Dados do Trabalho

Título

A IMPORTANCIA DO ATENDIMENTO INTEGRADO E RESOLUTIVO PARA REDUZIR O TEMPO DE INICIO DO TRATAMENTO EM 8.357 PACIENTES COM CANCER DE MAMA TRATADAS PELO SISTEMA UNICO DE SAUDE (SUS) NO CENTRO DE REFERENCIA DA SAUDE DA MULHER (CRSM).

Título em Inglês

THE IMPORTANCE OF INTEGRATED AND RESOLUTVE CARE TO REDUCE THE TIME TO START TREATMENT IN 8,357 BREAST CANCER PATIENTS TREATED BY THE UNIFIED HEALTH SYSTEM (SUS) AT THE WOMEN’S HEALTH REFERENCE CENTER (CRSM).

Introdução

Introduction: In 2021, it is estimated tha Brazil will have 66,280 new cases of breast câncer. Unfortunately, around 55% of the cases treated by SUS are symptomatic and are in advanced stages. The long time for biopsy and the beginnig of treatment contribute to the progression of these tumors, with worsening prognosis. In order to reduce the time to start therapy, we implemented a model of integrated multidisciplinar care with high resolution (CARE).

Objetivos

Objective: The purpose of this work is to demonstrate the main barries and solutions found to reduce the time to start treatment at the instituion, acoording to law nº 12.732, wich recommends the start of therapy in 60days, preventing the progression of the disease and reducing mortality.

Métodos

Method: The information was registered in the CRSM data colletion system from the first day of care until the start of therapy (surgical or chemotherapy), in a cross-sectional cohort of 8,357 patients from January 2011 to December 2018. Patients referred, were seen at CARE and underwent consultation with na anesthesiologist or oncology in the servisse receving a previus appointment to start treatment.

Resultados

Results: After the integration of the anestheologist and clinical oncologist, in 2014, there was a significant reduction from 55 to 38 days in the time to start treatment.
Discuccion: CARE started integrated care with biopsy on the same day as the initial consulation in 2006, reducing returns and time to diagnosis from 90 to 15 days. CRSM serves more than 1,200 new cases/year, about 30% of SUS cases in the city of São Paulo (SP). A 12 week surgical delay for all breast câncer patients fr one year (for example in the COVID 19 pandemic) would lead to 1,400 excess deaths in the United Kingdon and 6,100 in the United States, assuming surgery was the first treatment by 83%.

Conclusões

Conclusion: Our experience show that the training od mastologits to perform the biopsy in the first consultation, the public/private partnership to obtain the anatomopathological and immunohistochemical results in 15 days and the multidisciplinary integrated care is possible, llowing the average onset of treatment is close to 30 days, which may reduce the proportion of advanced cases in SUS and law nº 12.732.

Palavras Chave

Delay in the diagnosis and treatment

Área

DETECTION / DIAGNOSIS - Breast lesion