Breast cancer survival in Brazil: How much health care access impact on cancer outcomes?

BACKGROUND: Breast cancer has a high incidence and increasing mortality in Southern Brazil. The present study evaluated clinical and sociodemographic characteristics, and their association with overall survival in a private cancer center. METHODS: 1113 breast cancer patients were included in this study. The association between survival and clinicopathological and sociodemographic characteristics was analyzed using Cox regression and Kaplan-Meyer curves. RESULTS: Median age at diagnosis was 52 years (SD 13.5). Most patients were diagnosed in stages 0 and I (62.7%), while only 1.3% had stage IV disease. Five- and 10-year overall survival were 93.5% and 83.8%, respectively. According to multivariate analysis, age at diagnosis (HR 1.05; CI95 1.03–1.06), staging (stage III: HR 4.04; CI95 1.34–12.19; stage IV: HR 9.61; CI95 2.17–42.50), high KI67 (HR 5.46; CI95 1.27–23.32) and distant recurrence (HR 7.28; CI95 4.79–11.06) were significantly associated with survival. Smoking status, years of education, BMI, and tumor biological status were not significantly associated with mortality. CONCLUSIONS: This cohort of Brazilian patients, who received timely and appropriate treatment, achieved outcomes that are comparable to those from high income countries. Breast cancer mortality seems dependent on the quality of health care available to patients.