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Breast cancer is the second most malign neoplasm among the world's female population and influences the morbidity and mortality rates. This disease, many times associated to the necessity of mastectomy, provokes an impact on women's lives, regarding personal and family issues, related mainly to quality of life and sexuality. This is a transversal, hospital-based study aimed at evaluating the relationship between mastectomy, sexuality and women's quality of life. The research was carried out in a university hospital located in the City of São Paulo. The population of this study was composed of 100 women (N) who had breast cancer and underwent mastectomy. Data collection was carried out using a structured form, composed of sociodemographical data related to women and their partners, the items from "Medical Outcomes Study 36-item Short-Form Health Survey (SF-36)" and the "Sexual Quotient-Female Version (QS-F)". The data were introduced into the Epi Info database and analyzed in the statistical program Statistical Package for Social Sciences (SPSS) for Windows. The description of the population sample was carried out by the use of absolute and relative frequency, media, median, standard deviation and maximum and minimum values. For the analysis of correlation between the QS-F and quality of life scores, the Spearman Coefficient Correlation, was utilized for the analysis of quantitative variables. The comparison of the QS-F media according to the women and their partners´ characteristics, the disease/treatment was performed by using the Mann-Whitney Test. All the analyses with results p<0,05 were considered with statistical meaning. The women's average age was 51 years, the average years of study was 7,8 years, the major part (65%) was Catholic, with children (88%), a permanent spouse (68%) at the moment of the surgery. As for the disease, 63% have not had an advanced phase of the tumor and, in relation to the treatments, 75% have not undergone breast reconstruction, 85% have undergone chemotherapy, 68% radiotherapy and 66% hormontherapy. More than half of the women (58%) did not have sexual intercourse and among women who were having sexual intercourse, the major part (64,3%) was suffering with some kind of sexual dysfunction. In relation to the quality of life, the better scores were related to the social aspects, mental health, general heath conditions, functional capacity and vitality. There was a statistically significant association (p < 0,05) between the sexuality score and women's educational background, the partner's age and the scores related to the functional capacity, vitality, emotional related limitations and mental health. The mastectomy interferes in the sexual function and quality of life and the characteristics of this interference must be considered in the women's care planning in order to promote an integral and personalized care.
Breast cancer is the second most malign neoplasm among the world's female population and influences the morbidity and mortality rates. This disease, many times associated to the necessity of mastectomy, provokes an impact on women's lives, regarding personal and family issues, related mainly to quality of life and sexuality. This is a transversal, hospital-based study aimed at evaluating the relationship between mastectomy, sexuality and women's quality of life. The research was carried out in a university hospital located in the City of São Paulo. The population of this study was composed of 100 women (N) who had breast cancer and underwent mastectomy. Data collection was carried out using a structured form, composed of sociodemographical data related to women and their partners, the items from "Medical Outcomes Study 36-item Short-Form Health Survey (SF-36)" and the "Sexual Quotient-Female Version (QS-F)". The data were introduced into the Epi Info database and analyzed in the statistical program Statistical Package for Social Sciences (SPSS) for Windows. The description of the population sample was carried out by the use of absolute and relative frequency, media, median, standard deviation and maximum and minimum values. For the analysis of correlation between the QS-F and quality of life scores, the Spearman Coefficient Correlation, was utilized for the analysis of quantitative variables. The comparison of the QS-F media according to the women and their partners´ characteristics, the disease/treatment was performed by using the Mann-Whitney Test. All the analyses with results p<0,05 were considered with statistical meaning. The women's average age was 51 years, the average years of study was 7,8 years, the major part (65%) was Catholic, with children (88%), a permanent spouse (68%) at the moment of the surgery. As for the disease, 63% have not had an advanced phase of the tumor and, in relation to the treatments, 75% have not undergone breast reconstruction, 85% have undergone chemotherapy, 68% radiotherapy and 66% hormontherapy. More than half of the women (58%) did not have sexual intercourse and among women who were having sexual intercourse, the major part (64,3%) was suffering with some kind of sexual dysfunction. In relation to the quality of life, the better scores were related to the social aspects, mental health, general heath conditions, functional capacity and vitality. There was a statistically significant association (p < 0,05) between the sexuality score and women's educational background, the partner's age and the scores related to the functional capacity, vitality, emotional related limitations and mental health. The mastectomy interferes in the sexual function and quality of life and the characteristics of this interference must be considered in the women's care planning in order to promote an integral and personalized care.
ResumoO ensino médico de ginecologia deve orientar os seus discentes para a importância da mamografia no rastreamento do câncer de mama da mulher, porque este método diagnóstico tem sido considerado o exame mais sensível para a detecção precoce deste tipo de câncer. O programa Viva Mulher do Ministério da Saúde, é um programa multidisciplinar de aconselhamento genético, estabelecendo um cenário ideal para orientação das famílias de alto risco e com protocolo de pesquisa coordenados pelo corpo docente, e poderá ser dimensionado para o ensino médico. Uma vez que a lei estabelece a realização da mamografia a partir dos 40 anos nas mulheres, como método de rasteamento inicial do câncer de mama, sem, no entanto, especificar o tempo em anos da repetição do exame, o profissional fica exposto a questões éticas e aos processos judiciais inerentes aos atendimentos desses pacientes do Sistema Único de Saúde (SUS), realizados nos ambulatórios. É necessário dentro da academia, o levantamento e discussão desta questão, para que o futuro médico tenha sua base de atendimento e experiência consolidados ainda no curso de Graduação em Medicina e apto para o mercado de trabalho neste setor.Palavras-chave: ensino médico, mamografia, câncer de mama, legislação. Abstract Medical teaching of gynecology should guide their students to the importance of mammography in breast cancer screening of women, this diagnostic method has been considered the most sensitive exam for early detection of cancer. The program Viva Mulher of the Ministry of Health is a multidisciplinary program of genetic counseling, establishing the guidance of high-risk families and a research protocol coordinated the researchers, may be sized for medical education.Since the law provides mammography for 40 year old women without, however, specifying the time in years re-examination, the practitioner is exposed to ethical and legal proceedings relating to the care of these patients Health System (SUS), conducted in outpatient clinics. It is necessary to an extensive discussion on this matter within the Board of Medicine as well as within the academy so that the physician be aware that the option of using this diagnostic method after fifty years of age will be based on the rigors of law.
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