title: Breast cancer: diagnosis-to-treatment waiting times for elderly women at a reference hospital of São Paulo, Brazil.
abstract: This study compares waiting time from diagnosis of breast cancer to start of treatment with patients' social-demographic and clinical profiles in women aged 60 or more at the PérolaByington Hospital, São Paulo, over the years 2001-2006.It is a descriptive study based on secondary data in a sample of 1,299 cases. Social-demographic, clinical and temporal variables were collected. Patients were divided into two groups: those with period between diagnosis and start of treatment less than 60 days, and greater than 60 days. The average time between diagnosis and start of treatment was 74.7 days (SD = 212.6), and the median time was 45 days. This waiting time was lower for subjects without diagnosis and without prior treatment (p = 0.001), and also for those with tumors at Stage 0, in situ or Stage I(p = 0.001). Time was significant for the outcomes of relapse (p = 0.004) and metastasis (p = 0.038). Having established diagnosis and treatment also resulted in lower time to start of the required care. Improvement to the structuring and functioning of the health service is an essential need, for dealing with the cases of the disease in an efficient manner, an important challenge for Brazil's Unified Health System.
authors.affiliation: Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil, ufesmila_enfer@yahoo.com.br.
authors.forename: Camila Brandão
authors.initials: CB
authors.lastname: Souza
authors.affiliation: Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil, ufesmila_enfer@yahoo.com.br.
authors.forename: Suzete Maria
authors.initials: SM
authors.lastname: Fustinoni
authors.affiliation: Universidade Federal do Espírito Santo, Brasil.
authors.forename: Maria Helena Costa
authors.initials: MH
authors.lastname: Amorim
authors.affiliation: Universidade Federal do Espírito Santo, Brasil.
authors.forename: Eliana
authors.initials: E
authors.lastname: Zandonade
authors.affiliation: Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil, ufesmila_enfer@yahoo.com.br.
authors.forename: Jéssica Carvalho
authors.initials: JC
authors.lastname: Matos
authors.affiliation: Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil, ufesmila_enfer@yahoo.com.br.
authors.forename: Janine
authors.initials: J
authors.lastname: Schirmer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy; D003695:Delivery of Health Care; D005260:Female; D006761:Hospitals; D006801:Humans; D008875:Middle Aged; D061665:Time-to-Treatment; D014850:Waiting Lists