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.

Fatores associados à realização da prevenção secundária do câncer de mama no Município de Maringá, Paraná, Brasil / Factors associated with secondary breast cancer prevention in Maringá, Paraná State, Brazil

Este estudo analisou a prevalência e os fatores associados à realização da prevenção secundária do câncer de mama em mulheres de 40-69 anos do Município de Maringá, Paraná, Brasil. Realizou-se um estudo exploratório de corte transversal, tipo inquérito populacional, no Município de Maringá. A prevalência observada de realização do autoexame das mamas foi de 64,5 por cento, do exame clínico das mamas, 71,5 por cento, e de mamografia, 79 por cento. Os fatores que influenciaram na realização dessas ações foram: idade, escolaridade, raça, classe econômica, religião e realização de terapia hormonal. A classe econômica e a escolaridade influenciaram significativamente na realização das práticas preventivas, ou seja, quanto maior o nível socioeconômico, maior a realização. A orientação e realização das práticas preventivas devem estar ao alcance de todas as mulheres na faixa etária de maior risco, diminuindo, dessa maneira, o diagnóstico tardio e mortes desnecessárias e aumentando as chances de cura do câncer de mama.

This study analyzed the prevalence of secondary breast cancer prevention and associated factors in women 40 to 69 years of age in Maringá, Paraná State, Brazil. Prevalence was 64.5 percent for breast self-examination, 71.5 percent for clinical examination, and 79 percent for mammography. The data suggest that age, schooling, ethnicity, socioeconomic status, religion, and prior hormone replacement therapy influenced the rates of the three types of examination. Preventive practices were significantly more common among women of higher socioeconomic status. Proper orientation and performance of preventive measures and tests should be at the reach of all women in the highest-risk age bracket, thereby decreasing late diagnosis and avoidable deaths and increasing the odds of curing breast cancer.

Breast self-examination among nurses and midwives in Odemis health district in Turkey.

Background The second leading cause of death due to cancer in Turkey is breast cancer, which accounts for 24% of female cancers. Aims: To determine the practices of nurses and midwives and their attitude toward breast self-examination (BSE). Setting and Design: The descriptive survey was conducted to determine the practices of nurses and midwives and their attitude toward BSE. It tried to cover the total population rather than sampling part of it. However, 15 nurses and midwives, where there were errors detected in their data coding papers, and who did not accept to join the study, were excluded from the study. A total of 80 nurses and midwives were included in the study group. Materials and Methods: This survey was carried out at the State Hospital, all Public Health Cabins, and Family Health Centers, in the rural area of Izmir, a city located in the western region of Turkey. The data was collected between 15 March and 1 April 2004. Statistical Analysis: The analysis included descriptive statistics, to examine the association between BSE and medical history, knowledge of BSE, and attitude toward BSE. Results: The results of the study indicated that 52% of the sample performed BSE. Approximately 35% of those who performed BSE reported that they acquired information regarding BSE during their work experience. A significant relationship was found between higher levels of work experience and BSE practice. Except for age, no significant relation was found between the sociodemographic factors and BSE practice. The sample showed a strong belief in the breast lump being the cause of breast cancer and it had a significant correlation with BSE practice. Conclusion: A positive correlation was found between nursing work experience and their practice alongside BSE medical professionals. Almost all the nurses and midwives knew how to conduct BSE, but did not prioritize practicing it.

Breast self-examination as a method of early detection of breast cancer: knowledge and practice among antenatal clinic attendees in south eastern Nigeria

To determine antenatal women's knowledge and practice of breast self-examination as a method of early detection of breast cancer. It is a descriptive study involving 100 consecutive and consenting patients at the antenatal clinic of Abia State University Teaching Hospital, Aba, over the period 1[St] June, 2007 to 15 [Th] June, 2007. Using a structured questionnaire, the respondents' socio-demographic data were obtained as well as their knowledge of breast cancer, breast self-examination for early detection of breast cancer and the practice of breast self-examination. The majority [98%] of the women were married. Whilst 78% of the respondents practiced breast self-examination regularly, only 34% of them knew the reason for practising breast self-examination. This means that the breast self-examination practiced was mostly ineffective. Only 3% of the respondents knew about a mammogram whilst none had had a mammogram done in the past. The vast majority [97%] of the respondents had heard of cancer of the breast. Breast self-examination was positively associated with educational level attained. The level of practice of breast self-examination is very low in our community. Public health programmes that teach women to regularly examine their breast and to seek early treatment for any detected lesions should be publicized through the mass media, seminars, conferences, workshops at the grassroots level and health education at health facilities

Auto-exame de mama e fatores associados em uma população atendida pelo Programa Saúde da Família / Breast self exam and correlation with associated factors in population of Health Family Program

Avaliar o conhecimento e a prática do auto-exame das mamas (AEM) em uma população do litoral do Rio Grande do Sul, bem como a prevalência e a associação de fatores sociodemográficos. Métodos: Agentes de saúde ligados ao Programa Saúde da Família (PSF) convidaram mulheres com mais de 20 anos a fazerem avaliação clínica das mamas nos postos de saúde do município e aplicaram um questionário semi-estruturado. As variáveis estudadas foram idade, escolaridade, estado civil, renda familiar e história familiar de câncer de mama. Resultados: Foram avaliadas 728 mulheres atendidas no PSF. Observou-se que 97% das mulheres conheciam o AEM e 82,1% destas o praticavam. Ao avaliar a freqüência, entre as 592 que faziam o AEM, a realização mensal (correta) era feita por apenas 207 mulheres, 28% da amostra populacional. As variáveis que se apresentaram estatisticamente associadas com a prática do auto-exame mensal foram idade (p < 0,001) e o grau de escolaridade (p < 0,02). As associações com estado civil, cor, renda e história familiar positiva para câncer de mama não foram estatisticamente significantes. Conclusão: A prática e a freqüência do auto-exame das mamas na população estudada foram inadequadas, pois apenas 28% praticavam-no corretamente. A aderência esteve relacionada à maior idade e ao maior grau de escolaridade. Perspectivas: educar usando a denominação de autoconhecimento das mamas, porque exame tem conotação médica.

Objectives: In order to evaluate the knowledge and the pratice of the breast self examination (BSE) in a low income population from the north shore of the estate of Rio Grande do Sul, as well to report the prevalence and sociodemographic factors associations. Methods: Public health employees from the Health Family Program invited women over 20 years of age for a breast clinical examination at a community clinic. They were submitted to semi-structured questionaire about factors potentially associated to the knowledge and pratice of BSE. Current age, marital status, education level, family income and breast cancer history of close relatives were collected and reported. Results: 728 women were included in the study. About 97% of women had knowledge of the BSE and 82,1% of them referred a regular practice. Among the 592 that referred the practice of BSE, anly 207 (28% of the sample) did it monthly. The variables that were statistically associated with monthly BSE were: current age (p < 0.001) and educational level (p < 0.02). Marital status, family income and breast cancer history of close relatives did not generated statistical significant values. Conclusion: The practice and frequency of the BSE was inadequate in the study population although most of them reported knowing BSE, only 28% use to perform it correctly. Women with higher educational level and old age were more adherent to the BSE practice.

Validating breast self examination as screening modalities for breast cancer in eastern region of Nepal: a population based study.

Breast cancer is one of the most common causes of death in many developed countries amongst middle-aged women and is becoming common in developing countries as well. AIMS AND OBJECTIVES: The objective of this study was to evaluate the performance of Breast Self Examination (BSE) against examination conducted by the trained health personnel. METHODOLOGY: A descriptive evaluative study was conducted among women aged 15 to 60 years undertaken in urban and rural areas. It was a population-based study and non-probability sampling method was used for data collection. Respondents conducted Breast Self Examination on their own, and then investigators did clinical examination of breasts of the respondents to verify their findings. RESULTS: Mean age of the respondents was 34.54 +/- 9.12 years. Nearly half (44.8%) of the respondents were illiterate. On comparison of each variable of breast self- examination with the physical examination of breast, it was observed that size of the breasts and lump found in the breast had significant relation to performance during examination (P<0.1). The result of Kappa test showed 68% agreement between findings of examinations done by the experts and respondents. CONCLUSION: Breast Self Examination can be used as an important tool for primary prevention of breast cancer in Nepal, where sophisticated method like screening mammography for general public cannot afford.

Socioeconomic factors association with knowledge and practice of breast self-examination among Iranian women.

BACKGROUND: Breast cancer is the leading type of cancer in women and is one of the most frequent cancers among Iranian women. Delay in diagnosis and treatment of breast cancer diminishes a women's chance of survival. Breast self- examination (BSE) may be effective in early detection. The purpose of this study was to identify the relationship between Iranian women's socioeconomic status and their knowledge and practice of BSE. METHODS: Data were from a hospital-based case-control study among women diagnosed with breast cancer. Control subjects were matched to patients on age. 303 breast cancer patients and 303 control women were interviewed. Socioeconomic status and information including knowledge and practices of breast self examination and clinical breast examination were recorded and compared. RESULTS: The mean +/- SD age of cases and controls was 48.2 +/- 9.8 and 50.2 +/- 11.1 (range 24-84 years), respectively. The study revealed that there were significant relationships between education level and knowledge and practices of breast self examination in both cases and controls, increase in usage being observed with the level of education (P<0.05). CONCLUSION: The findings suggest that the knowledge and practices of women toward breast cancer early detection are inadequate in women with a lower level of education. Mass media cancer education should promote widespread access to information about early detection behavior.

Conhecimento e prática do auto-exame de mama / Knowledge and practice of breast self-examination in Goiânia

OBJETIVO: Determinar a prevalência e fatores associados ao conhecimento e prática do auto-exame das mamas (AEM) em amostra hospitalar de Goiânia. MÉTODOS: Realizou-se estudo descritivo sobre os fatores potencialmente associados ao conhecimento e prática do AEM numa coorte de 2073 pacientes. Usou-se entrevista estruturada, sendo as variáveis estudadas: idade, escolaridade, procedência, paridade, estado civil, renda familiar e amamentação. RESULTADOS: Observou-se que 75 por cento das mulheres conheciam e 51 por cento praticavam o AEM. Análise multivariada permitiu a obtenção das seguintes razões de chance: conhecimento do AEM entre donas de casa foi 4,2 vezes maior que entre as que trabalham fora; 2,1 vezes maior entre as acima de 30 anos; 2,1 vezes maior entre as com cinco ou mais anos de escolaridade; 1,98 vez maior entre as originárias da Grande Goiânia; 1,4 vez maior entre as com dois ou mais filhos; 1,68 vez maior entres aquelas com renda maior que dois salários mínimos. Em relação à realização do AEM, esta foi 1,7 vez mais freqüente nas donas de casa; 1,7 vez mais relatada nas maiores de 30 anos; 1,8 vez mais entre as originárias da Grande Goiânia; 1,8 vez mais freqüente naquelas com maior escolaridade; e 1,2 vez mais nas mulheres com renda superior a dois salários mínimos. CONCLUSÃO: A maioria das pacientes refere conhecer o auto-exame, e metade menciona praticá-lo. As camadas da população mais carentes de informação e conscientização sobre a importância dessa técnica na detecção precoce do câncer de mama apresentam alta taxa de desconhecimento e não o praticam.

OBJECTIVE: To ascertain frequency of women in a hospital sample in Goiânia, Brazil, who know about and carry out breast-self examination (BSE) as well as the factors associated to knowledge and practice of this diagnostic method. METHODS: A descriptive study was carried out aiming to identify factors potentially associated to BSE in a sample of 2,073 women. Data was collected using a standardized questionnaire of age, education level, origin, parity, civil status, income and breastfeeding antecedents of the women. RESULTS: 75 percent of women knew about BSE and 51 percent practiced it. A multivariate analysis yielded the following odds ratios: BSE knowledge was 4.2 times higher among housewives than women working away from home; 2.1 times higher among those aged 30 years or older; 2.1 times higher in those with 5 years or more of schooling, 1.98 times higher among those living in the Greater Goiânia Region, 1.4 times higher among those with 2 children or more, and 1.68 times higher among those with an income above 2 minimum wages. In relation to BSE practice, it was 1.7 times more frequent among housewives and among those 30 year or older, 1.8 times more frequent among those with more years of schooling and 1.2 more frequent among women with an income above 2 minimum wages. CONCLUSION: The majority of women knew about BSE, and half of them, practiced it. Less knowledge and less frequent practice of BSE was more often detected in poorer women, those with less health information and awareness about the usefulness of this method for early breast cancer detection.

Associação entre Apoio Social e Freqüência relatada de Auto-exame das Mamas no Estudo Pró-Saúde

Os programas de screening de câncer de mama representam uma estratégia efetiva para a redução de sua incidência e mortalidade. Nas últimas décadas, a importância das relações sociais na preservação da saúde vem sendo amplamente discutida, principalmente nos países desenvolvidos. Nesse contexto, inúmeros estudos epidemiológicos têm investigado a influência de características do ambiente psicossocial no risco de adoecer e de morrer, nos comportamentos relacionados à saúde e na utilização de serviços. Dentre essas características, destaca-se o conceito de apoio social que, no caso desse estudo, envolve as dimensões de apoio material, afetivo, emocional, de informação e interação positiva. O objetivo dessa investigação foi identificar associação entre a prevalência da prática do auto-exame das mamas e cinco diferentes dimensões de apoio social, entre as funcionárias de uma universidade no Rio de Janeiro. As perguntas relativas ao apoio social e a freqüência do AEM foram incluídas em um questionário estruturado auto-preenchido, na primeira etapa de coleta de dados de um estudo de coorte, com 4030 funcionários técnico-administrativos (sendo 2240 mulheres). A freqüência da prática relatada de AEM foi particularmente elevada entre as funcionárias do hospital universitário. Considerando-se o conjunto das funcionárias, a maior parcela (43%) informou realizar AEM “todo mês” ou “quase todo mês” e 24% informaram praticá-lo “raramente” ou “nunca”. A confiabilidade teste-reteste dessa informação foi alta: coeficiente kappa = 0,82 (IC95%:0,74-0,89). As respostas às perguntas que constituíram cada uma das cinco dimensões de apoio social compuseram escores, cuja distribuição apresentou concentração nos valores mais altos (médias próximas a 80 pontos). Mesmo assim, foi possível discriminar subgrupos que apresentavam diferentes prevalências da prática de AEM segundo tercis dos escores de apoio social. A prevalência da prática referida de AEM variou de forma direta com o nível dos cinco escores das dimensões de apoio social. Em cada dimensão, a chance de praticar AEM foi duas vezes maior entre as funcionárias situadas no tercil mais alto de apoio, comparadas às funcionárias situadas no tercil mais baixo. Tendo o mesmo grupo de referência, as funcionárias situadas no nível intermediário dos escores (2º tercil) apresentaram chance 50% maior de praticar AEM.A consistência dos resultados encontrados nas cinco dimensões permite concluir que níveis diferenciados de apoio social podem influenciar práticas de cuidados com a saúde como o AEM.

Screening programs represent an effective strategy for reducing breast cancer incidence and mortality. In recent decades, the importance of social relations in the preservation of health has been widely discussed, especially in developed countries. Within this context, numerous epidemiological studies have focused on the influence of characteristics of the psychosocial environment on the risk of becoming ill and dying, on health-related behaviors, and on the utilization of health services. One of the most important of such characteristics is the concept of social support, which in the case of this study involves material, affective, and emotional support as well as information and positive interaction. The objective of this study was to identify an association between the prevalence of breast self-examination (BSE) and five different dimensions of social support among employees at a university in Rio de Janeiro, Brazil. Questions pertaining to social support and frequency of BSE were included in a structured, self-applied questionnaire during the first stage of data collection in a cohort study with 4,030 technical and administrative employees (2,240 of whom are women). Frequency of self-reported BSE was particularly high among university hospital employees. Among female employees as a whole, the largest proportion (43%) reported performing BSE “every month” or “almost every month”, while 24% reported performing it “rarely” or “never”. Test-retest reliability for this information was high: kappa coefficient = 0.82 (95% CI: 0.74-0.89). Answers to questions constituting each of the five dimensions of social support comprised scores, whose distribution was concentrated on higher values (mean values close to 80 points). Even so, it was possible to distinguish sub-groups with different BSE prevalence rates according to social support score tertiles. Prevalence of self-reported BSE varied directly with the level of the five scores for social support dimensions. For each dimension, probability of performing BSE was twice as great among employees in the highest support tertile as compared to employees in the lowest tertile. Having the same reference group, employees in the intermediate score level (second tertile) had a 50% greater probability of performing BSE. onsistency of results in the five dimensions allows one to conclude that different levels of social support can influence health care practices such as BSE.

[Knowledge, attitudes and behaviours of women towards breast cancer screening]

The objective of this study was to describe knowledge, attitudes and behaviour of women towards breast cancer screening methods in two regions of north Tunisia. Thus 936 women from Ariana [urban region] and 993 women from Zaghouan [rural region] were selected and answered a questionnaire on their perception of the gravity of breast cancer, the vulnerability of women, the efficacy of screening and their use of screening. The use of screening was significantly more frequent in Ariana for both clinical breast examination and mammography, but screening use was modest. This low use of breast cancer screening contrasts with a positive attitude to breast cancer screening methods. The factors positively associated with use of screening were urban residence, age between 35 and 49 years, educational level and the perception that cancer treatment had advanced in Tunisia

Breast examination of older women in a teaching hospital.

INTRODUCTION: Breast examination during routine physical examination may help detect breast cancer and effect early treatment. OBJECTIVE: To determine whether doctors routinely perform breast examination in older women, and to assess attitudes of patients and doctors to this examination. METHODS: A questionnaire based survey of 150 women over 65 years attending a teaching hospital, and 51 doctors working in this hospital. RESULTS: Very few women had a breast examination performed by a doctor. All thought breast examination was important, and would give consent for this examination. Although the great majority of doctors thought breast examination should be done routinely only very few do so. CONCLUSION: Older women have a positive attitude towards breast examination, but this is not reflected by the practice of doctors. There is a need for change in attitudes and training among doctors so that breast examination would be performed routinely.

Cáncer de mama: evaluación clínica de casos tratados desde 1986 a 1996 en el Hospital Escuela de Corrientes / Breast cancer: clinical valuation of treated cases between 1986 to 1996 in the Hospital Escuela of Corrientes

El cáncer de mama es la principal causa de muerte en Argentina y el mundo, afortunadamente las posibilidades de diagnóstico temprano son mayores que otros cánceres. Planteamos como objetivos: Conocer su frecuencia, posibilidades de diagnóstico temprano y conciencia de las mujeres sobre el autocontrol. Se evaluaron 71 Historias Clínicas de pacientes internados en los Servicios de Ginecología y/o Cirugía del Hospital "José de San Martín"; paralelamente se encuestaron a 216 mujeres. El cáncer de mama se encontró en 2º lugar en frecuencia (36 por ciento) después del cáncer de cuello uterino (43 por ciento). El motivo de consulta mas frecuente fue por nódulo (78 por ciento) seguido en frecuencia el dolor (12 por ciento). La mayoría de las enfermas no consultan tempranamente, sólo el 12 por ciento lo hizo antes de los 2 meses. El nódulo era detectable con la palpación en un 83 por ciento y el dolor en un 50 por ciento. Los nódulos oscilaban entre 2 y 5 cm. de diámetro, generalmente eran duro elásticos (80 por ciento), la mitad no tenían adherencias. El diagnóstico de certeza lo dió siempre el estudio anatomopatológico. La estadificación demostró desgraciadamente que el 60 por ciento consulta en un estadio avanzado con pocas chances de cura. Con la encuesta se demostró falta total de control mamográfico, así como del autoexamen. En mujeres mayores de 40 años, solo un 16,5 por ciento se hace una mamografía al menos cada 2 años, un 63,1 por ciento no lo hace y el 21,4 por ciento desconoce la práctica de este estudio. Adecuada semiología, mamografía oportuna y correcta enseñanza del autoexamen en las mujeres, permitirían aumentar la sobrevida de las pacientes

Cobertura de prácticas de prevención del cáncer cervical uterino y mamario: análisis de una población asintomática en el Partido de La Matanza / Practical cover of prevention of the cervical and breast cancer: analysis of an asymptomatic population in the La Matanza district

El presente trabajo informa la cobertura del Pap, examen clínico mamario y autoexamen mamario en una población asintomática autoseleccionada para participar de un Programa de Detección del Cáncer y evaluar la concordancia entre los tests mencionados. Método: Se realizaron encuestas individuales a cada mujer atendida. Se utilizó el índice de Kappa para evaluar la concordancia. Resultados: 69,3 por ciento de las mujeres se realizaron un Pap en los últimos tres años y 37,1 por ciento el examen clínico mamario en el mismo lapso. 13,2 por ciento de las mujeres nunca se hizo un Pap y en 44,1 por ciento nunca fueron examinadas sus mamas. La concordancia fue significativa (p<0,0001). Conocen el autoexamen mamario 87,9 por ciento de las mujeres, pero lo realizan el 62,4 por ciento. Discusión y Conclusiones: Este es el primer informe en nuestro país que describe la cobertura de estas prácticas de detección. La realización del examen físico mamario es muy baja. De las mujeres que se hacen un Pap el 44 por ciento no recibe un examen físico mamario, sugiriendo una falla profesional o del sistema de salud

Sensibilidad, especificidad y valor predictivo del examen físico y de la mamografía en el diagnóstico preoperatorio de cáncer de mama / Sensitivity, specificity and predictive value of the physical exam and mammography in the preoperatory diagnosis of the breast cancer

El diagnóstico temprano del cáncer mamario es fundamental en la curación y pronóstico de las pacientes. Este se establece con base en la historia clínica, el autoexamen y la mamografía. El propósito de este trabajao fue investigar la sensibilidad la especificidad y el valor predictivo del examen físico y de la mamografía en el diagnóstico preoperatorio del cáncer mamario. En el estudio se incluyeron 523 pacientes mayores de 30 años con síntomas y signos de la glándula mamaria. Se investigó edad, características del tumor, pérdida de líquido por el pezón, signos de la areola y el pezón, y adenopatía axilar. Se practicaron 279 mamografías en dos proyecciones: craneocaudal y lateral; los diagnósticos fueron establecidos por los médicos radiólogos del Servicio de Imagenología. Todas las pacientes fueron intervenidas quirúrgicamente; 400 casos resultaron ser padecimientos benignos y en 123 se confirmó el diagnóstico de cáncer mamario mediante estudio transoperatorio. Los resultados obtenidos fueron los siguientes: El examen físico tuvo sensibilidad de 90.24 por ciento, especificidad 96.07 por ciento; valor predictivo positivo 72.8 por ciento y valor predictivo negativo 96.07 por ciento; el estudio radiológico de mamografía mostró sensibilidad del 78.57 por ciento, especificidad del 87.5 por ciento, valor predictivo positivo 69.6 por ciento y valor predictivo negativo 91.8 por ciento. Este análisis clínico muestra qué tan alto es el índice de exactitud que alcanzan el examen físico y la mamografía; también señala que ambos métodos dependen directamente tanto del adiestramiento como de la experiencia del clínico y del radiólogo

Teacher's knowledge and practice of breast self examination.

Data collected by interview of 100 teachers of schools and colleges regarding knowledge and practice of self examination of breast is analysed. Results showed that although the fear of breast cancer is common, the knowledge and practice of self examination was deficient and not regularly followed. A plea is made to publicise this in health education programmes and in media as a measure for early detection of breast cancer.

Punción de lesiones no palpables : muestras citológicas e histológicas / Fine needle aspiration and core biopsy of non-palpable lesions of the breast : cytologic and histologic samples

Se realizan consideraciones respecto a la utilización de agujas finas y gruesas para estudios citológicos o histológicos bajo guías ecográficas o estereotáxicas. Se analizan las ventajas y desventajas de cada uno de los métodos, recalcando las posibilidades de cada uno de ellos, efectuados por un equipo entrenado y permanentemente evaluado por correlaciones quirúrgicas o seguimientos.

Autoexamen de mama / Breast self-examination

Establecido el hecho que el autoexamen de mama es el método de pesquisa con mejores posibilidades de ser implementado en nuestro país, se proyecta un estudio con el objetivo de conocer la realidad de la utilización de este método entre mujeres jóvenes de la ciudad de Concepción. Se realiza una encuesta a alumnas de tercer y cuarto año de enseñanza media de tres diferente colegios urbanos y a sus madres. Se consiguió 2.016 respuestas de jóvenes y 673 de sus madres. El 24.94 por ciento de las estudiantes y el 66.6 por ciento de las madres dijeron examinarse las mamas, aunque sólo alrededor del 29 por ciento lo hace frecuentemente y con regularidad. Entre las jóvenes, no se observaron diferencias en la frecuencia de autoexamen entre los cursos ni entre los colegios, mientras que entre las madres se observó una mayor frecuencia de autoexamen entre las mujeres con mayor nivel de educación y pertenecientes al colegio de mayor estándar socioeconómico. El mayor porcentaje de las mujeres que realizaban autoexamen con periodicidad adecuada habían recibido instrucción profesional, sin embargo, alrededor de la mitad de las mujeres reconocieron que su motivación se había originado a raíz de información general, destacándose la importancia de las charlas entre las madres y de las revistas juveniles entre las estudiantes