Title: Breast Cancer Survival after mammography dissemination in Brazil: a population-based
analysis of 2,715 cases
Version: 2 Date: 09 May 2022
Reviewer's report:
Thanks to the opportunity to review this article it is well written but i have some comments
Title  Breast Cancer Survival in the mammography era in Brazil: a population-based analysis of
2,715 cases -" mammography era  " i am not sure to use the
this in the title  since it is five year period it is not a long period to call  "era"
abstract  "after one decade of mammography" - period must be described
conclusion you cannot say that can represent Brazil as whole - it is more southeast  region
introduction
Brazil's last population-based survival rate reported figures of 74.3% from 2000 to 2014  - this
is relative survival  ( concord ) you are looking on global survival without looking the life table
of campinas. you can not extrapolate to the population of campinas. My suggestion is  :" data
of women  with  breast  cancer  registered in the PBCR of Campinas "
adequate data ... PBCR are related to incidence and survival from population cancer registries  it
is relative survival  therefore you can say  that  this cohort was selected from the PBCR database
The scarcity of quality data in low and middle... Brazil is not classified as low and middle income
country  anymore .... please update ( line 64)
at inca database there is two PBCRs in campinas one at unicamp with data  from  1995 to 2005 ,
the other at  SMS has data from 2010 to 2016 .Is there any data from 2006 to 2009   ?   .. could
you clarify ..
This period reflects one decade of mammography  spread ... which decade ?
it is missing in the introduction some data about mammography screening in
campinas .. the coverage ...  it is about 65% ( in  2019) higher than other
Brazilian regions  (https://www.inca.gov.br/controle-do-cancer-de-mama/dados-e-numeros/
rastreamento-na-populacao-alvo)
how this study can guide police makers  - be more informative  ...on survival, age distribution...
etc
Methods -  in PBCR we say cases based on death certificate only ( DCO)  excluded  as routine
on survival studies
The remaining were considered alive until March 31, 2020.... when it was the last search for
vital status of the cases ? march 2020?  or it was a decision  to stop in march 2020    to have
five  and ten years  for  survival estimates ?
missing information on the follow up   is around 48%?  therefore the survival is overestimated ....
Crossing information through systems and the different records accessed enable to correct -
please cite the systems .. and mention the % of mistakes  founded..
results - please mention the average number of cases by year of breast cancer
discussion  line 148 add a reference
Why ? radiological or clinically...   how was detection rate for radiological and clinical..  it was
possible to verify through the PBCR data ( lines 161 , 162)how   can  you assume this ?
you cannot compare your results with concord because they calculated relative survival  ..
lines  174 and 175 .. where we are ?...in survival ? equal to cancer centers ?? ...
line 196 the PBCRS approach is based in multiple sources  active and passive data abstraction
as a routine
line 205 - if it is impossible to verify how you can be  sure about this survival estimates ?
therefore your  results are  unlikely .
line 208-brazil it not a low and middle income country ...
Limitation   there is not data  about  biomarkers at PBCRS to classify the cancer cases the
molecular subtype classification has  influence in  treatment options  and  survival  outcomes