Análise de sobrevida e fatores prognósticos associados ao câncer de mama em uma unidade de alta complexidade em oncologia do Sistema Único de Saúde do Tocantins – 2015 a 2019

Abstract

Breast cancer is the leading cause of cancer-related death among Brazilian women, with a growing impact in the North and Northeast regions. This study aimed to analyze survival and prognostic factors associated with breast cancer in a High-Complexity Oncology Unit of the Unified Health System (SUS) in Tocantins State, Brazil, from 2015 to 2019. A retrospective cohort study was conducted using data from the Hospital-Based Cancer Registry (RHC) of the National Cancer Institute (INCA). The sample comprised 287 women diagnosed with malignant breast neoplasms (ICD-10: C50). Survival analysis was performed using the Kaplan– Meier method and Cox proportional hazards model to identify prognostic factors. The median age of the women was 52 years, lower than the national average. The overall survival rate was 91.5% at one year and approximately 43% at three years, with a median survival of 32 months. Advanced clinical staging, the absence of chemotherapy and hormone therapy, as well as non- attendance at follow-up imaging examinations, were associated with lower survival (p<0.05). In contrast, surgical treatment and regular follow-up were identified as protective factors. These findings indicate that late diagnosis and regional inequalities in access to treatment negatively affect survival, reinforcing the need for public policies aimed at early detection and continuity of oncological care in the Northern region of Brazil.