Mastectomized women’s perception of breast cancer early detection

Abstract

BackgroundA third of new cases of breast cancer could be detected early, which would prevent more serious consequences, such as mastectomy and death. Access to the subjectivity of mastectomized patients becomes relevant to elucidate failures in early detection of breast cancer and thus improve the cancer care network. Given that, the present study aimed to identify mastectomized women’s perception of the quality of care provided by the cancer care network for the early detection and diagnosis of breast cancer.MethodsQualitative study carried out at a public outpatient cancer center in the city of Fortaleza, Ceará, Northeastern Brazil, to analyze the perceptions of 26 women who had undergone mastectomy after breast cancer based on Symbolic Interactionism.ResultsThe thematic analysis showed how women (re)structure their lives in the face of the structural and social aspects of coping with breast. Two essential themes emerged: “Contradictions regarding access to primary health care services and obstacles to the organization of SUS formal care network services” and “The informal and private health care network increase quality care coverage”.ConclusionsThe absence of effective measures in Primary Health Care and patients’ ‘pilgrimage’ in the formal health care network have delayed early detection breast cancer.

Access of the patient to the cancer network under the “Sixty-Day Law”: Integrative Review

“…In addition to inequality, there are also factors related to intersectoral actions and social and economic policies that can mitigate differences in income and education (3) . Level of education is one of the aspects that hinder access to breast cancer screening: more years of education are associated with a greater chance of adherence to examinations (24)(25)(26)(27) . Individuals with a low level of education do not recognize the importance of the examination, and end up not performing it (18)(19)(20)30,32) .…”

“…According to some studies, the SUS is seen by the population as a system with a time-consuming service, mainly when it comes to specialist consultations and diagnostic examinations. For this reason, some users choose the private system to perform preventive examinations (23,26) . Access to private service corroborates the relationship between socio-economic factors and access to health care services, as people with low income cannot access these services.…”

“…Another problem is lack of equipment such as mammogram machines (20) . There is a discrepancy in distribution of technology for early diagnosis, and most of the time these tools are concentrated in certain regions of the country or of each state, mainly in more developed regions, which do not always have the highest prevalence of the disease (25)(26) . This misallocation leads to inequality, as some women perform the examination more times that needed, while some have never performed them (33) .…”

“…Regarding this inequality in access to both diagnosis and treatment, one study stressed that patients have to move to different cities to get consultations and have their needs met. Patient migrate between cities and even between states, further demonstrating inequality of access (21,26) . Waiting lines delay diagnosis and treatment, and studies show that in addition to migration, networks of friends are used to gain access to treatment, not obeying the flow established in the territory (28,32) .…”

“…In addition, a study noted that the best way to improve women's adherence to screening examination is through effective communication between health professionals and patients (26) . Quality care favors customer service.…”