# Time interval between diagnosis to treatment of breast cancer and the impact of health insurance coverage: a sub analysis of the AMAZONA III Study (GBECAM 0115)

Source: https://onco.cc/key-papers/paper-maschmann-amazona-iii-time-to-treatment-bcrt-2023/  
OnCo record `paper-maschmann-amazona-iii-time-to-treatment-bcrt-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Women with breast cancer in Brazil's public health system waited a median of 56 days from diagnosis to first treatment, against 34 days for privately insured women, close to the 60-day limit set in law.

## Summary

A sub-analysis of 1,709 women with stage I to III breast cancer from the AMAZONA III cohort, diagnosed from January 2016 to March 2018 at 22 Brazilian centres, measuring days from diagnosis to first cancer treatment and the factors associated with starting more than 60 days after diagnosis, the limit set by Brazil's Law 12.732 of 2012.

## Fields

- Kind: Key paper
- Last checked: 2026-11-03
- Journal: Breast Cancer Research and Treatment
- Year: 2023
- DOI: 10.1007/s10549-022-06809-8
- Authors: Maschmann RM, De Jesus RG, Werutsky G, Rebelatto TF, Queiroz GS, Simon SD, Bines J, Barrios CH, Rosa DD
- Findings: Median diagnosis-to-treatment interval 46 days overall (IQR 28 to 75).; 56 days in the public system against 34 days in the private system (p<0.0001).; Public-system patients had higher odds of starting treatment after 60 days: odds ratio 4.74 (95% CI 3.09 to 7.26).; The longer public-system interval held regardless of stage, whether surgery or systemic treatment came first, subtype and region.
- What it means: Brazil's 60-day law sets a ceiling, and this is a measurement of how the public system performs against it for one cancer. Knowing where the delay sits is what lets a patient or a health service push on it.
- Caveats: Observational; centres were cooperative-group sites.; Published online in December 2022, in the February 2023 issue.

## Sources

- DOI: 10.1007/s10549-022-06809-8: https://doi.org/10.1007/s10549-022-06809-8
- PubMed 36586038: https://pubmed.ncbi.nlm.nih.gov/36586038/

## Connected records

- cancers: [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/)
- companies: [Latin American Cooperative Oncology Group](https://onco.cc/companies/lacog/)
- trials: [AMAZONA III: prospective evaluation of breast cancer at Brazilian institutions (GBECAM 0115)](https://onco.cc/trials/nct02663973/)
- people: [Carlos Barrios](https://onco.cc/people/barrios-carlos/), [Daniela Dornelles Rosa](https://onco.cc/people/daniela-dornelles-rosa/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/)

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