A survey of 400 Brazilian women has exposed significant gaps in access to breast cancer screening and in public understanding of the disease, UOL reports. The Ipsos poll, commissioned by the pharmaceutical company Novartis, interviewed women over 35 across all regions of the country, including patients in the public SUS system and in private clinics and hospitals.
The findings arrive during October, the month dedicated to breast cancer awareness, and suggest that awareness campaigns have not resolved persistent barriers to timely diagnosis and treatment.
Why it matters
Breast cancer mortality has fallen sharply in developed countries, but Brazil has seen far less progress. According to the Global Burden of Disease analysis cited by UOL, deaths from the disease dropped 23.1 percent in Europe since 1990, while Brazil's reduction over the same period was just 4.5 percent.
Guilherme Novita, president of the Brazilian Society of Mastology (SBM), told UOL that the difference reflects how quickly women in other countries seek care. In Europe, he said, routine mammography is common and women recognize that a change in the breast is not normal, so they consult a doctor quickly and get fast access to appointments.
Screening delays hit public patients hardest
The survey found that 63 percent of respondents complained about waiting times for a mammogram appointment. Among women using SUS, that figure rose to 77 percent.
Roughly one in three participants said they do not have a mammogram every year, and 15 percent of those whose doctor requested the exam never went through with it.
Novita told UOL that although Brazil appears to have enough mammography machines overall, they are concentrated in the South and Southeast, which helps explain the scheduling difficulties. He said the average wait for treatment to begin is 150 days.
Brazilian law grants women over 40 the right to a mammogram, requires follow-up tests within 30 days of an abnormal result, and sets a 60-day limit for starting treatment after a cancer diagnosis. Novita said reading the legislation gives the impression of living in Norway, but that reality diverges from what the rules promise.
In the private system, delays are shorter but still present. Novita said women sometimes wait for all their check-up results before booking a return visit, which can push the start of treatment to 60 or even 90 days.
Confusion over recurrence and long-term care
The poll found that 45 percent of women said they have many doubts about breast cancer. One point Novita stressed is that any change on a mammogram, even a slightly suspicious lesion that does not clearly indicate cancer, should be reported to a doctor immediately so that additional tests can settle the question.
Awareness of recurrence risk was mixed. While 87 percent of participants knew the disease could return, 39 percent did not know what "recidiva" — the medical term for recurrence — means. Novita acknowledged that doctors sometimes speak as if patients share their vocabulary, adding that this reminds him he is talking to a patient, not a colleague.
Twenty-nine percent of respondents said they receive less information than they would like, a share that climbs to 37 percent among SUS users.
Six in ten women said follow-up care after tumor treatment is important for lowering the risk of the cancer coming back, leaving four in ten unaware of that benefit. Novita warned that the idea lightning never strikes twice does not apply here, noting that women who have had breast cancer face a much higher risk of developing a new tumor in the years after treatment, which makes stricter monitoring necessary.
The survey also found that 64 percent of women understand that some cases require additional treatment to keep the tumor from returning, and that this phase can last up to ten years. Novita said many patients still believe everything ends with the last chemotherapy or radiotherapy session after surgery.
Heart health and weight enter the picture
Because more women now survive the disease, long-term side effects of treatment have become a bigger concern. Novita said patients should also see a cardiologist or general practitioner to check cholesterol and blood pressure periodically, since cancer medications can raise both. He described chemotherapy as far from harmless.
He added that health teams should monitor weight, which can rise for reasons ranging from emotional strain to the corticosteroids used to control allergic reactions to other cancer drugs. Obesity, he said, further increases cardiovascular risk and raises the threat of the tumor returning.
Novita also noted that cancer therapy can weaken muscles, a change often mistaken for a sign of menopause, which many patients enter earlier than usual. Without professionals to guide physical exercise, he said, managing these issues becomes harder.
The survey results point to a gap between the rights Brazilian law guarantees and what women actually experience, particularly in the public system. Watch for whether health authorities and candidates in this month's state-level discussions act on calls to strengthen screening capacity and patient follow-up.
