ABSTRACT
This study aimed to evaluate the clinical image quality of mammograms performed in users of the Brazilian Unified Health System (SUS) referred to a tertiary hospital. Methods: A prospective study assessed mammograms from women referred to a specialist breast center in Goiânia, Goiás, Brazil, between May and October 2017. Scans performed in the preceding 6 months, either screening or diagnostic, were included in the study. Clinical quality was determined from 40 variables related to patient identification, technical performance, the equipment, radiological findings, reporting of results, and breast positioning. Scans performed in the public and private healthcare networks were compared regarding mammographic positioning. Results: Overall, 4,560 variables associated with the clinical quality of the images were evaluated in scans from 114 women with a mean age of 50.6 years. A total of 660 (14.47%) inadequacies were found, 443 (67.12%) of which were related to breast positioning. The most common errors were as follows: pectoral muscle could not be seen in 86.8% of scans in the craniocaudal view and inframammary angle could not be seen in 79.8% of scans in the mediolateral oblique view. Considering the breast-positioning criteria evaluated in the mediolateral oblique view, there was a greater risk of the breast not being centrally positioned with the nipple in profile (RR 4.66; 95%CI 1.05−20.62; p=0.02) and of nonvisualization of the retro-areolar area (RR 4.14; 95%CI 0.92−18.66; p=0.04) in the exams performed in the private compared to the public network.
ABSTRACT
The role of Basic Health Care (BHC) professionals is essential in the primary and secondary prevention of breast cancer. The aim of this study was to characterize BHC professionals in the Health Regions of a federative unit and to assess their knowledge about breast cancer. This was a prospective study carried out with BHC professionals from the state of Goiás. Phase 1 Preparation of material and training of the team. Phase 2 Agreement of actions between executing team and coordination of health regions. Phase 3 Presentation of project at the collegiate meeting. Phase 4 Qualification of BHC professionals with different learning methods and application of questionnaires, evaluating the contribution of the action. A total of 1,133 professionals were included; mean age was 36.3 years, and they were predominantly women (87.6%), working as community health agents (59.2%) and at public service (76.3%). Only 53.8% of professionals identified the female sex as a risk factor for breast cancer, while 90% identified family history as an important factor for the development of the disease. Important changes in physical examination that can occur in patients with the disease, such as skin retraction, skin bulging and nipple injury, were mentioned as a risk factor only by 35.3%, 31.3% and 39.7%, respectively. BHC professionals who participated in the project had less than ten years of professional experience and significant restrictions of knowledge about primary and secondary prevention of breast cancer. They still experience difficulties in accessing mammography and specialized care.
ABSTRACT
Introduction: Mammography screening has been the best method for detecting early tumors and reducing breast cancer mortality according to different studies. In Brazil, the number of women who undergo mammography tests by the Brazilian Unified Health System (SUS) has been far below international recommendations. Objective: To describe the number of mammographies, mammography coverage, and the amount spent on this exam during 2019 by SUS, in Brazil. Method: Ecological study with data from the Department of Informatics of the Brazilian Unified Health System and the Brazilian Institute for Geography and Statistics in order to verify the number of mammographies performed by the SUS concerning the Brazilian female population in Brazil, in the age group of 50 to 69 years, in the states and in macro-regions during 2019. Results: In 2019, 2,660,469 mammographies were performed in the country out of the expected total of 12,154,979, accounting for a 21.9% mammography coverage by SUS at the cost of BRL 117,841,231.97. The lowest coverage rates were verified in the states of Amapá (0.6%) and the Federal District (4.9%), whereas the best rates were found in the states of Paraná (29.7%) and Alagoas (29.6%). Conclusions: The number of mammographies performed in Brazil in 2019 by SUS corresponded to almost » of the country's need, with mammography coverage far below the target and being widely different among the many Brazilian states.