Breast cancer care from a suspected case detected in primary health care in Sao Paulo and Campinas, Brazil

We aimed to identify factors that inter-fere in breast cancer (BC) suspected cases detect-ed in Primary Health Care (PHC) that drive the referral to Specialized Care (SC) Sao Paulo and Campinas, Brazil. We interviewed 664 women (353 from Sao Paulo and 311 from Campinas) di-agnosed with BC, referred to SC from PHC. Mul-tilevel logistic regression analysis was used to the identification of associations between BC suspect-ed cases by PHC and the socioeconomic and cancer care variables. The following showed a significant association: higher schooling level (OR = 0.59; 95% CI = 0.35-0.98); medical visit payment for cancer-related care (OR = 0.59; 95% CI = 0.36-0.96), continued attendance at PHC after begin-ning treatment at SC (OR = 0.62; 95% CI = 0.41-0.95); breast examined in PHC before referral to SC (OR = 1.61; 95% CI = 1.10-2.34) and first mammography requested in PHC (ECM) (OR = 2.81; 95% CI = 1.95-4.00). The request for mam-mography and the clinical breast examination is incorporated into the PHC for the early detection of BC in the cities. Continuing the care at the PHC and better socioeconomic conditions, such as hav-ing a higher education level and capacity to pay for care, can reduce the likelihood of suspected cases.