A Mamografia e seus Desafios: Fatores Socioeducacionais Associados ao Diagnóstico Tardio do Câncer de Mama

Abstract

RESUMO:No Brasil, a cada ano, são registrados quase 60 mil novos casos de câncer de mama. Entretanto, das mais de 10 milhões de mamografias esperadas em mulheres na faixa etária dos 50 aos 69 anos, apenas 2,5 milhões foram realizadas em 2013. O rastreamento populacional por meio da mamografia vem se mostrando uma estratégia eficaz na redução de mortes em mulheres principalmente acima dos 50 anos. O objetivo deste estudo foi avaliar os fatores socioeducacionais associados ao diagnóstico tardio do câncer de mama e a valorização do rastreamento por meio da mamografia em mulheres assintomáticas. Entre janeiro de 2000 a dezembro de 2014, 26 artigos foram selecionados em todo o território nacional e revisados. A população do estudo foi de mulheres na faixa-etária entre 25 a 69 anos. Observou-se que 68,2% dos casos avaliados eram mulheres de baixa renda, 94,1%, com baixa escolaridade, e 72,7 % demonstraram total dependência do SUS. Os dados ainda indicaram que 61,2% do diagnóstico para o câncer de mama encontravam-se em estádios avançados (lll e lV). O diagnóstico tardio e, por vezes, a terapêutica inadequada contribuem para que o câncer de mama continue sendo a principal causa de morte entre as mulheres brasileiras. Deve-se considerar a educação para autonomia e corresponsabilidade do público feminino nos cuidados de sua saúde na expectativa de minimizar o tempo prolongado entre a suspeita da anormalidade nas mamas e a confirmação diagnóstica por falta de realização da mamografia e a adesão de mulheres assintomáticas aos programas de prevenção. PALAVRAS-CHAVE:Câncer de Mama; Prevenção; Mamografia. MAMMOGRAPHY AND ITS CHALLENGES: SOCIO-EDUCATIONAL FACTORS ASSOCIATED TO LATE DIAGNOSIS OF BREAST CANCERABSTRACT: Brazil has a yearly 60000 new cases of breast cancer. However, only 2.5 million mammographies were taken in 2013 for an expected ten millions in females within the 50-69 year-old age bracket. Population scanning by mammography proves to be an efficient strategy for the reduction of mortality in over 50-year-old females. Current analysis evaluates the socio-educational factors associated to late diagnosis of breast cancer and the valorization of scanning by mammography in asymptomatic females. Twenty-six articles published in Brazil were reviewed between January 2000 and December 2014, with females within the 25 -69 year-old age bracket. Further, 68.2% of evaluated cases were low-wage females; 94.1% had low schooling and 72.7 % were totally dependent on the NHS. Data also showed that 61.2% of breast cancer diagnoses were already within an advanced stage (lll and lV). Late diagnosis and frequently inadequate therapy contributed towards the fact that breast cancer remains the main mortality cause among Brazilian females. Education on autonomy and co-responsibility of females is mandatory in health care to minimize the period between suspected breast abnormality and confirmation through the lack of mammography and the adhesion of asymptomatic females in prevention programs.

Social determinants of health related to adhesion to mammography screening

“…Regarding schooling and income, intermediate social determinants of health, considered in this research, significant values were observed in the three domains of the scale in association with schooling, with the perceived barriers being most representative. Studies have identified a significant association between the level of schooling and health knowledge to adherence to early detection methods for breast cancer (20,24) ; However, on the contrary to the study, research developed with 776 women with the objective of identifying factors that influence the practice of mammography based on CHBMS, identified that the level of education and knowledge about breast cancer have no significant relation with adherence and have no statistically significant association with any range domain (25) . It was observed that, as the income increases, the level of perceived benefits of the mammographic examination intensifies.…”

Elaboração e avaliação de material educativo sobre a prevenção do câncer de mama

“…Além disso, ao aproximar-se da cultura das usuárias, o texto torna-se de fácil compreensão e podem ser utilizadas frases comuns ao cotidiano das mulheres, atingindo o público que se destina (DeWalt, Callahan, Hawk, Broucksou, Hink, Rudd & Brach, 2010;Echer, 2005). Tenta-se informar e desfazer percepções distorcidas sobre a realização da mamografia, bem como sobre o câncer e os tratamentos indicados (Assis & Mamede, 2016;Seabra, 2015).…”

Perception of safety during the mammography exam:

“…Like any health campaign, its effectiveness depends, to some extent, on the population's awareness and adherence to the proposed screening methods. Thus, for example, mammography is recommended, it is available as a strategic exam, but it is necessary to mobilize women to seek medical care for referral [6].…”