• Fernando Wladimir Silva Rivas, Rodrigo Gonçalves, Bruna Salani Mota, Isabel Cristina Esposito Sorpreso, Tatiana Natasha Toporcov, José Roberto Filassi, Edia di Tullio Lopes, Laura Raíssa Schio, Yann-Luc Patrick Comtesse, Edmund Chada Baracat, and José Maria Soares Júnior.
• Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
• Clinics (Sao Paulo). 2024 Jan 1; 79: 100510100510.

BackgroundBrazil faces notable Breast Cancer (BC) mortality despite lower incidence rates versus developed countries. Despite guidelines from medical societies, Brazilian public policy recommends biennial mammographic screening for women aged 50 to 69. This study investigates sociodemographic and clinical factors related to BC detection methods and clinical stage at diagnosis.MethodsThe authors conducted a cross-sectional study at a São Paulo tertiary hospital. Patients were divided into 'symptomatic' and 'mammographic' detection groups. Bivariate analyses by detection method and clinical stage compared groups' profiles in terms of sociodemographic and clinical characteristics. Poisson regression analyses assessed sociodemographic and molecular subtypes´ influence on "mammographic detection" prevalence and "advanced-stage BC", reporting prevalence ratios and 95 % Confidence Intervals.ResultsThe authors studied 1,536 BC patients admitted from January 2016 to December 2017. The "mammographic detection" group had a higher proportion of patients aged 50‒69 years (62.9 % vs. 44.1 %), white race (63.3 % vs. 51.6 %), Catholic religion (58.2 % vs. 51.1 %), and Luminal A subtype (25.2 % vs. 13.2 %) compared to the "symptomatic detection" group. Patients with early-stage disease were more likely to have higher education levels (8.1 % vs. 5.5 %) and be married (39.8 % vs. 46.6 %) compared to those with advanced-stage. Molecular subtypes were significantly associated with the detection method and stage. The prevalence of advanced-stage disease in "mammographic" (n=313) and "symptomatic" (n=1191) groups was 18.5 % and 55 %, respectively . Mammographic detection significantly reduced advanced-stage BC prevalence (PR = 0.40, 95 % CI 0.31‒0.51).ConclusionMammographic detection reduces advanced-stage breast cancer prevalence in Brazil, emphasizing the importance of regular screenings, especially among at-risk sociodemographic groups. Enhancing mammographic screening accessibility, lowering the starting age to 40, and extending coverage to include annual mammograms can significantly lower breast cancer mortality in Brazil, benefiting public health and patient outcomes.Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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