# Improvements in Timely Care and Patient-Reported Outcomes for Breast Cancer: A Seven-Year Southern Brazilian Cohort Analysis

## TL;DR

Breast cancer patients in southern Brazil experienced better quality of life and faster treatment initiation over seven years due to improved care models.

## Contribution

This study demonstrates longitudinal improvements in patient-reported outcomes and treatment timeliness in breast cancer care through streamlined pathways and early rehabilitation.

## Key findings

- Patient-reported outcomes improved significantly in quality of life and body perception over seven years.
- Time from diagnosis to treatment initiation decreased significantly from 21.0 to 10.9 days between 2013 and 2024.
- Multidisciplinary care models and guideline-adherent services enhanced outcomes in middle-income settings.

## Abstract

What are the main findings?
Patient-reported outcomes improved across all domains, including quality of life and body perception.A significant reduction was observed in the time from diagnosis to treatment initiation.

Patient-reported outcomes improved across all domains, including quality of life and body perception.

A significant reduction was observed in the time from diagnosis to treatment initiation.

What are the implications of the main findings?
Streamlined care pathways and early rehabilitation models can improve both treatment timeliness and patient-reported outcomes in breast cancer care.Expanding access to multidisciplinary, guideline-adherent oncology services may reduce disparities and enhance quality of care in middle-income settings.

Streamlined care pathways and early rehabilitation models can improve both treatment timeliness and patient-reported outcomes in breast cancer care.

Expanding access to multidisciplinary, guideline-adherent oncology services may reduce disparities and enhance quality of care in middle-income settings.

Background/Objective: Breast cancer is one of the leading diseases affecting the Brazilian population and is often diagnosed at advanced stages. Due to its heterogeneity, treatment involves multiple therapeutic modalities, such as chemotherapy, hormone therapy, immunotherapy, and radiotherapy. The aim of this study was to characterize the profile of patients undergoing treatment for breast cancer in a private hospital in southern Brazil, and to assess the physical and psychological effects associated with different therapeutic modalities. Methods: An ambidirectional longitudinal cohort study was conducted from September 2018 to December 2024, incorporating retrospective data since 2013. Clinical and therapeutic data were collected, and Patient-Reported Outcome Measures (PROMs) using the QLQ-C30 Summary Score (QLQ-BR23, FACT-ES, BREAST-Q, LMC21) and Symptom Global Score questionnaires were analyzed using mixed-effects models to evaluate physical, emotional, cognitive, social, and overall quality-of-life domains, as well as body image. The temporal trend of time-to-treatment was assessed via linear regression. Results: Among 871 individuals evaluated, 98.4% were female, and invasive ductal carcinoma was the predominant histological type (75.1%). Radiotherapy was one of the most frequently used treatment modalities (39.2%), while immunotherapy had the lowest usage rate (2.7%). A significant reduction in the time between diagnosis and initiation of treatment was observed from 2013 to 2024 (from 21.0 to 10.9 days; p < 0.01), reflecting improvements in healthcare services. Mixed-effects models for PROMs indicated significant improvements across all assessed domains (p < 0.01) over the 48-month follow-up, despite a median follow-up of 22 months. Conclusions: High-quality and timely oncological care provided to breast cancer patients in a private hospital in southern Brazil demonstrates the implementation of a dynamic, agile, and human-centered care model, contributing to improved clinical and patient-reported outcomes validated by robust longitudinal analysis.