Abstract
Breast cancer (BC) is the most common malignant disease among women worldwide, with a rising incidence. It poses a significant burden in Latin America, where mortality rates have remained consistently high over recent decades, in contrast to some high-income countries (HICs), where these rates have decreased. The increase in survival rates has been driven by expanded screening coverage and advancements in the treatment of stage II, III, and metastatic breast cancer. Achieving similar improvements in low- and middle-income countries (LMICs) requires the incorporation of these strategies, which has been particularly challenging in resource-limited settings. In this narrative review, we have analyzed laws and ordinances launched by Brazilian government since the creation of its public health system in 1990. Alongside analysis of these governmental landmarks, we have pointed out the main published results regarding breast cancer staging distribution at diagnosis, strategies for timely diagnosis, screening coverage and barriers to treatment access in the last decades, aiming to understand the achievements by implemented public politics. Once, we have described the public health scenario in breast cancer, we have identified factors that represent bottlenecks to improve outcomes in breast cancer in Brazil and have proposed potential actions that might change this landscape. These actions could be centered on timely diagnosis and treatment beginning, attempt to widen access to new medicines, widen telehealth utilization since breast cancer detected abnormalities up to treatment and follow up after treatment conclusion. The authors have discussed how these actions could be implemented in Brazilian public health system, aiming to drive better outcomes.