Abstract Background: Long waiting times (WTs) to begin treatment after breast cancer (BC) diagnosis have been reported in the Brazilian public health system. However, there is a paucity of data regarding strategies that encompass women that look for primary care units due to self- perceived breast abnormalities up to the point of diagnosis. We have conducted a cross-sectional study to describe WTs from self-perception breast abnormalities to diagnosis and from diagnosis to the initiation of cancer treatment in the South-Fluminense region. Methods: A retrospective study was conducted by assessing medical reports of all BC patients registered at a High Complexity Oncology Assistance Unit (Unidade de Alta Complexidade em Oncologia, UNACON) from October 2021 to September 2023. Sociodemographic, clinicopathological, and WTs data were collected. WTs were subdivided into categories: 1) Waiting time (WT) from self-perception of breast abnormalities to the first imaging test (WT1); 2) WT from imaging test to core biopsy (WT2); 3) WT from biopsy collection to report release (WT3); 4) WT from biopsy report release to the first medical visit at UNACON (WT4); 5) WT from the first medical visit to the first treatment (WT5); 6) WT from the first imaging test to the first treatment (WT6); and 7) WT from breast biopsy report release to the first breast cancer treatment (WT7). The inclusion criteria required that WT data be recorded. All analyses were conducted using Python version 3.9 and p-values were adopted at 5% level of significance in all tests. The study was approved by Institutional Review Board, Coeps of Fundação Oswaldo Aranha CAAE 79726824.1.0000.5237. Results: A total of 322 cases were registered at UNACON, with 300 meeting the inclusion criteria. The median age was 59.0 years (95% CI 57.49- 60.51). Among patients, 143 (47.66%) were married, 163 (54.34%) were non-white and 117 (39.00%) were employed. In terms of educational level, 106 patients (35.33%) had an elementary school education, 100 (33.33%) had a high school education, and 28 (9.33%) had a university degree. The clinical stage at the diagnosis were 20 patients (6.67%) at stage 0 (in situ), 63 (21%) were at stage I, 117 (39%) were at stage II, 75 (25%) were at stage III, and 13 (4.33%) were at stage IV. The following WTs (median) have been found: WT1 was 59.0 days, (CI 95% 42.0 to 65.0); WT2 was 59.0 days (CI 95% 50.0 - 68.0); WT3 was 13.0 days (CI 95% 12.0 - 14.0); WT4 was 29.0 days (CI 95% 27.0 - 30.0); WT5 was 65 days (CI 95% 58.0 -71.0); WT6 was 185.0 days (CI 95% 174.0 - 202.0) and WT7 was 99.0 days (CI 95% 92.0 - 108.0). We observed a difference in WT1 between white patients 50 days versus non-white patients 60 days (p=0.04). Additionally, we observed in WT6 a difference of having a high school education 169 days compared to 225 days for those with only an elementary school education (p=0.01). Conclusion: Timely diagnosis in BC is a critical goal to be reached for public health in Brazilian population. Brazilian law established a 60-day interval to begin treatment after diagnosis, however this interval has been frequently longer, as we demonstrated in our results. Additionally, the WT from self-perception abnormalities to diagnosis is excessively long, meaning that focusing solely on the WT after diagnosis provides an unrealistic view of the overall timeline. Variables such as race and educational level may further exacerbate disparities within the system. By characterizing delays in diagnosis procedures and treatment beginning in the region, our data highlight weak points in the public health system. To recognize and plan a symptomatic woman directed strategy aligned with offering diagnosis procedures at an only one unit care might short WTs promoting timely diagnosis and treatment for BC. These insights can help local government managers to redirect actions to improve oncological care. Citation Format: Heloisa Resende, Leandro Ladislau, Vinícius de Queiroz Aguiar, Nataline Freitas de Azevedo Santos, Rafael Angelo Pinto de Souza, Filippe Rocha Mello, Frederico da Rocha Mello, Caio Miranda Oliveira, André Mattar. Delays from Self-Detection to Treatment of Breast Cancer in the South Fluminense Region: A Cross-Sectional Analysis [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-04-08.
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