ArticleThe oncologist2022
Breast Cancer Treatment Delay in SafetyNet Health Systems, Houston Versus Southeast Brazil.
Article in The oncologist, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quantifying the impact of treatment delays on breast cancer survival outcomes: a comprehensive meta-analysis.GeroScience · 2026Pooled it
- Incidence of palliative treatment among breast cancer patients undergoing neoadjuvant therapy: an analysis of the Brazilian public health system.Scientific reports · 2025Article
- Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014-2019.BMC public health · 2023Article
- Effects of the COVID-19 pandemic on delays in diagnosis-to-treatment initiation for breast cancer in Brazil: a nationwide study.Ecancermedicalscience · 2023Article
- Breast cancer in women 40-50 and over 70 years of age: the need for screening in Brazil.Radiologia brasileiraReview
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBreast cancer outcomes among patients who use safety-net hospitals in the highly populated Harris County, Texas and Southeast Brazil are poor. It is unknown whether treatment delay contributes to these outcomes.
methodsWe conducted a retrospective cohort analysis of patients with non-metastatic breast cancer diagnosed between January 1, 2009 and December 31, 2011 at Harris Health Texas and Unicamp's Women's Hospital, Barretos Hospital, and Brazilian National Institute of Cancer, Brazil. We used Cox proportional hazards regression to evaluate association of time to treatment and risk of recurrence (ROR) or death.
resultsOne thousand one hundred ninety-one patients were included. Women in Brazil were more frequently diagnosed with stage III disease (32.3% vs. 21.1% Texas; P = .002). Majority of patients in both populations had symptom-detected disease (63% in Brazil vs. 59% in Texas). Recurrence within 5 years from diagnosis was similar 21% versus 23%. Median time from diagnosis to first treatment defined as either systemic therapy (chemotherapy or endocrine therapy) or surgery, were comparable, 9.9 weeks versus 9.4 weeks. Treatment delay was not associated with increased ROR or death. Higher stage at diagnosis was associated with both increased ROR and death.
conclusionTime from symptoms to treatment was considerably long in both populations. Treatment delay did not affect outcomes. IMPACT: Access to timely screening and diagnosis of breast cancer are priorities in these populations.
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