Breast cancer in Brazil: Screening program and surgical approach. (August 2021)

• Record Type: Journal Article
• Authors: Nascimento, João Henrique Fonseca; Vieira, Adriano Tito Souza; Souza Filho, Benjamim Messias; Tomaz, Selton Cavalcante; Delgado Bocanegra, Ronald Enrique; Melo Costa, Vitor Savio; Johnson, Luís Fernando Pinto; Gusmão-Cunha, André; Silva Neto, Marinho Marques; Andrade, André Bouzas
• Is Part Of: Cancer epidemiology. Volume 73(2021)
• Publication Date: 2021-08
• Subjects: Breast cancer -- Breast cancer screening -- Mammography -- Mastectomy -- Breast-conserving surgery; Cancer -- Epidemiology -- Periodicals; Cancer -- Prevention -- Periodicals; Cancer -- Diagnosis -- Periodicals; Carcinogenesis -- Periodicals; 616.994005
• DOI: 10.1016/j.canep.2021.101970
• Languages: English
• ISSNs: 1877-7821

Abstract

Highlights: Mammography programs have been encouraged and expanded in Brazil since the 2010. Numbers of breast-conserving surgeries are rising, in detrimental of radical surgeries. Average days of hospitalization was associated with an increasing number of breast-conserving surgery. Abstract: Background: Screening mammography for breast cancer (BC) is a current strategy that reduces the mortality of BC by up to 30 %. Although mastectomy has been an important component of treatment for decades, conservative surgery (lumpectomy) has become the gold-standard approach for most cases, yet it depends on early detection of the BC. Methods: This was an epidemiological study performed through DATASUS (2010–2018). We evaluated the temporal trend of screening mammograms, deaths from BC, and surgical procedures at national, regional and state levels. Statistical analysis was performed on VassarStat®—Website for Statistical Computation (Vassar College, New York, USA) and the R-software (R Foundation, v.4.0.3). Results: During 2010–2018 there were 67, 392 oncological mastectomies and 48, 567 lumpectomies in Brazil's health system. Mastectomies decreased in the Northeast (–3.67 % ± 0.43 per year) and in Bahia state (–3.58 % ± 0.24 per year). Lumpectomies increased in Brazil (median 2.19 (–9.6 to 20.96)), the Northeast (median –12.07 (–25.8 to 9.43)) and Bahia (median 0.16 (–29.1 to 1.9)). Also, screening mammograms increased in Brazil (3.29 % ± 0.43), the Northeast (6.36 % ± 0.49) and Bahia (5.51 % ± 0.31), with 35, 317, 728 exams during this period. Deaths from BC increased annually in Brazil (+4.13 % ± 0.86), the Northeast (+4.76 % ± 1.45) and Bahia (+5.65 % ± 0.83). Conclusion: The number of mammograms related to the screening program increased in the years 2010–2018 in Brazil. Furthermore, we identified an increase in lumpectomies as opposed to mastectomies, and this approach is associated with a reduction in hospitalization days by almost a half, which in turn might result in a cost decrease and probably an earlier return to work.