Investigation on risk factors
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Investigation on risk factors for breast cancer (age, genetic and endocrine factors). Individual clinical follow-up for women at high risk of breast cancer. |
Of the sample, 120 (90.2%) said they performed this action, indicating the following main factors to characterize the population at high risk for breast cancer: history of personal or family breast cancer (100.0%), smoking (75.0%), and history of personal or family ovarian cancer (62.5%). Of all 120 participants who investigated this action, 50.0% reported that the return visit for women at high risk should be within three to six months. |
Of all 13 (9.8%) participants who said they did not investigate risk factors, all informed lack of time as the reason. |
Clinical exam of breasts
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Annual CEB, in all women of 40 years of age and older, and women of 35 years of age and older if belonging to groups of high risk for developing breast cancer. |
Of all participants, 117 (88.0%) reported CEB and 113 (96.6%) of them requested medical evaluation in case of alteration in the exam, 60 (45.1%) reported "no age-related restriction" to start the CEB. |
Of 16 participants who reported no CEB, the lack of time was mentioned by 13 of them. Among the 68 participants who had problems to perform this exam, 48 (70.6%) also mentioned the lack of time and 20 (29.4%) absence of a routine for this activity. |
Mammogram
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MMG: women aged 50 to 69 years every two years; 40 to 49 years, diagnostic MMG in case of altered CEB. For women with high risk of breast cancer, start at 35 years of age, with annual exams. The nurse is responsible for checking the results of the exams requested and performed, and for referring them to breast and cervical cancer diagnosis and/or treatment . |
Of the sample, 97 (72.9%) reported that MMG should be performed annually and 82 (61.7%) reported the age for the first MMG is >40 years. Of the sample, 100 (75.2%) performed an active search for women with suspected report, and 43 (32.3%) referred them to reference services. Active search for women who did missed the exam was reported by 37 (27.8%) professionals. |
Of 133 nurses, 59 (44.4%) reported challenges to perform MMG, with scheduled exam reported by 45 (76.3%) of them, and missing patients by 19 (32.2%). |
Breast self-exam
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Recommend breast self-palpation whenever the woman feels comfortable, without recommending any specific technique, valuing any casual discovery of small breast alterations. Recommend searching for medical support in case of doubt about the findings of breast self-palpation. |
Of all participants, 123 (92.5%) reported advising the patient on how to examine her breasts; of these, 60 (48.8%) advised that it should be during the menstruation period. Monthly exam was reported by 95 (77.2%) professionals. |
Seven of all 10 participants who said they did not recommend BSE mentioned lack of time as the reason. |
Educational actions
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Develop individual or collective educational activities that promote community mobilization and participation. |
Of the sample, 88 (66.1%) reported educational actions about breast cancer to patients. |
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Nursing con consultation
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Conduct the nursing consultation and CEB according to the patient's age group and clinical profile. Request exams according to the protocols or technical standards established by the local administrator. Examine and evaluate patients with signs and symptoms of cervical and breast cancer. |
Of the sample, 127 (95.5%) reported nursing consultation, ranging from 10 to 20 visits per day, for 86 (67.7%) of them. |
Of the six nurses who reported not performing nursing consultation, five (83.3%) attributed it to work overload. |
Breast ultrasound
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Breast US is the method of choice for imaging exam of palpable lesion in women of less than 35 years of age. For women of 35 years of age or older, mammogram is the method of choice. Breast US is a complement of MMG in the following situations: - Nodule with no expression; - Regular or slightly lobulated nodule, which may be a cyst; - Diffuse asymmetric density that may be a solid lesion; cyst or breast parenchyma. |
Of total, 92 (69.2%) reported that there was no interval established for the examination, since it depends on the result of CEB and MMG. |
Of all 75 nurses who reported challenges in the implementation of the USG, 69 (92.0%) mentioned scheduling. Of all 38 participants who reported challenges in the evaluation of USG by the physician, 32 (84.2%) reported the delay in the return visit scheduling. Of all 133 nurses, 65 (48.9%) reported that the waiting time between the request for the exam and the return with the result is >6 months. |