Abstract
IntroductionBreast cancer is the leading cause of death by cancer in women in Brazil. Timely access to treatment is a priority for health policy in the country. However, indicators of the disease are not equally distributed between women. Poverty and low levels of schooling associate with late diagnosis, worse prognosis and lower survival.ObjectiveTo investigate differences between women from different socio-demographic profiles in the breast cancer care trajectory in Belo Horizonte, Brazil.MethodThis is a hermeneutic study through narrative analysis. The selection of the participants was based on data from hospital records of four public and private oncology services in Belo Horizonte, Brazil, according to the following variables: age, levels of schooling, and treatment cost source (Proxy of income): In-depth interviews were performed with 35 women characterized in three profiles: Profile 1 (n = 7), age range 51–69 years, schooling ≥15 years and private treatment cost; Profile 2 (n = 13), age range 35–58 years, schooling = 11 years and predominantly public treatment costing; Profile 3 (n = 15), age range 43–79 years, schooling ≤ 8 years and public treatment cost.ResultsThe analysis of the narratives allowed the identification of three main themes (preventive care and first signs/symptoms; search for care and diagnosis of cancer; treatment and perceptions about care received) that highlighted differences between the trajectories, with prejudice to women with characteristics of greater vulnerability (Profile 3).ConclusionAlthough in Brazil the attention to women with breast cancer is guided by principles of equality and equity of care, it is necessary to develop mechanisms to prevent discriminatory practices and that guarantee equality of access to diagnosis and treatment.
Highlights
Breast cancer is the leading cause of death by cancer in women in Brazil
Women in profile 2 were aged between 35 and 58 years. They had an intermediate level of schooling (11 years of study) and their cancer care is predominantly funded by the Brazilian public health system (SUS)
Other important problems related to the breast cancer care have been identified: precarious labor ties that make it difficult to seek preventive care, suffering during treatment caused by material and immaterial deprivation, lack of basic social support in post-treatment, among others
Summary
Breast cancer is the leading cause of death by cancer in women in Brazil. Timely access to treatment is a priority for health policy in the country. Prevention actions and timely access to resources of medium and high complexity for diagnosis and treatment of breast cancer are priorities of public health policy in Brazil [2]. The most frequently investigated population segment is one that presents characteristics of social vulnerability and does not fit into said care, either due to difficulties in scheduling appointments and examinations, or due to behavioral barriers (lack of information, fear, shame, etc.). Given this context, it is necessary to know how women from different social groups perceive their disease process and care trajectory to establish comparisons and investigate differences in the care received
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