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Rev Assoc Med Bras (1992) · Jan 2023
Critical assessment of resource waste in staging and follow-up of breast cancer.
- Juliana Vieira Biason Bonometto, Claudia Vaz de Melo Sette, Patricia Xavier Santi, Jean Henri Maselli-Schoueri, GiglioAuro DelAD0000-0002-2009-824XCentro Universitário Faculdade de Medicina do ABC, Department of Oncology - Santo André (SP), Brazil., and CuberoDaniel de Iracema GomesDIG0000-0002-1936-2605Centro Universitário Faculdade de Medicina do ABC, Department of Oncology - Santo André (SP), Brazil..
- Centro Universitário Faculdade de Medicina do ABC, Department of Oncology - Santo André (SP), Brazil.
- Rev Assoc Med Bras (1992). 2023 Jan 1; 69 (12): e20230565e20230565.
BackgroundBreast cancer is a public health problem with both high incidence and cure rates. After treatment, patients are monitored for long periods of time due to the risk of recurrence. Thus, staging and follow-up strategies should consider not only the best results for the patient but also its costs for the public health system.ObjectiveThe objective of this study was to quantify the waste of resources on breast cancer follow-up and evaluate its impact on the public health system.MethodsThis is a retrospective analysis of consecutive medical records to identify the intervals between consultations and tests used for staging and during the first 2 years of follow-up of patients with breast cancer treated at a public hospital in Brazil. Data were compared with the guidelines of the main international consensus.ResultsMedical records of 60 consecutive patients treated in 2018 were selected, of whom 52 had 2 or more years of follow-up, and 8 had only 1 year of complete follow-up. A total of 34 patients (56.67%) underwent excessive examinations for stating. During follow-up, 125 surplus consultations were performed (33.6%). In this phase, 111 surplus exams were also performed, representing an increase of 100.9%. A total of 423 laboratory tests were performed for 18 patients in the first year and 229 tests for 14 patients in the second year.ConclusionExcessive tests and consultations significantly burdened the Unified Health System without any benefit to patients. Better adherence to staging and follow-up recommendations could reduce costs and optimize the limited resources used in the public health system.
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