | | - Iara Renault de Medeiros
- Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina. Juiz de Fora, Minas Gerais, Brasil
| | | | - Maria Teresa Bustamante-Teixeira
- Universidade Federal de Juiz de Fora (UFJF), Faculdade de Medicina, Programa de Pós-Graduação em Saúde Coletiva. Juiz de Fora, Minas Gerais, Brasil
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de Freitas RM, Guerra MR, Fayer VA, Campos AAL, Cintra JRD, Warren J, Ervilha RR, de Paula CD, Bustamante-Teixeira MT. Histological and Immunohistochemical Characteristics for Hereditary Breast Cancer Risk in a Cohort of Brazilian Women. Rev Bras Ginecol Obstet 2022; 44:761-770. [PMID: 35468643 PMCID: PMC9948274 DOI: 10.1055/s-0042-1743103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population. METHODS This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016. RESULTS Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group. CONCLUSION From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.
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Affiliation(s)
- Renata Mendes de Freitas
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.,Epidemiology of Congenital Malformations Laboratory, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Maximiliano Ribeiro Guerra
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Vívian Assis Fayer
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | | | - Joan Warren
- Independent Researcher, Washington, United States
| | - Rafaela Russi Ervilha
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Camila Damasceno de Paula
- Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Campos AAL, Guerra MR, Fayer VA, Ervilha RR, Cintra JRD, Medeiros IRD, Silveira MCD, Bustamante-Teixeira MT. Tempo para diagnóstico e tratamento do câncer de mama na assistência pública e privada. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210103.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RESUMO Objetivo: Analisar o tempo para o diagnóstico e tratamento do câncer de mama e os fatores associados, segundo o tipo de assistência (pública vs. privada). Métodos: Coorte retrospectiva com 477 mulheres diagnosticadas com câncer de mama entre 2014-2016. Os dados foram coletados em um serviço de oncologia de um município de Minas Gerais, entre 2018-2019. As análises foram realizadas pelo método de Kaplan-Meier e pelo modelo de regressão de Cox. Resultados: O tempo mediano para diagnóstico foi de 70 dias, sendo menor para aquelas que descobriram a doença por exames de rastreamento e diagnosticadas em estádios iniciais. O tempo mediano para o tratamento foi de 32 dias, sendo menor para as mulheres assistidas pela rede privada, com alta escolaridade e diagnosticadas em estádios iniciais. Conclusões: Assistência na rede privada e facilitadores do acesso ao cuidado do câncer de mama associaram-se a menores tempos de espera.
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Nogueira MC, Fayer VA, Corrêa CSL, Guerra MR, Stavola BD, dos-Santos-Silva I, Bustamante-Teixeira MT, Silva GAE. Inequities in access to mammographic screening in Brazil. CAD SAUDE PUBLICA 2019; 35:e00099817. [DOI: 10.1590/0102-311x00099817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 02/06/2019] [Indexed: 12/24/2022] Open
Abstract
Abstract: Our objectives with this study were to describe the spatial distribution of mammographic screening coverage across small geographical areas (micro-regions) in Brazil, and to analyze whether the observed differences were associated with spatial inequities in socioeconomic conditions, provision of health care, and healthcare services utilization. We performed an area-based ecological study on mammographic screening coverage in the period of 2010-2011 regarding socioeconomic and healthcare variables. The units of analysis were the 438 health micro-regions in Brazil. Spatial regression models were used to study these relationships. There was marked variability in mammographic coverage across micro-regions (median = 21.6%; interquartile range: 8.1%-37.9%). Multivariable analyses identified high household income inequality, low number of radiologists/100,000 inhabitants, low number of mammography machines/10,000 inhabitants, and low number of mammograms performed by each machine as independent correlates of poor mammographic coverage at the micro-region level. There was evidence of strong spatial dependence of these associations, with changes in one micro-region affecting neighboring micro-regions, and also of geographical heterogeneities. There were substantial inequities in access to mammographic screening across micro-regions in Brazil, in 2010-2011, with coverage being higher in those with smaller wealth inequities and better access to health care.
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Duarte DDAP, Corrêa CSL, Fayer VA, Nogueira MC, Bustamante-Teixeira MT. Avaliação de método para classificação automatizada de pares em relacionamentos probabilísticos de bancos de dados. CAD SAUDE PUBLICA 2019; 35:e00066419. [DOI: 10.1590/0102-311x00066419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 08/23/2019] [Indexed: 11/21/2022] Open
Abstract
Resumo: O objetivo foi testar e avaliar a acurácia de um método para a seleção de escore em relacionamento probabilístico de banco de dados, de forma a viabilizar a automatização da identificação de pares verdadeiros dispensando a etapa de inspeção manual. Estudo de acurácia utilizando dados do Sistema de Informação do Câncer de Mama (SISMAMA) de Minas Gerais, Brasil, de 2009 e 2010. Após o processo de limpeza e padronização, foi realizado o relacionamento probabilístico dos bancos 2009 e 2010 utilizando 16 passos, sendo que cada passo foi inspecionado manualmente para se obter um padrão-ouro. Posteriormente, selecionaram-se amostras que foram inspecionadas e avaliadas para calcular a acurácia do método de seleção dos pares verdadeiros. Todos os passos e amostras com 200 e 300 pares apresentaram alta sensibilidade (recall) > 0,97, alto valor preditivo positivo (precision) > 0,95 e altas acurácia (> 0,97), medida F (> 0,96) e área sob a curva precision-recall (> 0,98). A amostra com 100 pares evidenciou altos valores para essas medidas, porém com escores mais baixos. Dos 16 passos avaliados, o uso de apenas três de forma combinada foi suficiente para identificar 99,24% dos pares verdadeiros no banco total. O método proposto permite automatizar o relacionamento das bases de dados, mantendo a acurácia do método. Facilita a utilização de relacionamento probabilístico no âmbito dos serviços de saúde, especialmente para a vigilância e gestão em saúde.
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Nogueira MC, Guerra MR, Cintra JRD, Corrêa CSL, Fayer VA, Bustamante-Teixeira MT. Disparidade racial na sobrevivência em 10 anos para o câncer de mama: uma análise de mediação usando abordagem de respostas potenciais. CAD SAUDE PUBLICA 2018; 34:e00211717. [DOI: 10.1590/0102-311x00211717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 05/02/2018] [Indexed: 01/23/2023] Open
Abstract
Os objetivos foram investigar a associação entre raça/cor e a sobrevivência em 10 anos de mulheres com câncer de mama e o papel do estadiamento como mediador. Coorte hospitalar com 481 mulheres com câncer invasivo de mama, diagnosticadas entre 2003 e 2005. Foram feitas comparações entre mulheres brancas e negras quanto às características sociodemográficas e ao estadiamento, usando o teste qui-quadrado, e à sobrevivência em 10 anos, usando os métodos de Kaplan-Meier e regressão de Cox. Foram estimados para a variável raça/cor efeitos diretos e indiretos, mediados pelo estadiamento, com ajuste para a condição social da área de residência e idade, utilizando o modelo de respostas potenciais (contrafactual) e regressão múltipla de Cox. As mulheres negras residiam em setores censitários de menor renda, eram usuárias do setor público em maior proporção e foram diagnosticadas com estadiamentos mais avançados. A sobrevivência específica em 10 anos foi de 64,3% (IC95%: 60,0; 68,9), com diferença significativa entre brancas (69,5%; IC95%: 64,8; 74,6) e negras (44%; IC95%: 35,2; 55,1). Nos modelos múltiplos, ajustados para renda e idade, as negras tiveram pior prognóstico (HR = 2,09; IC95%: 1,76; 2,51), e a proporção mediada pelo estadiamento foi de 40% (IC95%: 37; 42). Há disparidade racial na sobrevivência do câncer de mama em 10 anos, mediada principalmente pelo estadiamento mais avançado da doença nas mulheres negras. Isso aponta para a necessidade de ampliar a cobertura e a qualidade do programa de rastreamento dessa doença e facilitar o acesso ao diagnóstico e tratamento precoces, com vistas à redução da iniquidade racial.
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Gonçalves H, Guerra MR, Duarte Cintra JR, Fayer VA, Brum IV, Bustamante Teixeira MT. Survival Study of Triple-Negative and Non-Triple-Negative Breast Cancer in a Brazilian Cohort. Clin Med Insights Oncol 2018; 12:1179554918790563. [PMID: 30083066 PMCID: PMC6071162 DOI: 10.1177/1179554918790563] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/19/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Brazilian cohort and identify potential prognostic factors. METHODS This hospital-based retrospective cohort study included 447 women with breast cancer treated at referral centers in Southeastern Brazil. Overall and disease-free survival were compared; prognostic factors were evaluated. RESULTS Triple-negative breast cancer corresponded to 19.5% of breast cancer diagnosis and was more prevalent among nonwhite and less educated women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 5-year overall and disease-free survival were 62.1% and 57.5% for TNBC and 80.8% and 75.3% for non-TNBC, respectively (P < .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with nonwhite ethnicity, lower education level, lymph node involvement, and advanced stage. CONCLUSIONS Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.
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Affiliation(s)
- Homero Gonçalves
- Instituto Oncológico de Juiz de
Fora/Hospital 9 de Julho, Juiz de Fora, Brazil
- Post-Graduate Program in Health, Faculty
of Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Maximiliano Ribeiro Guerra
- Post-Graduate Program in Public Health,
Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
- Inserm U900, Institut Curie, PSL
Research University, Paris, France
| | | | - Vívian Assis Fayer
- Post-Graduate Program in Public Health,
Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Igor Vilela Brum
- Faculty of Medicine, Universidade
Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Maria Teresa Bustamante Teixeira
- Post-Graduate Program in Health, Faculty
of Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
- Post-Graduate Program in Public Health,
Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
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Fayer VA, Guerra MR, Cintra JRD, Bustamante-Teixeira MT. Ten-year survival and prognostic factors for breast cancer in the southeast region of Brazil. Rev Bras Epidemiol 2018; 19:766-778. [PMID: 28146166 DOI: 10.1590/1980-5497201600040007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 05/31/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction: Breast cancer is an important public health issue in many parts of the world. Thus, it shows relevant incidence and is considered one of the main causes of death from cancer among women. Objective: To analyze ten-year survival and prognostic factors in women with invasive breast cancer. Methods: The cohort was composed of 195 women assisted in an oncology referral center in the municipality of Juiz de Fora, state of Minas Gerais, Brazil, who were diagnosed with the disease in 2000 and 2001. Sociodemographic, tumoral, health service, and treatment-related characteristics were analyzed. The Kaplan-Meier method was used to estimate the survival functions and the Cox model of proportional hazards for the evaluation of prognostic factors. Results: The ten-year survival after diagnosis was of 56.3%. The major independent prognostic factors associated with increased risk of death were tumor size > 2.0 cm (hazard ratio - HR = 1.9; confidence interval - 95%CI 1.0 - 3.2) and presence of compromised lymph nodes (HR = 3.7; 95%CI 2.1 - 5.9). Conclusion: These findings reinforce the need of adopting actions that ensure access of the target population to the recommended diagnostic and therapeutic modalities, thus contributing to achieve earlier diagnosis and better survival rates.
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Affiliation(s)
- Vívian Assis Fayer
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Juiz de Fora - Juiz de Fora (MG), Brasil
| | - Maximiliano Ribeiro Guerra
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Juiz de Fora - Juiz de Fora (MG), Brasil
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Corrêa CSL, Pereira LC, Leite ICG, Fayer VA, Guerra MR, Bustamante-Teixeira MT, Corrêa CSL, Pereira LC, Leite ICG, Fayer VA, Guerra MR, Bustamante-Teixeira MT. Rastreamento do câncer de mama em Minas Gerais: avaliação a partir de dados dos sistemas de informações do Sistema Único de Saúde*. Epidemiologia e Serviços de Saúde 2017; 26:481-492. [DOI: 10.5123/s1679-49742017000300006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/04/2016] [Indexed: 11/02/2022] Open
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Diniz RW, Guerra MR, Cintra JRD, Fayer VA, Teixeira MTB. Disease-free survival in patients with non-metastatic breast cancer. Rev Assoc Med Bras (1992) 2017; 62:407-13. [PMID: 27656849 DOI: 10.1590/1806-9282.62.05.407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/25/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Breast cancer is the second most common malignancy in the world and the one with highest incidence in the female population; it is also a major cause of death from cancer among women. OBJECTIVE To analyze the disease-free survival (DFS) at 5 years and prognostic factors in women with non-metastatic invasive breast cancer treated at a referral center for cancer care located in a medium-sized city in the Southeast of Brazil. METHOD Patients diagnosed with the disease between 2003 and 2005 and identified through the institution's cancer hospital records were analyzed. The follow-up of cases was carried out through hospital records, and complemented by search in the database of the Mortality Information System (SIM) as well as telephone contact. The variables analyzed were distributed in the following blocks: socio-demographic data, tumor-related characteristics, and treatment-related characteristics. Survival functions were calculated using the Kaplan-Meier method and the prognostic factors were analyzed based on Cox proportional hazard model. RESULTS The study showed a DFS at 5 years of 72% (95CI 67.6-75.9). The main variables independently associated with DFS were lymph node involvement, use of hormone therapy, and education level. CONCLUSION This study reinforces the importance of early diagnosis for DFS, pointing to the role of social aspects in this regard. The relevance of this research in the country is also highlighted, given the scarcity of studies on DFS in the Brazilian population.
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Affiliation(s)
- Roberta Wolp Diniz
- MSc in Collective Health from Universidade Federal de Juiz de Fora (UFJF) - Clinical Oncologist, Instituto Oncológico/Hospital 9 de Julho, Juiz de Fora. Coordinator of the Medical Oncology Residency Program at Instituto Oncológico de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Maximiliano Ribeiro Guerra
- PhD in Collective Health from Universidade Estadual do Rio de Janeiro (UERJ) - Professor of the Department of Collective Health, Faculdade de Medicina, UFJF, Juiz de Fora, MG, Brazil
| | - Jane Rocha Duarte Cintra
- PhD in Collective Health from UFJF - MD, Oncologist, and Adjunct Professor of Medical Oncology, Universidade Presidente Antonio Carlos, Juiz de Fora, MG, Brazil
| | - Vívian Assis Fayer
- MSc in Collective Health from UFJF - Physiotherapist and Grant holder for technical support to research in the Collective Health Graduate Program (PPGSC) and the Center for Advisement, Training and Studies in Health (NATES) of UFJF, Juiz de Fora, MG, Brazil
| | - Maria Teresa Bustamante Teixeira
- PhD in Collective Health from UERJ - Coordinator of the Collective Health Graduate Program, Adjunct Coordinator of the NATES/UFJF and Editor-in-chief of the APS Journal, Juiz de Fora, MG, Brazil
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Godinho MR, Ferreira AP, Fayer VA, Bonfatti RJ, Greco RM. Capacidade para o trabalho e fatores associados em profissionais no Brasil. Rev Bras Med Trab 2017. [DOI: 10.5327/z1679443520177012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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