Treatment Disparities, Heterogeneities, and Barriers to Access for Patients with Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer - A National Survey from Brazil

Q: What patient group and cancer subtype were examined in the survey?

The study focused on HER2-negative, hormone receptor-positive metastatic breast cancer patients in Brazil, comparing access across public and private health systems.

Q: How did waiting times for treatment differ between SUS and the private sector?

Median waiting time was longer in SUS than in the private sector for both surgery and chemotherapy, with statistically significant differences.

Q: What barriers beyond waiting time were highlighted in access to care?

The survey reported limited availability of certain medications in SUS, fewer specialized palliative care teams, and regional differences that further contributed to inequality.

Sep 23, 2026

Uploaded by Grenda

Breast cancer in Brazil presents major access inequities, particularly for hormone receptor-positive, HER2-negative metastatic disease treated through the resource-limited public system (SUS). An online 48-question survey of Brazilian oncologists (150 included) evaluated waiting time from oncology unit entry to treatment initiation, medication availability, and access to palliative and multidisciplinary teams across public versus private care. The survey found longer median waits for surgery and chemotherapy in SUS, limited availability of fulvestrant, and fewer specialized palliative teams, with additional regional differences. Findings support public investment and structural system improvements to ensure timely, equitable metastatic breast cancer care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Simple Summary

Abstract

Keywords

1. Introduction

Public versus private health system context

Article Treatment Disparities, Heterogeneities, and Barriers to Access for Patients with Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: A National Survey from Brazil Heloisa Resende 1,2,*, Vinícius de Q. Aguiar 1, Nataline F. de A. Santos 1, João Vitor Siqueira Jardim 1 and André Ornelas 3 Received: 1 July 2025 Revised: 14 August 2025 Accepted: 15 August 2025 Published: 19 August 2025 Citation: Resende, H.; Aguiar, V.d.Q.; Santos, N.F.d.A.; Jardim, J.V.S.; Ornelas, A. Treatment Disparities, Heterogeneities, and Barriers to Access for Patients with Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: A National Survey from Brazil. Curr. Oncol. 2025, 32, 471. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)curroncol32080471 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Centro Universitário de Volta Redonda (UniFOA), Volta Redonda 27240-560, Rio de Janeiro, Brazil; [viniciusqa@hotmail.com](viniciusqa@hotmail.com) (V.d.Q.A.); [nataline.freitas@yahoo.com.br](nataline.freitas@yahoo.com.br) (N.F.d.A.S.); [jvsiqueira78@hotmail.com](jvsiqueira78@hotmail.com) (J.V.S.J.) 2 Instituto Projeto CURA, São Paulo 05507-020, São Paulo, Brazil 3 Novartis Brazil, São Paulo 04706-900, São Paulo, Brazil * [Correspondence: heloisa.resende@foa.org.br](Correspondence: heloisa.resende@foa.org.br); Tel.: +55-(24)988634641 Simple Summary Breast cancer is the most common cancer in Brazilian women, and many cases are diagnosed at advanced stages. Access to treatment can vary depending on whether patients are treated in the public or private health system. In this study, we surveyed oncologists across Brazil to understand how these differences impact the care of patients with a specific type of advanced breast cancer. We found that patients treated in the public system often experience longer waiting times to start treatment and have limited access to certain medicationsand palliative care services. Differences were also seen between regions of the country, highlighting further inequalities. These findings show that public investment and structural improvements in Brazil’s health system are needed to ensure that all patients receive timely and equitable cancer care. The results can inform policies to reduce disparities and improve treatment access for people with breast cancer in Brazil. Abstract Breast cancer (BC) is the most common malignancy among Brazilian women, with a high percentage of the cases diagnosed at advanced or metastatic stages (mBC) . In Brazil, where 75% of the population depends on the resource-limited public health system (SUS), mBC poses significant treatment challenges and disparities. To characterize this scenario, we conducted an online survey assessing treatment strategies available for HER2-negative, hormone receptor (HR)-positive mBC across public and private health systems. The 48-question survey addressed topics such as waiting time (WT) from oncology unit entry to treatment initiation, availability of oncologic medications, and access to palliative and multidisciplinary care teams. Between 2 August 2022 and 30 September 2022, a total of 180 oncologists were invited, and 150 met the inclusion criteria. The median WT for surgery was 60 days in the SUS versus 30 days in the private sector (p < 0.0001), and for chemotherapy, 30 days in the SUS versus 15 days privately (p < 0.0001) . Endocrine therapy was the preferred first-line treatment in the SUS (83.3%), while fulvestrant was available to only 48% of respondents. Additionally, specialized palliative care teams were ava

FAQs

What patient group and cancer subtype were examined in the survey?

The study focused on HER2-negative, hormone receptor-positive metastatic breast cancer patients in Brazil, comparing access across public and private health systems.

How did waiting times for treatment differ between SUS and the private sector?

Median waiting time was longer in SUS than in the private sector for both surgery and chemotherapy, with statistically significant differences.

What barriers beyond waiting time were highlighted in access to care?

The survey reported limited availability of certain medications in SUS, fewer specialized palliative care teams, and regional differences that further contributed to inequality.

Sep 23, 2026

Uploaded by Grenda