Efeitos da pandemia do novo coronavírus no seguimento adequado do tratamento cirúrgico de mulheres com câncer de mama

Abstract

Breast cancer is a multifactorial disease that mainly affects women and has shown an increase in incidence and mortality rates. Early identification and treatment are important elements for patients' survival and quality of life. During the COVID-19 pandemic, many services were affected, including oncology services, with restrictions and a decrease in the flow of patients. According to Brazilian legislation, treatment for cancer patients must be started early within 60 days. Thus, the objective was to evaluate the effects of the COVID 19 pandemic in the follow-up of the surgical treatment of women with breast cancer. Analytical, retrospective, longitudinal study, carried out in a reference mastology outpatient clinic of the public network in the city of Fortaleza - Ceará, Brazil. The research involved the collection of data from 140 medical records of women attended at the site from November 2021 to January 2022 diagnosed with breast cancer and elective surgery performed. According to the proposed objectives, it was found that the follow-up of the surgical treatment of patients diagnosed by biopsy performed by the mastology clinic was predominantly adequate, performed in a period of less than 60 days. However, for patients referred with diagnosis by biopsy outside the reference, this period was longer than 60 days in most women. The time between the diagnostic biopsy and the first visit to the service during the COVID-19 pandemic was predominantly less than 30 days. For patients without a defined diagnosis, the time between the 1st consultation and diagnosis by biopsy was also, for the most part, less than 30 days. Of the clinical and sociodemographic factors associated with the start of consultations, age was associated with the shortest time between biopsy and the 1st consultation (p=0.022). Schooling of more than 9 years of study was associated (p=0.026) with shorter treatment time for patients diagnosed outside the institution, with an 84% lower prevalence in time to treatment. In patients diagnosed in the reference, the type of tumor (p=0.019) and the use of Neoadjuvant therapy (p=0.000) were associated with shorter treatment time. It is concluded that care for outpatients, even in the context of a pandemic, took place in a timely manner.