{"entity":{"id":"paper-rosa-amazona-iii-bcrt-2020","kind":"paper","name":"The impact of sociodemographic factors and health insurance coverage in the diagnosis and clinicopathological characteristics of breast cancer in Brazil: AMAZONA III study (GBECAM 0115)","aka":[],"tldr":"Brazilian women treated for breast cancer in the public health system were more often found with advanced disease and less often through screening than women with private insurance.","summary":"AMAZONA III is a prospective cohort at 23 Brazilian sites of women newly diagnosed with invasive breast cancer from January 2016 to March 2018. Of 2,950 patients, median age 53.9, 63.1 per cent were treated in the public system. Most (68.6 per cent) had stage II to III disease. Luminal A-like was the commonest subtype (48.0 per cent), followed by luminal B HER2-positive-like (17.0) and triple-negative (15.6). Only 34 per cent were diagnosed by screening.","asOf":"2026-11-03","links":[{"label":"DOI: 10.1007/s10549-020-05831-y","url":"https://doi.org/10.1007/s10549-020-05831-y"},{"label":"PubMed 32728860","url":"https://pubmed.ncbi.nlm.nih.gov/32728860/"}],"tags":[],"related":[],"cancers":["breast-hr-positive","tnbc"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":["lacog"],"institutions":["inca-brazil","ac-camargo"],"pathways":[],"terms":[],"trials":["nct02663973"],"people":["daniela-dornelles-rosa","barrios-carlos"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"provenance":{"editedBy":"OnCo country deep dive, Brazil (wave 2)","editedOn":"2026-11-03"},"journal":"Breast Cancer Research and Treatment","year":2020,"doi":"10.1007/s10549-020-05831-y","pmid":"32728860","authors":"Rosa DD, Bines J, Werutsky G, Barrios CH, et al.","paperType":"observational","findings":["Stage III at diagnosis: 33.5 per cent of publicly insured against 14.7 per cent of privately insured patients (p<0.0001).","Only 34 per cent of all patients were diagnosed by a screening test.","Luminal B HER2-positive (19.2 against 14.2 per cent) and HER2-positive (8.8 against 5.1 per cent) subtypes were more common in public-system patients."],"whatItMeans":"In Brazil the same disease is found later in the public system, which treats most women. The authors note that Brazil's cancer registries are limited in number and quality, which is why a cohort like this is needed to see it.","caveats":["Sites were centres taking part in a cooperative group study and may not represent the whole country.","Insurance type is a marker for income, region and access, so the paper describes association, not cause."],"participants":2950},"route":"/key-papers/paper-rosa-amazona-iii-bcrt-2020/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"company":[{"id":"lacog","kind":"company","name":"Latin American Cooperative Oncology Group","route":"/companies/lacog/"}],"institution":[{"id":"ac-camargo","kind":"institution","name":"A.C. Camargo Cancer Center","route":"/institutions/ac-camargo/"},{"id":"inca-brazil","kind":"institution","name":"Instituto Nacional de Câncer (INCA)","route":"/institutions/inca-brazil/"}],"trial":[{"id":"nct02663973","kind":"trial","name":"AMAZONA III: prospective evaluation of breast cancer at Brazilian institutions (GBECAM 0115)","route":"/trials/nct02663973/"}],"person":[{"id":"barrios-carlos","kind":"person","name":"Carlos Barrios","route":"/people/barrios-carlos/"},{"id":"daniela-dornelles-rosa","kind":"person","name":"Daniela Dornelles Rosa","route":"/people/daniela-dornelles-rosa/"}]}}