Clinical and Epidemiological Profile of Breast Cancer in Mexico: Results of the Seguro Popular

Abstract

PurposeOne half of the Mexican population lacks comprehensive health care coverage. In 2003, a reform to the General Health Law was approved that led to the creation of the System of Social Protection in Health and made universal health coverage mandatory. The main innovation of this reform was Seguro Popular, which provided coverage for breast cancer. Here we report the outcomes of women with breast cancer treated at a cancer center in Mexico under Seguro Popular.Materials and MethodsThis was a retrospective cohort study that included all patients with breast cancer treated in the Instituto Nacional de Cancerología in Mexico City between January 2007 and December 2013 with Seguro Popular coverage. Demographic and clinical information were collected and survival outcomes were analyzed.ResultsA total of 4,300 women with breast cancer were included in this analysis. Most patients had locally advanced disease at diagnosis (53%, n = 2,293), and 13% (n = 558) presented with stage IV disease. Neoadjuvant chemotherapy was administered to 1,834 patients (52%), with a pathologic complete response in 25.1% (n = 460). Median follow-up was 40.5 months. Five-year survival for the entire cohort was 82% (95% CI, 81% to 84%). Five-year survival was 97% for early-stage disease (95% CI, 95% to 98%), 82% for locally advanced disease (95% CI, 80% to 84%), and 36% for metastatic disease (95% CI, 30% to 42%).ConclusionThis represents the first description of a cohort of patients with breast cancer treated in Mexico under Seguro Popular. Seguro Popular has allowed our institution, and other Mexican centers, to establish efficient standardized mechanisms to treat patients with breast cancer.

Risk factors for the development of hematological toxicity during the application of weekly paclitaxel in breast cancer

“…On the other hand, 89.5% of the population maintained a dose intensity above 75 mg/m 2 /week despite the fact that 1 out of each 5 patients had advanced disease, which comparable with the mean dose intensity of 77 mg/m 2 / week reported outside the setting of clinical trials for early disease 3 . According to a previous publication of our group, this 10.5% of patients with a dose intensity lower than 75 mg/m 2 /week does not negatively affect our population survival 14 .…”

Alerta Rosa: Novel Alert and Navigation Breast Cancer Program in Nuevo Leon, Mexico, for Reducing Health System Interval Delays

“…). Stages at diagnosis of Alerta Rosa patients partially differ from those reported in Mexico by the Instituto Nacional de Cancerologia, a large referral oncologic hospital (stage II 45% vs. 36%, stage III 32% vs. 36%, and stage IV 5% vs. 13%, respectively) .…”

Implementation of a microsurgical breast reconstruction program in Mexico

“…Breast cancer is the most common malignancy in Latin America and in Mexico (Chávarri‐Guerra et al, ; Reynoso‐Noveron et al, ), and providing multidisciplinary care for patients with breast cancer represents a major challenge for healthcare systems throughout the region (Chávarri‐Guerra et al, ; Reynoso‐Noveron et al, ). Since 2007, the Mexican government, through the Seguro Popular insurance system, has provided coverage for breast cancer treatment (Chávarri‐Guerra et al, ;Consejo de Salubridad General, ; Reynoso‐Noveron et al, ). Unfortunately, Seguro Popular does not cover other interventions, such as reconstructive surgery (Consejo de Salubridad General, ; Reynoso‐Noveron et al, ).…”

“…Since 2007, the Mexican government, through the Seguro Popular insurance system, has provided coverage for breast cancer treatment (Chávarri‐Guerra et al, ;Consejo de Salubridad General, ; Reynoso‐Noveron et al, ). Unfortunately, Seguro Popular does not cover other interventions, such as reconstructive surgery (Consejo de Salubridad General, ; Reynoso‐Noveron et al, ). The National Cancer Institute of Mexico (INCan) provides care under Seguro Popular coverage, and although breast reconstruction was available, its cost had to be covered out‐of‐pocket until 2012, when a federal government grant helped establish the Post‐Mastectomy Program (PMP), aimed at providing free reconstruction (Cuenta De La Hacienda Pública Federal, ).…”

“…Since 2007, the Mexican government, through the Seguro Popular insurance system, has provided coverage for breast cancer treatment (Chávarri-Guerra et al, 2012;Consejo de Salubridad General, 2011;Reynoso-Noveron et al, 2017). Unfortunately, Seguro Popular does not cover other interventions, such as reconstructive surgery (Consejo de Salubridad General, 2011;Reynoso-Noveron et al, 2017) Little is known about the status of both breast reconstruction and microsurgery in Latin America. A survey conducted among plastic surgeons in Argentina showed that most respondents performed less than 25 breast reconstructions per year, of which 80% were implantbased (Mayer, de Belaustegui, & Loustau, 2018).…”