Detecção Precoce Do Câncer De Mama: Como Atuam Os Enfermeiros Da Atenção Primária À Saúde?

Abstract

RESUMOObjetivo: investigar as ações para o controle do câncer de mama desenvolvidas por enfermeiros da Estratégia Saúde da Família em uma capital do Nordeste brasileiro. Casuística e Métodos: estudo transversal, com 80 enfermeiros atuantes na Estratégia da Saúde da Família, entre novembro de 2012 e junho de 2013. Utilizaram-se um formulário validado e testado e o programa EPI INFO 2008 versão 3.5.1 para análise descritiva dos dados. Resultados: os enfermeiros referiram investigar os fatores de riscos para a doença (91%), realizar o Exame Clínico das Mamas (96,3%) e solicitar mamografia (51,3%). Observou-se falta de familiaridade com os fatores de alto risco e das indicações de realização dos exames de detecção precoce. As ações, em sua maioria, não são planejadas de forma sistemática e se restringem ao momento do exame de Papanicolaou. Conclusão: constatou-se que há ações que divergem das recomendações do Ministério da Saúde, assim há necessidade de capacitação profissional. PALAVRAS-CHAVE:Detecção Precoce de Câncer; Neoplasias da Mama; Enfermeiras e Enfermeiros; Atenção Primária à Saúde. ABSTRACT Objective: to investigate the breast cancer control actions developed by nurses of the Family Health Strategy in a capital city in Brazil's Northeast. Method: cross-sectional study with 80 nurses working in the Family Health Strategy, between November 2012 and June 2013. We utilized a validated and tested questionnaire and the EPI INFO 2008 version 3.5.1 program for descriptive data analysis. Results: the nurses reported investigating the risk factors of the disease (91%), conducting clinical breast exams (96.3%), and ordering mammography (51.3%). There was an observed lack of familiarity with the high-risk factors and the indications for early detection exams. The actions are mostly not systematically planned and are limited to the moment of the Papanicolaou exam. Conclusion: it was verified that there are actions that differ from the Ministry of Health recommendations, as well as the need for professional qualification.

Breast cancer screening program for risk groups: facts and perspectives

“…However, in the assistance observed in the PHC in the city of São Paulo, less than half of the 950 users were asked about family history of cancer and had an annual MMG request; and 30.9% of those at high risk had this test done at intervals other than the recommended interval. Moreover, a fact that draws attention and corroborates the findings of the multicenter study (27)(28)(29)(30) is the predominance of age guidance to start CBE and MMG after age 40, regardless of the user's high or standard risk. This situation indicates that, after more than a decade, the consensus of annual screening for high-risk women starting at age 35 has not yet been implemented.…”

“…In the Brazilian program for the of breast cancer, the mention of genetic predisposition with a definition of conduct dates back to 2004 (8) . Nevertheless, between 2013 and 2014, a multicenter study conducted in the cities of São Paulo, Diadema, Ribeirão Preto and São Luiz do Maranhão, with PHC nurses, indicated that most of them assess risk factors including family history of cancer, claim to perform CBE in female users, guide CBE without age restriction and without following any periodicity, prevailing annual indication of MMG for women aged 40 years or more (27)(28)(29)(30) . Three research fields demonstrated that more than 50% of the nurses requested MMG, while in Ribeirão Preto, almost all of the interviewees were not allowed to request this exam (27)(28)(29)(30) .…”

“…Three research fields demonstrated that more than 50% of the nurses requested MMG, while in Ribeirão Preto, almost all of the interviewees were not allowed to request this exam (27)(28)(29)(30) . In Maranhão, the main driver for mammographic investigation was age (30) .…”

“…Thus, modeling, protocols, tools and feasibility assessments emerged for the implementation of personalized breast cancer prevention and early detection by risk stratification, involving users and other health system actors (5,(10)(11)(12)(13)(14)(15)(16) . However, in Brazil and other Latin American countries, the identification and screening of women according to genetic susceptibility still lacks a better understanding, with little evaluation of family history of cancer in the last decade (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . Furthermore, prior to the pandemic of COVID-19, 3.2 million new cases of breast cancer per year were estimated for 2050 (1) .…”

Conhecimento sobre câncer de mama entre enfermeiros da atenção primária de Divinópolis/MG

“…; Conhecimento sobre câncer de mama entre enfermeiros da atenção primária de Divinópolis/MG aproximar os meios sociais e à cultura inter-relacionada nos mesmos. Além disso, esses profissionais podem desempenhar um papel essencial no processo de prevenção dessa patologia, através de orientações de saúde direcionada à população (13,15,18) .…”