Cracking the code: Pioneering early detection and management of breast cancer in the Brazilian public healthcare system

Abstract

Breast cancer (BC) remains a significant health concern in Brazil, particularly within its public healthcare system, the Unified Health System, known by its Portuguese acronym “SUS”, with early detection being one of the main challenges. A review of literature and policy documents was conducted to evaluate the performance and challenges of BC screening and early diagnosis in SUS. Brazilian experts in BC early detection attended a three-day meeting to discuss the challenges of SUS's existing early detection program and provide recommendations for surmounting them. The study identified that Brazil's current opportunistic BC screening model perpetuates issues with access to screening and regional disparities, while also generating low effectiveness and inefficiency. It also highlights several causes of delays in early diagnosis and treatment. The conclusions suggest an urgent need for an organized national BC screening program, in addition to the implementation of early diagnosis strategies, with multifaceted interventions, including urgent referral guidelines for suspected cases, training of key health professionals, patient navigation, and one-stop breast clinics. Implementing these changes could alleviate the economic strain on the healthcare system while improving patient outcomes.