Câncer de mama e organização de serviços: do atendimento básico à referência na Casa de Saúde Santa Marcelina Itaquera, no município de São Paulo / Breast cancer and organization of services: the problem of the delayed diagnosis and treatment in patients of the Casa de Saúde Santa Marcelina unidade Itaquera of the city of São Paulo

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Introduction: The breast cancer is one of the most extensively studied cancers worldwide in many aspects, including in relation to its epidemiological characteristics, some very peculiar. This is due to the fact that breast cancer in women is one of the most important causes of morbidity and mortality from cancer in almost all populations of the planet since the second half of this century.Objectives: to describe the characteristics of public services of ambulatorial attendance in relation to the access and resolutivity of patients with diagnosis of breast cancer attended in the reference of the Casa de Saúde Santa Marcelina Itaquera Sao Paulo.Methodology: Exploratory study on a quantitative perspective, transverse and descriptive. Constituted by a sample of 52 women attended in the Outpatient Clinic of Mastology in the Center of Specialties which used the service from June to September 2008, on a fixed day in the week, and subsequently submitted to surgery for treatment of breast cancer. It was utilized a form of questions that permitted to know the level of information and accessibility of the women with breast cancer. The descriptive analysis was presented by means of tables of frequencies, averages and standard deviations. When appropriate was made the analysis not parametric (Pearsons chi-square). The data were stored in Excel spreadsheet and then analyzed using the statistical package STATA.Results:Most patients were age over 50 years (59.62 per cent). Women were responsible for the perception of their problem by breast self-examination (65.38 per cent). The nodule was the dominant clinical and radiological findings (73.08 per cent) and infiltrating ductal carcinoma was the most common histological type (88.47 per cent). Significant proportion of patients (61.54 per cent did not have its breasts examined for his doctors. A basic health unit (82.69) was the feature most searched.There was no delay in the medical attendance (61.54 per cent). The time of delay to be taken care of between 3 and 6 months occurred in 26,32 per cent of the women.Only 1 woman (1.92 per cent) had staging 0 for breast cancer.There were 32 (30.77 per cent) women with more than 50 years, and 68, 75 per cent and 31.25 per cent had stage I,IIA,IIB,IIA,IIB and III,IV respectively.Conclusions: Despite of the casuistic be small for this sample the data allow to conclude that despite of the women attend the service of health, they are responsible by the perception of her mammary problem through the auto-exam and detect more the breast cancer than the service of primary attention. There is a delay of more of 6 months between the diagnosis made in the UBS and the attendance made in the reference service , boosting the evolution of the breast cancer.

ASSUNTO(S)

diagnóstico precoce precocious diagnosis accessibility neoplasias mamárias 0rganização de serviço organization of services acessibilidade breast neoplasia health politics políticas de saúde

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