Integrality of Care for Women with Breast Cancer: Access and Organization in the Health Care Network in a Northeast State

Abstract

Introduction: In Brazil, breast cancer is the most common cancer among women and the leading cause of death from neoplasms. Late diagnoses and delays in treatment impact female survival and the sustainability of the health system. Objective: To analyze the comprehensiveness of care for women with breast cancer, considering access and organization of the Health Care Network in a Brazilian Northeast state. Method: A qualitative, exploratory study with empirical phenomenological design. Semi-structured interviews were conducted with users, oncology services professionals, primary care, and municipal, state, and federal management. Results: Difficulties were found in primary care in the systematic mapping of the territory for timely breast cancer control interventions. Users face long delays between suspicion, diagnosis, and the start of treatment. Problems with the quality of and access to specialists and examinations, including the availability of pathology services (collection and histopathology) within the National Health System (SUS), force many women to search for private assistance to expedite diagnosis and treatment, generating personal costs and delays for those who depend exclusively on the public system. Furthermore, the fragmentation of therapeutic steps across different accredited services and locations hinders continuity of care, complicates the user's journey, and overburdens services in the capital. Conclusion: The poor integration and coordination among levels of care highlight the need for organized screening and implemented lines of care, with defined flows, trained professionals, and equitably infrastructure focused on ensuring comprehensive, timely, and quality care.