Prognostic factors and overall survival of breast cancer in the city of Goiania, Brazil: a population-based study

Freitas‐Junior, Ruffo; Nunes, Romão da Cunha; Martins, Edésio; Curado, María Paula; Freitas, Nilceana Maya Aires; Soares, Leonardo Ribeiro; Oliveira, José Carlos de

doi:10.1590/0100-69912017005003

Cited by 16 publications

(10 citation statements)

References 21 publications

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“…Cancer statistics can reveal the effectiveness of public health policies, the equity of resource distribution, and the impact of predictive factors on survival. Therefore, assessing breast cancer survival can help establish criteria for the objective evaluation of patient prognosis and can contribute to the improvement of cancer control strategies [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of breast cancer survival in a northeastern Brazilian state based on prognostic factors: A retrospective cohort study

et al. 2022

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Breast cancer is a major health problem worldwide. Analysis of breast cancer epidemiology in emerging countries enables assessment of prognostic factors, cancer care quality, and the equity of resource distribution. We aimed to estimate the overall (OS) and cancer-specific survival (SS) of breast cancer patients in the northeastern Brazilian state of Sergipe to identify independent prognostic factors. We analyzed a cohort for the factors age at diagnosis, place of residence, time to treatment, staging, and molecular classification, using the Kaplan–Meier method, log-rank test, Pearson’s chi-squared test and Cox regression model. The outcome was the vital status at the end of the study. Our analysis showed an OS probability of 0.72 and an SS probability of 0.75. In multivariate analysis, time to treatment within 60 days, stage IV, and triple-negative classification remained independent prognostic factors for both OS [unadjusted hazard ratio (HRp) 1.50 (1.21; 1.86), HRp 16.56 (8.35; 32.85), and HRp 2.73 (1.73; 4.29), respectively] and SS [HRp 1.43 (1.13; 1.81), HRp 20.53 (9.45; 44.56), and HRp 3.14 (1.88; 5.26), respectively]. Better survival was demonstrated for the following patients: those receiving their first treatment after 60 days, with an OS of 52.5 months (51.2; 53.8) and SS of 53.5 months (52.3; 54.7); stage I patients, with an OS of 58.8 months (57.7; 60.0) and SS of 59.2 months (58.1; 60.3); patients without nodal metastasis, with an OS of 54.2 months (53.0; 55.4) and SS of 55.6 months (54.5; 56.7); and patients with luminal A classification, with an OS of 56.8 months (55.0; 58.5) and SS of 57.8 months (56.2; 59.4). This study identified independent prognostic factors and that OS and SS were lower for patients from Sergipe than for patients in high-income areas. Therefore, determining the profiles of breast cancer patients in this population will inform specific cancer care.

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Section: Introductionmentioning

confidence: 99%

Analysis of breast cancer survival in a northeastern Brazilian state based on prognostic factors: A retrospective cohort study

et al. 2022

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“…Several randomized clinical trials conducted between the 1960s and the 1990s have reported a reduction in mortality from breast cancer of up to 40% in the female population of 50–69 years of age submitted to breast cancer screening [1–3]. In geographical regions with limited financial resources and difficulties in accessing standard oncological treatment [4–6], this strategy may represent an opportunity for more conservative treatments and better clinical outcomes [7–9].…”

Section: Introductionmentioning

confidence: 99%

Temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service between 2008 and 2017

et al. 2019

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Background In Brazil, 70% of the population depends on the public healthcare system. Since early detection is considered crucial, this study aimed to evaluate temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service (SUS) according to the different regions of the country between 2008 and 2017. Methods This ecological study analyzed data on breast cancer screening within the SUS for women aged 50–69 years. Coverage was calculated from the ratio between the number of screening tests conducted and the expected number for the target population. Joinpoint regression analysis was used to calculate annual percent changes (APC) in coverage. Results Around 19 million mammograms were performed in 50–69-year old women within the SUS between 2008 and 2016. The estimated APC indicates that breast cancer screening coverage increased by 14.5% annually in Brazil between 2008 and 2012 ( p < 0.01), with figures stabilizing between 2012 and 2017 as shown by an APC of − 0.4% ( p = 0.3). In the five geographic regions of the country, the APC initially increased, then stabilized in the north, northeast and southeast and decreased in the south and Midwest. Of the 26 states, coverage increased in seven and remained stable in six. In the other 13, there was an initial increase followed by stabilization in 11, and a reduction in coverage in two. In the Federal District, coverage remained stable throughout the study period. Conclusion Evaluation of the temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service revealed an initial increase, confirming that public policies were effective, although insufficient to ensure organized screening. There appears to be a lack of uniformity between the different regions and states and this situation is highlighted in the final 5-year period, with the APC reflecting stabilization of breast cancer screening coverage.

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“…Although metastatic breast cancer was not included as a separated health state, an additional decrease of utilities due to metastasis was reflected in a proportion (i.e. 8.4%) of patients within the breast cancer state [33]. Similarly, lower utility values due to end-stage ovarian cancer were applied to the proportion of women in the 'ovarian cancer' state, whose survival was expected to be < 1 year (i.e.…”

Section: Utilitiesmentioning

confidence: 99%

Economic Modelling of Screen-and-Treat Strategies for Brazilian Women at Risk of Hereditary Breast and Ovarian Cancer

Galendi¹,

Diz

Stock³

et al. 2020

Appl Health Econ Health Policy

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Background Clinical evidence supports the use of genetic counselling and BRCA1/2 testing for women at risk for hereditary breast and ovarian cancer. Currently, screen-and-treat strategies are not reimbursed in the Brazilian Unified Healthcare System (SUS). The aim of this modelling study was to evaluate the cost effectiveness of a gene-based screen-and-treat strategy for BRCA1/2 in women with a high familial risk followed by preventive interventions compared with no screening. Methods Adopting the SUS perspective, a Markov model with a lifelong time horizon was developed for a cohort of healthy women aged 30 years that fulfilled the criteria for BRCA1/2 testing according to the National Comprehensive Cancer Network (NCCN) guideline. For women who tested positive, preventive options included intensified surveillance, risk-reducing bilateral mastectomy and bilateral salpingo-oophorectomy. The Markov model comprised the health states 'well', 'breast cancer', 'death' and two post-cancer states. Outcomes were the incremental costs per quality-adjusted life-year (QALY) and the incremental costs per life-year gained (LYG). Data were mainly obtained by a literature review. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the results. Results In the base case, the screen-and-treat strategy resulted in additional costs of 3515 Brazilian reais

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Prognostic factors and overall survival of breast cancer in the city of Goiania, Brazil: a population-based study

Cited by 16 publications

References 21 publications

Analysis of breast cancer survival in a northeastern Brazilian state based on prognostic factors: A retrospective cohort study

Analysis of breast cancer survival in a northeastern Brazilian state based on prognostic factors: A retrospective cohort study

Temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service between 2008 and 2017

Economic Modelling of Screen-and-Treat Strategies for Brazilian Women at Risk of Hereditary Breast and Ovarian Cancer

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