Encuesta a mujeres uruguayas sobre conocimientos relacionados con la prevención del cáncer de mama / Survey of Uruguayan women on knowledge related to the prevention of breast cancer / Levantamento de mulheres uruguaias sobre conhecimentos relacionados à prevenção do câncer de mama

Introducción: En Uruguay el cáncer de mama (CM) ocupa el primer lugar en incidencia y mortalidad por cáncer en mujeres. Objetivo: Evaluar el conocimiento de mujeres uruguayas sobre el tamizaje de cáncer de mama. Material y métodos: Se trata de un estudio observacional descriptivo y transversal. Se aplicó una encuesta dirigida a mujeres, que fue difundida mediante las redes sociales. El consentimiento informado se solicitó al inicio de la encuesta, como requisito excluyente para poder realizar la misma. Se mantuvo el anonimato de las pacientes en el análisis estadístico y se contó con la aprobación del Comité de Ética del Hospital de Clínicas. Resultados: Participaron 1859 mujeres. El 75.1% (1396) de las encuestadas reconoce el CM como el de mayor mortalidad en mujeres. El 52% (967) cree que 3 de cada 10 mujeres tienen riesgo de desarrollar CM, y 18.4% (342) desconoce su prevalencia. El 60.2% (1119) reconoce a la mamografía como prueba que ha logrado disminuir la mortalidad por CM. El 64.2% (1193) cree que se realiza a partir de los 40 años. Sobre la frecuencia, el 60.5% (1125) considera que se realiza de forma anual. Los factores de riesgo para desarrollar CM mayormente considerados fueron tabaquismo (60.9%, 1132), obesidad (57.%, 1060) y sedentarismo (56.8%,1056). Conclusiones: Nuestros resultados evidencian que las encuestadas están informadas de manera adecuada sobre la importancia del CM y de realizar el tamizaje mamográfico para prevenirlo; sin embargo, el 74.3% (1381) cree que el mismo, debe comenzar a hacerse a los 40 años.

Introduction: In Uruguay, breast cancer (BC) has the highest incidence and mortality of all cancer in women. Objectives : To assess the knowledge of Uruguayan women about breast cancer screening for the early detection of BC. Material and Methods : This is a descriptive and observational study. A survey was applied to woman, it was disseminated through social networks. Informed consent was requested at the beginning of the survey as an exclusive requirement to be able to carry it out. In the statistical analysis, the anonymity of the patients was maintained and the approval of the Ethics Committee of the Hospital de Clínicas was obtained. Results : 1859 women participated. 75.1% (1396) of those surveyed recognize BC as the one with the highest mortality in women. 52% (967) believe that 3 out of 10 women are at risk of developing BC, and 18.4% (342) do not know its prevalence. 60.2% (1119) recognize mammography as a test that has managed to reduce mortality from BC. 64.2% (1193) believe that it is done after 40 years of age. Regarding the frequency, 60.5% (1125) consider that it is carried out annually. The most considered risk factors for developing BC were smoking (60.9%, 1132), obesity (57%, 1.060) and sedentary lifestyle (56.8%, 1056). Conclusions : Our results show that the respondents are adequately informed about the importance of CM and the performance of screening mammography.

Introdução : No Uruguai, o câncer de mama (CM) tem a maior incidência e mortalidade de todos os cânceres em mulheres. Objetivos: Avaliar o conhecimento de mulheres uruguaias sobre o rastreamento do câncer de mama para a detecção precoce do CM. Material e Métodos : Trata-se de um estudo descritivo e observacional. Foi aplicado um questionário às mulheres, divulgado através das redes sociais. O consentimento informado foi solicitado no início da pesquisa como requisito exclusivo para poder realizá-la. Na análise estatística, foi mantido o anonimato dos pacientes e obtida a aprovação do Comitê de Ética do Hospital de Clínicas. Resultados: participaram 1859 mulheres. 75.1% (1396) dos pesquisados ​​reconhecem o CB como o de maior mortalidade em mulheres. 52% (967) acreditam que 3 em cada 10 mulheres estão em risco de desenvolver CM e 18.4% (342) não conhecem sua prevalência. 60.2% (1119) reconhecem a mamografia como um exame que tem conseguido reduzir a mortalidade por CM. 64.2% (1.193) acreditam que é feito após os 40 anos. Em relação à frequência, 60.5% (1125) consideram que é realizado anualmente. Os fatores de risco mais considerados para desenvolver CM foram tabagismo (60.9%, 1132), obesidade (57%, 1.060) e sedentarismo (56.8%, 1056). Conclusões: Nossos resultados mostram que as entrevistadas estão adequadamente informadas sobre a importância do MC e a realização da mamografia de rastreamento.

Perceived self-efficacy and breast self-examination in women from Monteria (Colombia) / Autoeficacia percibida y autoexamen de mamas en mujeres de Montería (Colombia) / Auto-eficácia percebida e auto-exame da mama nas mulheres em Montería (Colômbia)

Introduction: The breast self-examination practice can be influenced by perceived self-efficacy. This individual characteristic, defined as confidence in one's abilities to achieve a goal, can positively help women develop health-promoting behaviors that lead them to carry out routine and regular practices for the early detection of breast cancer. Objective: To determine the level of perceived self-efficacy and its relationship to the adequate practice of BSE in women over 20 years of age in Montería, Colombia. Materials and methods: Analytical study, with 867 women aged 20 years or older, selected by multi-stage random sampling. A sociodemographic survey was used for data collection, the overall self-efficacy scale and a questionnaire to measure the BSE practice. The data was stored in a Microsoft Excel spreadsheet and processed in SPSSS version 24. Results: 867 women participated, with a mean age 36.2 years (SD = 13.0). 72.6% (629) did a BSE. Only 2% (20) of the participants practice it adequately. The BSE practice was greater in women with a higher level of self-efficacy (86.2%). Conclusions: In Montería, women over 20 years of age practice BSE inappropriately, which contrasts with a high level of self-efficacy. This factor is essential to improve health care practices and conduct them on a regular basis.

Introducción: La práctica del autoexamen de mamas puede estar influida por la autoeficacia percibida. Esta característica individual, definida como la confianza en las propias capacidades para alcanzar una meta, puede ayudar de forma positiva a que las mujeres desarrollen conductas promotoras de salud y realicen prácticas de cuidado rutinarias y regulares para la detección temprana del cáncer de mama. Objetivo: Determinar el nivel de autoeficacia percibida y su relación con la práctica adecuada del AEM en mujeres mayores de 20 años de Montería (Colombia). Materiales y métodos: Estudio analítico, con 867 mujeres mayores de 20 años, seleccionadas por muestreo aleatorio multietápico. Se utilizó una encuesta sociodemográfica para la recolección de información, la Escala de Autoeficacia General Percibida y un cuestionario para medir la práctica del AEM. Los datos se almacenaron en una hoja de cálculo de Microsoft Excel y fueron procesados en el programa SPSSS, versión 24. Resultados: Participaron 867 mujeres, con una edad promedio 36,2 años (DE = 13,0). El 72,6% (629) se practica el AEM. Solo el 2% (20) de las participantes lo hacen de forma adecuada. La práctica del AEM fue mayor en mujeres con un mayor nivel de autoeficacia (86,2%). Conclusiones: En Montería, las mujeres de más de 20 años de edad practican de forma inadecuada el AEM, lo que contrasta con un alto nivel de autoeficacia. La autoeficacia es fundamental para mejorar la prácticas de cuidado de la salud y desarrollarlas de forma regular.

Introdução: A prática do auto-exame da mama pode ser influenciada pela percepção de auto-eficácia. Esta característica individual, definida como confiança nas próprias capacidades para atingir um ob- jetivo, pode ajudar positivamente as mulheres a desenvolver comportamentos de promoção da saúde e a envolver-se em práticas de cuidados de rotina e regulares para a detecção precoce do câncer de mama. Objetivo: Determinar o nível de auto-eficácia percebido e a sua relação com a prática adequada da AEM em mulheres com mais de 20 anos de idade em Montería (Colômbia). Materiais e métodos: Estudo analítico, com 867 mulheres com mais de 20 anos de idade, selecionadas por amostragem aleatória em várias fases. Foi utilizado um inquérito sociodemográfico para recolher informação, a Escala Geral de Auto-Eficácia Percebida e um questionário para medir a prática da AEM. Os dados foram armazenados numa folha de cálculo Microsoft Excel e processados em SPSSS, versão 24. Resultados: 867 mulheres participaram, com uma idade média de 36,2 anos (SD = 13,0). 72,6 % (629) dos participantes praticaram AEM. Apenas 2 % (20) dos participantes o fazem de forma adequa- da. A prática da AEM foi mais elevada nas mulheres com um nível superior de auto-eficácia (86,2%). Conclusões: Em Monteria, as mulheres com mais de 20 anos de idade praticam inadequadamente a AEM, o que contrasta com um elevado nível de auto-eficácia. A auto-eficácia é fundamental para melhorar as práticas de cuidados de saúde e desenvolvê-las numa base regular.

Predictores de las prácticas sobre el autoexamen de mamas en estudiantes de Enfermería de una universidad privada, Lima, Perú / Predictors of breast self-examination practices in nursing students from a private university, Lima, Peru

Resumen Objetivo: El objetivo del estudio fue analizar los predictores de las prácticas sobre el autoexamen de mamas en estudiantes de Enfermería de la universidad Católica Sedes Sapientiae, Lima, Perú, 2019. Metodología: Es un estudio observacional, analítico y transversal. La población estuvo conformada por 92 personas universitarias de ambos sexos. Se ejecutó una guía de evaluación para medir la técnica del autoexamen de mamas, un cuestionario autodirigido para evaluar el conocimiento de esta técnica y por último una ficha de datos para la variable realización de autoexamen de mamas, entre otras variables sociodemográficas y de formación académica. Resultados: Entre los resultados principales, se muestra que el 65.22 % de las personas estudiantes no realizó el autoexamen de mamas y el promedio de la técnica fue bajo (M=4.41) de un rango de 0 a 12 puntos. Asimismo, se evidenció que los predictores de la realización del autoexamen de mamas fueron el nivel alto de conocimiento de esta técnica (PR: 8.73; p = 0.022), la edad (PR: 1.04; p = 0.021) y capacitación (PR: 2.42; p = 0.005). Además, los predictores de la técnica fueron el conocimiento de esta (coeficiente: 1.70; p = 0.023) y la edad (coeficiente: 1.70; p = 0.023). Conclusión: En conclusión, la mayoría de estudiantes no realiza las prácticas sobre el autoexamen de mamas, además, los predictores de estas prácticas son el conocimiento sobre la técnica la edad y la capacitación. Ante estos hallazgos se deberían brindar intervenciones educativas promocionales y preventivas al estudiantado.

Abstract Aim: The objective of this study was to analyze the predictors of breast self-examination practices of nursing students at the Catholic SedesSapientiae University, Lima, Peru, 2019. Methods: It was an observational, analytical and cross-sectional study. The target population were 92 university students of both sexes. In order to analyze this, the researchers passed an evaluation guide to measure the breast self-examination technique, a self-directed questionnaire to assess this technique's knowledge, and a data sheet for the variable performance of breast self-examination, among other sociodemographic and academic training variables. Results: Part of the main results show that 65.22% of the students did not perform breast self-examinations, and the average of the technique was low with a range of 0 to 12 points (M=4.41). The results also evidenced that the predictors of the performance of the breast self-examination were the high level of knowledge of this technique (PR: 8.73; p=0.022), the age (PR: 1.04; p=0.021), and the training (PR: 2.42; p=0.005). The predictors of the technique were the knowledge about it (coefficient: 1.70; p=0.023) and the age (coefficient: 1.70; p=0.023). Conclusion: In conclusion, the majority of students did not carry out the practices on breast self-examination; likewise, the predictors of these practices are the knowledge about this technique, the age, and the training. Given these findings, educational, promotional, and preventive interventions should be provided to the students.

RESUMO Objetivo: O objetivo do estudo foi analisar os preditores das práticas de autoexame das mamas em estudantes de enfermagem da Universidade Católica Sedes Sapientiae, Lima, Peru, 2019. Metodologia: É um estudo observacional, analítico e transversal; a população era composta por 92 universitários de ambos os sexos. Foi executado um roteiro de avaliação para mensurar a técnica do autoexame das mamas, um questionário autodirigido para avaliar o conhecimento dessa técnica e, por fim, uma planilha de dados da variável realização do autoexame das mamas entre outras variáveis sociodemográficas e de treinamento acadêmico. Resultados: Dentre os principais resultados, evidencia-se que 65.22% das alunas não realizaram o autoexame das mamas e a média da técnica foi baixa (M=4.41) com variação de 0 a 12 pontos, além disso, constatou-se que os preditores da realização do autoexame das mamas foram o alto nível de conhecimento desta técnica (RP: 8.73; p= 0.022), idade (RP: 1.04; p= 0,021) e treinamento (RP: 2.42; p= 0.005); e os preditores da técnica foram o conhecimento (coeficiente: 1.70; p= 0.023) e idade (coeficiente: 1.70; p= 0.023). Conclusão: Em conclusão, a maioria das alunas não realiza as práticas sobre o autoexame das mamas, da mesma forma, os preditores dessas práticas são o conhecimento dessa técnica; idade e treinamento. Diante desses achados, intervenções educacionais, promocionais e preventivas devem ser fornecidas aos alunos.

Conocimiento para predecir la práctica y la actitud del autoexamen mamario / Knowledge to predict the practice and attitude of breast self-examination

Introducción: el cáncer de mama es la primera causa de muerte en mujeres. Se espera que al incrementar el conocimiento sobre el autoexamen mamario se incremente su práctica. Objetivo: determinar el nivel de conocimiento, actitudes y prácticas y su relación con respecto a la autoexploración de cáncer de mama en mujeres de más de 20 años. Material y métodos: estudio transversal mediante encuesta a una muestra de 503 mujeres mayores de 20 años. Se recabó información sociodemográfica y datos requeridos para evaluar conocimiento, prácticas y actitudes sobre el autoexamen. Para identificar las relaciones se probó un modelo de ecuaciones estructurales. Resultados: la capacidad predictiva del modelo para variables endógenas fue baja. El nivel de conocimiento del autoexamen es básico en 81.9%, el 74% refirieron actitudes desfavorables y solo el 39.8% practican el autoexamen. Conclusiones: el estudio muestra una persistencia de bajos niveles de conocimiento sobre la finalidad de la autoexploración, una actitud desfavorable para realizarla y una práctica incorrecta de la técnica.

Background: Breast cancer is the first cause of death in women. Increasing knowledge about breast self-examination is expected to increase its practice. Objective: To determine the level of knowledge, attitudes and practices regarding breast self-examination in women over 20 years of age. Material and methods: Cross-sectional study through a sample survey of 503 women over 20 years of age. Sociodemographic information and data required to evaluate knowledge, practices and attitudes about self-examination were collected. To identify the relationships, a structured equation model was tested. Results: The predictive capacity of the model for endogenous variables was low. The level of knowledge of the self-examination is basic in 81.9%, 74% reported unfavorable attitudes and only 39.8% practice the self-examination. Conclusions: The study shows persistence of low levels of knowledge about the purpose of self-examination, an unfavorable attitude to carry it out and an incorrect practice of the technique.

Linfoma primario no Hodgkin de mama / Primary Non-Hodgkin's Breast Lymphoma

Introducción: El cáncer de mama se ha convertido en un verdadero desafío a la calidad y expectativa de vida de la población mundial, con un aumento considerable en su incidencia y prevalencia. Cuba cuenta, desde 1987, con un Programa de Control de Cáncer Mamario. Objetivo: Ejemplificar el estudio de un caso con linfoma no Hodgkin primario de la mama, su cuadro clínico y los medios diagnósticos utilizados. Caso clínico: Paciente femenina de 70 años de edad, color de la piel negra, que acudió al Consultorio Médico de la Familia por presentar malestar general, molestias y aumento de volumen en la mama derecha. Se le remitió a consulta de cirugía y se le realizaron estudios complementarios. Se detectó nódulo de mediana densidad, contornos parcialmente definidos, distorsión del tejido vecino, otros nódulos de menos tamaño y densidad en el cuadrante inferior interno, calcificaciones vasculares en ambas mamas. Una biopsia corrobora linfoma no Hodgkin difuso de células grandes de alto grado. Conclusiones: El linfoma primario no Hodgkin de mama es muy raro y de difícil diagnóstico clínico porque no se dispone de signos, síntomas o criterios de imagen específicos para ello. El autoexamen de mama continúa siendo el principal método de diagnóstico del cáncer de mama y aunque el examen clínico, el ultrasonido de mama y la mamografía apoyan la presunción, es la biopsia quien solo brinda la confirmación diagnóstica precisa(AU)

Introduction: Breast cancer has become a real challenge to the quality of life and to life expectancy of the world population, with a considerable increase in its incidence and prevalence. Cuba has, since 1987, a breast cancer control program. Objective: To present a case with primary non-Hodgkin's lymphoma of the breast in a 70-year-old patient, its clinical picture and the diagnostic means used. Clinical case: 70-year-old female patient, with black skin, who came to the family medical office due to malaise, discomfort and increased volume in her right breast. She was referred to surgery and complementary studies were performed. Nodule of medium density was identified, with partially defined contours, distortion of the neighboring tissue, together with other nodules of less size and density in the lower internal quadrant, and vascular calcifications in both breasts. A biopsy confirms diffuse high-grade large-cell non-Hodgkin's lymphoma. Conclusions: Primary non-Hodgkin's lymphoma of the breast is very rare and difficult to diagnose clinically because there are no specific signs, symptoms or imaging criteria for it. Breast self-examination continues to be the main method of diagnosis for breast cancer and, although clinical examination, breast ultrasound and mammography support such diagnostic presumption, it is the biopsy that only provides the precise diagnostic confirmation(AU)

BRCAR: herramienta de soporte en la evaluación del riesgo para cáncer de mama / BRCAR: Support Tools for Risk Evaluation of Breast Cancer

Introducción: El cáncer de mama es el tumor maligno más frecuente en el mundo, en Cuba, es la segunda causa de muerte en mujeres. La insuficiencia en el diagnóstico precoz y la existencia de novedosas estrategias de tratamiento plantean la necesidad de establecer formas eficaces para identificar el riesgo en personas sanas, sin embargo en nuestro país no se cuenta con un método eficaz para predecir el riesgo y direccionar las acciones preventivas y terapéuticas. Objetivo: Crear un estándar nacional orientado a la identificación del cáncer de mama como soporte a la práctica médica y como herramienta de apoyo en la evaluación del riesgo. Método: Se combinaron 28 variables (determinadas por los factores de riesgo de cáncer de mama) a las cuales se les atribuyeron parámetros de ponderación asociados al nivel de incidencia registrado en la literatura médica, utilizando un algoritmo de votación como elemento matemático central. Resultados: Se desarrolló un sistema computarizado para la evaluación del riesgo de cáncer de mama en personas sanas. Conclusiones: BRCAR es una herramienta de soporte para objetivar el riesgo del cáncer de mama, al determinar el impacto de determinados factores de riesgo, con el fin de direccionar los métodos de estudio para la detección precoz(AU)

Introduction: Breast cancer is the most frequent malignant tumour in the world; it is the second cause of women death in Cuba. The insufficiency in early diagnosis and the existence of novel treatment strategies raise the need to establish effective ways to identify risk in healthy people, however in our country there is no effective method to predict risk and direct preventive actions and therapeutic. Objective: To create a national standard aimed at identifying breast cancer as a support to medical practice and support tool in risk assessment. Method: 28 variables (determined by risk factors for breast cancer) were combined; assigning to those variables weighting parameters associated with the level of incidence recorded in the medical literature, using a voting algorithm as the central mathematical element. Results: A computerized system was developed to assess the risk of breast cancer in healthy people. Conclusions: BRCAR is a support tool to objectify the risk of breast cancer, by determining the impact of certain risk factors, in order to direct study methods for early detection(AU)

Intervención educativa sobre cáncer de mama / Educative Intervention about Breast Cancer

Introducción: El cáncer de mama es una proliferación maligna de las células epiteliales que revisten los conductos o lobulillos mamarios. Objetivo: Evaluar la efectividad de una intervención educativa sobre cáncer de mama. Métodos: Se realizó un estudio cuasi-experimental de intervención educativa sobre cáncer de mama en mujeres mayores de 30 años pertenecientes al consultorio 13 del Policlínico Pedro del Toro; de Holguín durante el 2018. La población de estudio la constituyó el total de mujeres adultas mayores de 30 años de edad, 124 pertenecientes al consultorio en estudio. La muestra quedó conformada por 80 pacientes, seleccionadas mediante el muestreo aleatorio simple. Resultados: En cuanto a las necesidades identificadas, las 80 pacientes (100 por ciento) expresaron la necesidad de conocer acerca de los factores de riesgo del cáncer de mama. Antes del programa educativo predominaron las mujeres con conocimientos inadecuados sobre prevención del cáncer de mama, autoexamen de mama y factores de riesgo (80 por ciento, 65 por ciento y 80 por ciento, respectivamente). Luego de la intervención aumentaron a suficientes: en el primer caso al 85 por ciento, en el segundo y tercero a 100 por ciento. La aplicación de dicho programa resultó efectiva en 68 féminas, para un 85 por ciento. Conclusiones: La intervención educativa fue efectiva, porque demostró un incremento en el nivel de conocimiento sobre la prevención, los factores de riesgo y el autoexamen de mama(AU)

Introduction: Breast cancer is a malignant growth of epithelial cells that line the ducts or breast lobules. Objective: To assess the effectiveness of an educative intervention about breast cancer. Methods: A quasiexperimental study of an educative intervention about breast cancer was carried out, during 2018, with women over 30 years belonging to the family medical office 13 of Pedro del Toro Polyclinic of Holguín. The study population was made up of all women aged over 30 years: 124 women, who belonged to the medical office under study. The sample was made up of 80 patients, selected by simple random sampling. Results: Regarding the identified needs, all the patients expressed the need to know about the risk factors for breast cancer. Before the educative program, women with inadequate knowledge of breast cancer prevention, breast self-examination, and risk factors predominated (80 percent, 65 percent, and 80 percent, respectively). After the intervention, this amount increased to enough: in the first case, it increased to 85 percent; in the second and third cases, it increased to 100 percent. The application of this program was effective in 68 women, accounting for 85 percent. Conclusions: The educative intervention was effective because it showed an increase in the level of knowledge about prevention, risk factors and breast self-examination(AU)

Knowledge on breast cancer and breast self-examination among public-school teachers of Aurora province, Philippines

Background and Objective@#Breast cancer remains one of the top leading morbidity and mortality among women within the country and around the world. Breast self-examination has been considered as a safe and easy to perform screening procedure to detect breast lumps and swelling. This study was conducted to determine knowledge on breast cancer and breast self-examination among public-school teachers.@*Methodology@#A cross-sectional design was employed involving 348 professional teachers in Aurora, Philippines in April 2019. Self-report questionnaire derived from literatures was used to generate participants' knowledge on breast cancer and breast self-examination. Descriptive statistics like frequency, percentages and averages were used in data analysis. @*Results@#Majority of the participants are females (83.3%) whose age is between 31-40 years old (37.9%). Three hundred twenty-seven (94%) participants have knowledge on breast cancer while two hundred ninety four (84.48%) of them have knowledge on breast self-examination. @*Conclusion@#Professional teachers have knowledge on breast cancer and breast self-examination however, health care providers and concerned health agencies need to continue and enhance comprehensive health education about breast cancer and breast self-examination to teachers. It is essential that awareness program about these need to be integrated to teacher's training programs or professional development activities.

Diretrizes de rastreamento do câncer de mama com práticas personalizadas e baseadas em risco: estamos preparados? / Breast cancer screening guidelines with personalized, risk-based practices: are we ready?

O estudo averiguou se a literatura atual pode ajudar na orientação de sistemas e profissionais de saúde para a promoção de rastreamento personalizado centrado no perfil de risco das mulheres. Revisamos artigos publicados entre 2010 e 2015, indexados no banco de dados Medline. Os artigos foram selecionados com base em conteúdo tratando de métodos de rastreamento, diretrizes e fatores de risco levados em consideração no processo de tomada de decisão. Os descritores de busca foram câncer de mama, rastreamento, diretrizes e avaliação de qualidade. Os 40 artigos selecionados para leitura completa foram organizados em ordem cronológica segundo a data de publicação. Dos 40 artigos, 32 se referem a diretrizes nacionais ou internacionais já existentes sobre rastreamento do câncer de mama. Vários fatores de risco relevantes para estratégias de rastreamento, incluindo os modelos de avaliação de risco cumulativo, são considerados em todos os 40 artigos, sendo os mais comuns idade, histórico familiar e densidade do tecido da mama. Contudo, não há consenso explícito sobre se o rastreamento do câncer de mama deve ser visto como uma escolha da paciente ou se é um imperativo das políticas de saúde pública. As evidências sugerem que os sistemas de saúde e os médicos deveriam considerar a mudança do paradigma de rastreamento rotineiro de mulheres de 50 a 69 anos para o rastreamento personalizado do câncer de mama baseado em avaliação de risco nos países em que isso é factível.(AU)

The study ascertained whether the current literature may be helpful in guiding health systems and healthcare providers to promote personalized screening centered on women's risk profiles. We reviewed Medline database indexed articles published between 2010 and 2015, indexed in the Medline databased. Articles were selected based on their content dealing with screening methods, guidelines, and risk factors considered in the decision-making process. The descriptors used for the search were breast cancer, screening, guidelines, and quality assessment. The 40 articles selected for full text reading were organized in chronological order by date of publishing. Of the 40 articles, 32 refer to the existing national or international breast cancer screening guidelines. Various risk factors relevant to screening strategies, including the cumulative risk assessment models, are considered in all 40 articles, with the most common being age, family history, and breast tissue density. However, there is no explicit consensus on whether to view breast cancer screening as a patient choice or as an imperative of public health policies. The evidences suggest that health systems and physicians should consider switching from the routine screening paradigm for women aged 50-69 to personalized risk-assessment-based screening for breast cancer in countries where this is feasible. (AU)

Conocimiento del autoexamen de mama y testículo en estudiantes universitarios / Knowledge of university students on breasts and testicles self-examination

Introducción: El autoexamen de mama y el autoexamen de testículos son métodos de detección temprana sencillos, económicos, seguros, no invasivos, que no requieren ningún instrumento especial para su ejecución y que permiten una mayor conciencia y conocimiento del propio cuerpo. Objetivo: Determinar el conocimiento de la práctica del autoexamen de mama o testículo en un grupo de estudiantes universitarios. Métodos: Estudio descriptivo, transversal. Se aplicó un cuestionario sobre conocimientos de autoexamen de mama o testículo, consumo de tabaco, alcohol y variables sociodemográficas. El análisis de datos incluyó distribución de frecuencias, porcentajes y razones de prevalencia. Resultados: Del total de la muestra, el 43,9 por ciento eran hombres, de ellos el 30,7 por ciento manifestó conocer cómo se debía realizar el autoexamen de testículo. Los masculinos pertenecientes a estratos altos, los que se encontraban cursando tercer año y quienes tenían estudios afines con la facultad de salud mostraron las mayores tasas de conocimiento. De las mujeres, el 73,7 por ciento conocía cómo realizar el autoexamen de mama, demostrando tasas mayores de conocimientos las que cursaban cuarto año, las que pertenecían a estratos altos y las que tenían estudios afines con la facultad de salud. No se encontró asociación estadística con el conocimiento del autoexamen de testículo; mientras que ser mayor de 22 años y pertenecer a estratos altos fueron factores predisponentes para el autoexamen de mama. Conclusiones: Las mujeres tienen mayor percepción de la importancia del autocuidado para su salud, a la vez que manifiestan mayor conocimiento de los procedimientos para realizar el autoexamen. No obstante, existen hombres y mujeres que no saben aún como realizarlo, de ahí la importancia de desarrollar e implementar programas de educación, prevención y promoción del autoexamen en los estudiantes universitarios(AU)

Introduction: Breasts self-examination and testicles self-examination are simple, economic, safe, non-invasive early detection's methods that do not require any special tool for their performance and that foster a higher awareness and knowledge on your own body. Objective: To determine the knowledge of the breast or testicles self-examination practice in a group of university students. Methods: Descriptive, cross-sectional study. It was performed a questionnaire on the knowledge of the breast or testicles self-examination, tobacco and alcohol consumption, and socio-demographic variables. Data analysis included frequencies and percentages distribution, and prevalence ratios. Results: From the total of the sample, 43,9 percent were men, and 30,7 percent of them expressed to have knowledge on how to perform the testicles self-examination. Males corresponding to high strata, the ones that were in third year of the major, and those who had studies related to the Health's Faculty showed higher rates of knowledge. From women, 73,7 percent knew how to perform the breasts self-examination showing higher rates of knowledge the ones that were in the fourth year of the major, the ones that belonged to higher strata and the ones that had studies related with the Health's Faculty. There was not found statistic association with the knowledge on testicles self-examination; while being older than 22 years old and belonging to high strata were predisposing factors for breasts self-examination. Conclusions: Women have higher perception of the importance for health of self-care, while they show more knowledge on the procedures to perform self-examination. Nevertheless, there are men and women that do not know yet how to perform it, that is why it is important to develop and implement programs of education, prevention and promotion of the self-examination in university students(AU)

Theory-based training to promote breast cancer screening among women with breast cancer worries: randomized controlled trial

ABSTRACT BACKGROUND: Breast cancer worries are important determinants in relation to behavior favoring breast cancer screening. OBJECTIVE: To determine the effect of theory-based training to promote breast cancer screening among women with high and low levels of breast cancer worries. DESIGN AND SETTING: Randomized controlled trial, conducted in two family health centers. METHODS: In total, 285 women were recruited. Women with low levels of breast cancer worries were included in the first intervention group (112 women) and the first control group (112 women), while women with high levels of breast cancer worries were included in the second intervention group (37 women) and the second control group (43 women). Theory-based training to promote breast cancer screening was given to intervention groups. The women's willingness to undergo breast cancer screening and breast cancer worry scores were evaluated at 1, 3 and 6 months. RESULTS: The women in the low cancer-worry intervention group performed breast self-examination more in months 1 and 6 following the training, and the women in the high cancer-worry control group performed breast self-examination more in month 3 (P < 0.05). No difference between the women who had low or high levels of breast cancer worries were observed in relation to breast self-examination, clinical breast examination or mammography (P > 0.05). CONCLUSION: The level of worry did not affect the success of theory-based training, and the training was partially effective with regard to willingness to undergo breast cancer screening.

Conocimientos, actitudes y prácticas sobre autoexamen de mamas en universitarias del área de la salud. Cartagena (Colombia)* / Knowledge, attitudes and practices about breast self-examination of private university students in the health area. Cartagena (Colombia)

Objetivo: determinar los conocimientos, actitudes y prácticas sobre el autoexamen de mama en estudiantes del área de la salud, en una universidad privada de Cartagena de Indias (Colombia). Materiales y métodos: se realizó un estudio descriptivo, transversal, con una población de referencia de 513 estudiantes universitarias, tamaño muestral de 165 mujeres de 20 a 49 años de edad. Se aplicó una encuesta, que contempló las variables sociodemográficas, conocimientos, actitudes y prácticas sobre el autoexamen de mama. Resultados: de las mujeres encuestadas el 36,4% (60) pertenecen al estrato socioeconómico 2, el 81,2% manifiesto no ser madre de familia, 50,3% pertenecen al régimen contributivo. Se encontró que 80,6% (133) de la población encuestada conoce como se realiza el autoexamen de mama, más de la mitad afirma que esta práctica debe realizarse a partir de los 20 años (64,2% (106)) y el 67% (110) están de acuerdo con las bondades de esta técnica. El 78,7% de las estudiantes participantes considera esta práctica adecuada para la detección de alteraciones en la mama u otros hallazgos sugestivos de cáncer de mama. Con relación a las actitudes, para el 95,8% (158) de las jóvenes es bueno realizarlo, aunque un porcentaje importante de estas mujeres nunca lo realiza (30,9% (51)). Conclusiones: la mayoría de las estudiantes tienen buenos conocimientos sobre el autoexamen de mama, reconocen la importancia de la realización del mismo, presentan una actitud favorable, y tienen una buena práctica..(AU)

Objective: to determine the knowledge, attitudes and practices on breast self-examination of university students in the health area at private university in Cartagena (Colombia). Materials and methods: a cross-sectional study with a reference population of 513 university students, sample size of 165 women from 20 to 49 years of age. A survey was applied, which included demographic variables, knowledge, attitudes and practices about breast self-examination. Results: the women surveyed, the 36.4% (60) belong to the socio-economic stratum 2, 81.2% revealed not to be mother of a family, 50.3% belong to the contributory regime. It was found that 80.6% (133) of the population surveyed know how to perform breast self-examination, more than half said that this practice should be made from the 20 years (64.2%) (106) and 67% (110) are in accordance with the advantages of this technique. The 78.7% of the student participants considered this practice suitable for detection of alterations in the breast or other findings suggestive of breast cancer. With regard to attitudes, for 95.8% (158) of the young people is well done, although a significant percentage of these women never performed ((30.9%) (51)). Conclusions: most of the students have good knowledge about breast self-examination, recognize the importance of performing it, present a favorable attitude, and have a good practice..(AU)

Tamización para cáncer de mama en el departamento del Huila, Colombia / Screening for mammary cancer in the state of Huila, Colombia

Introducción. En Colombia, la tamización para cáncer de mama, de acuerdo con las normativas del Ministerio de Protección Social, se hace mediante el examen clínico anual de la mama a partir de los 40 años y la mamografía bienal entre los 50 y los 69 años. Se presenta la experiencia en tamización con mamografía y examen clínico de la mama en el departamento del Huila de Colombia. Materiales y métodos. El departamento del Huila, al sur de Colombia, tiene una población de 1'097.615 habitantes, y se seleccionaron 15 municipios para este estudio. La tamización se llevó a cabo entre junio de 2011 y diciembre de 2013, y se adaptó un vehículo que permanecía en cada uno de los municipios durante un tiempo establecido. Dicha unidad móvil contaba con recepción, consultorio médico y unidad de mamografía digitalizada. Se hizo una ronda de tamización con el examen clínico de la mama y la mamografía de dos proyecciones. Resultados. Se valoraron 5.212 mujeres, 4.995 de las cuales contaban con información completa. De estas, 100 (2 %) tenían hallazgos positivos en el examen clínico de la mama. El 51,9 % de las mamografías fueron caracterizadas como BI-RADS 3 y el 1,12 %, como BI-RADS 4 o 5. Se confirmó el diagnóstico de cáncer en 29 pacientes, 9 con carcinoma in situ y 20 con carcinoma infiltrante, de las cuales 17 (59 %) tenían tumores en los estadios clínicos tempranos. Discusión. Se muestra que es posible hacer tamización para cáncer de mama con mamografía y examen clínico de la mama en municipios alejados de los grandes centros urbanos de Colombia, si se cuenta con una infraestructura básica y médicos generales o enfermeras con entrenamiento en la detección temprana del cáncer de mama

Introduction: Breast cancer screening in Colombia is performed following the "Ministerio de Salud y Protección Social" guidelines, through annual clinical examination starting with women 40 years old and biennial mammography in women between 50 and 69 years old. The article shows the experience in screening with mammography and breast clinical examination in the state of Huila, Colombia. Methods and materials: The state of Huila, located in southern Colombia, has a population of 1,097,615. Fifteen townships were selected for the study. Screening was carried out between June 2011 and December 2013. A customized vehicle stayed in every single township during an stablished period of time. This mobile unit was equipped with a reception area, a doctor´s office and a digitalized mammography unit. Screening was performed by breast clinical examination and a two-projection mammography. Results: 5,212 patients were screened, of which 4,995 had complete information. 100 women (2%) had positive clinical breast examination findings; 51.9% of the mammographies were BI-RADS 3, and 56 (1.12%) were BI-RADS 4 or 5. Diagnosis of cancer was confirmed in 29 patients, 9 of them with carcinoma in situ, and 20 with infiltrating carcinoma, of which 17 (59%) had early stage tumors. Discussion: This work shows that it is possible to screen for mammary cancer with mammography and breast clinical examination in townships away from the large urban centers of Colombia, provided there are a basic infrastructure and general physicians or nurses with training in early detection of breast cancer

Autoexamen de seno: conocimientos, actitudes y prácticas en mujeres de una institución de educación superior / Self-examination of breast: Knowledge, attitudes and practices in women of a higher education institution / Autoexame das mamas: conhecimentos, atitudes e práticas em mulheres de uma instituição de ensino superior

Introducción. Según la Organización Mundial de la Salud, el cáncer de seno es el segundo más común en el mundo, con un estimado de 1,67 millones de casos nuevos diagnosticados en 2012, lo que equivale al 25 % de todos los cánceres.Objetivo. Identificar los conocimientos, actitudes y prácticas frente al autoexamen de seno en mujeres de una institución de educación superior, durante el segundo semestre de 2017. Materiales y métodos. Se llevó a cabo un estudio de enfoque cuantitativo, de tipo descriptivo y transversal en una población 1125 estudiantes de sexo femenino. Su duración fue de un año y se contó con una muestra de 287 participantes de una institución de educación superior. La información se recolectó mediante una encuesta para evaluar los conocimientos, actitudes y prácticas del autoexa-men de seno. Resultados. El 40,7 % de la población estudiada sí se practica el autoexamen de seno, 72,03 % con una frecuencia adecuada y 38,13 % en la etapa sugerida del ciclo menstrual. Conclusión. La mayor parte de la población no se practica el autoexamen, además, existe poca clari-dad sobre la frecuencia y el momento en que se debe hacer

Introduction. According to World Health Organization, breast cancer is the second most common cancer in the world with an estimated 1.67 million new cases of cancer diagnosed in 2012, equivalent to 25% of all cancers. Objective. Identify the knowledge, attitudes and practices facing breast self-examination in women of a higher education institution during the second semester of 2017Materials and methods. Quantitative, descriptive and transversal was carried out in a population 1,125 students of female gender; the study elapsed one year, on a sample of 287 participants of a higher education institution. Information collection was conducted using a survey to evaluate knowle-dge, attitudes and practices of breast self-examination.Results. 40.7% of the studied population does practice breast self-examination, being 72.03% with an adequate frequency and 38.13% in the suggested stage of the menstrual cycle.Conclusion. The major part of the population does not practice self-examination, and there is poor clarity about frequency and time in which it should be performed

Introdução. Segundo a Organização Mundial da Saúde, o câncer de mama é o segundo de neoplasia mais frequente no mundo, com um número estimado de 1,67 milhões de novos casos diagnosticados em 2012, o equivalente a 25% de todos os tipos de câncer.Objetivo. Identificar conhecimentos, atitudes e práticas sobre o auto-exame das mamas em mulheres de uma instituição de ensino superior, durante o segundo semestre de 2017.Materiais e métodos. Foi realizado um estudo de abordagem quantitativa, descritiva e transversal em uma população de 1125 estudantes do sexo feminino. Sua duração foi de um ano e uma amostra de 287 participantes de uma instituição de ensino superior. As informações foram coletadas por meio de uma pesquisa para avaliar os conhecimentos, atitudes e práticas do auto-exame das mamas.Resultados. 40,7% da população estudada realiza auto-exame das mamas, 72,03% com frequência adequada e 38,13% na fase sugerida do ciclo menstrual.Conclusão. A maior parte da população não pratica o auto-exame; além disso, há pouca clareza sobre a frequência e o momento em que deve ser feito

Factors Affecting Breast Self-examination Behavior Among Female Healthcare Workers in Iran: The Role of Social Support Theory / 예방의학회지

OBJECTIVES: In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers. METHODS: This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2. RESULTS: The mean age of the participants was 37.1±8.3 years, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (β=0.380, p<0.05), and protection motivation (β=0.604, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (β=0.202, p<0.05) had a significant positive effect on breast self-examination behavior. CONCLUSIONS: The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.

Fatores associados às alterações em mamografias / Factors associated with changes in mammograms / Factores asociados a las alteraciones en las mamografías

Objetivo: analisar os fatores associados com alterações em mamografias. Método: estudo transversal realizado com 145 mulheres atendidas pela estratégia saúde da família, em um município da região noroeste do Paraná/Brasil. Os dados foram coletados por meio de entrevista semiestruturada, no período de agosto de 2014 a outubro de 2015. Os dados foram analisados por meio dos Testes qui-quadrado de Pearson e Exato de Fisher. O projeto foi aprovado por Comitê de Ética em Pesquisa. Todos os aspectos éticos foram respeitados. Resultados: a idade média das mulheres atingiu 52,5 anos, as brancas (OR=0,17), nulíparas (OR=4,53), com alterações no autoexame (OR=12,72), exame clínico (OR=35,75) e com histórico de problemas anteriores (OR=9,45) apresentaram maior chance de alterações na mamografia. Conclusão: os fatores associados a alteração na mamografia foram a cor branca, a nuliparidade, a identificação de alterações durante o autoexame e no exame clinico e a existência de problema mamário anterior.

Objective: to examine factors associated with changes in mammograms. Method: in this cross-sectional study of 145 women receiving care under the family health strategy in a municipality in northwestern Paraná, Brazil, data were collected by semi-structured interviews between August 2014 and October 2015 and analyzed using Pearson's Chi-square test and Fisher's exact test. The project was approved by the research ethics committee. Results: the women were of mean age 52.5 years. Those who were white (OR = 0.17), nulliparous (OR = 4.53), with alterations at self-examination (OR = 12.72), clinical examination (OR= 35.75) and a history of previous problems (OR = 9.45) presented a greater likelihood of changes in mammography. Conclusion: the factors associated with altered mammography were white skin color, nulliparity, alterations during self-examination and clinical examination, and a previous breast problem.

Objetivo: analizar los factores asociados con las alteraciones en las mamografías. Método: estudio transversal realizado junto a 145 mujeres atendidas por la estrategia salud de la familia, en una ciudad del noroeste de Paraná/Brasil. Se recolectaron los datos por medio de una entrevista semiestructurada, en el período de agosto de 2014 a octubre de 2015. Se analizaron esos datos por las pruebas chi-cuadrado de Pearson y Exacto de Fisher. El proyecto fue aprobado por el Comité de Ética en Investigación. Se respetaron todos los aspectos éticos. Resultados: el promedio de edad de las mujeres fue de 52,5 años, las blancas (OR = 0,17), nulíparas (OR = 4,53), con alteraciones en el autoexamen (OR = 12,72), examen clínico (OR = 35,75) y con historia de problemas anteriores (OR = 9,45) presentaron mayor probabilidad de alteraciones en la mamografía. Conclusión: los factores asociados a alteración en la mamografía fueron el color blanco, la nuliparidad, la identificación de alteraciones durante el autoexamen y en el examen clínico y la existencia de problema mamario anterior.

Relaciones de pareja como factor relacionado con la práctica del autoexamen de mama en estudiantes universitarias / Couple relationships as a factor related to the practice of breast self-examination in university students

Resumen Introducción: Existe controversia sobre la relación entre las creencias y la realización de la autoexploración mamaria en las mujeres y se carece de estudios que muestren la influencia que las parejas pueden tener en dicha práctica. Objetivo: Identificar si existe asociación entre el autoexamen de mama, los estilos de vida, las creencias en salud y las relaciones de pareja en estudiantes universitarias. Materiales y métodos: Estudio transversal con 284 mujeres estudiantes de la Universidad Veracruzana. Se aplicó el cuestionario de Creencias en salud hacia el autoexamen de mama y un cuestionario de datos personales. Resultados: La media de edad fue 20,32 años. Solo 19,7% de las estudiantes reportaron realizar el autoexamen de mama de manera mensual. Las mujeres que no tenían pareja mostraron mayores barreras hacia el autoexamen y menores beneficios percibidos. La edad favoreció la realización del autoexamen de mama, mientras que las barreras percibidas lo limitaron. Por su parte, tener pareja se asoció con menores barreras y mayores beneficios percibidos hacia el autoexamen. Conclusiones: Existe baja realización del autoexamen en las estudiantes a pesar del conocimiento que poseen del mismo. Tener pareja disminuye las barreras percibidas hacia la realización del autoexamen de mama.

Abstract Introduction: There is controversy about the relationship between beliefs and the realization of breast self-examination in women and there is a lack of studies which show the influence that couples can have in that practice. Objective: To identify whether there is an association between breast self-examination, lifestyles, health beliefs, and partner relationships in university students. Materials and methods: A cross-sectional study was conducted with 284 women students from the University of Veracruz. The Health beliefs questionnaire was applied to breast self-examination and a personal data questionnaire. Results: The average age was 20.32. Only 19.7% of the students reported the realization of breast self-examination monthly. Women who did not have a couple showed greater barriers to self-examination and lower perceived benefits. Age favored the realization of breast self-examination, while the perceived barriers limited it. On the other hand, having a couple was associated with lower barriers and increased benefits to self-examination. Conclusions: There is low self-examination in the students despite their knowledge. Having a couple decreases the perceived barriers to conducting breast self-examination.