The quarantine imposed by the new coronavirus has led many Brazilian women to stop going to the gynecologist or mastologist to prevent or treat breast cancer. That’s what the research reveals Breast cancer: health care during quarantine, made by Ibope Inteligência for the company Pfizer between September 11th and 20th, by platform online. 1,400 women aged 20 to over 60 years, from classes A, B and C, living in the city of São Paulo, the Federal District and the metropolitan regions of Rio de Janeiro, Belém, Porto Alegre and Recife were heard .
According to the survey, 62% of respondents did not go to their doctors during social isolation, for fear of contracting covid. As a result, they stopped doing routine tests that could help prevent the disease. In the group considered at risk, which includes those over 60, 73% said they were waiting for the end of the pandemic to make an appointment or perform routine tests.
The head of Coordination for Prevention and Surveillance of the National Cancer Institute José Alencar Gomes da Silva (Inca), Liz Almeida, said that women who did not go to doctors during social isolation acted correctly. “They were absolutely right not to leave the house.” The World Health Organization (WHO) has advised that if the woman is asymptomatic, without any sign of the disease, the fact that she postpones an examination for early detection of cancer, in this case breast cancer, will not have major impacts on her life . The WHO guidance is aimed at all women in the recommended range who should be undergoing tests for early detection of cancer, who are those between 50 and 69 years of age.
Liz Almeida said that the Ministry of Health’s guidance is that women between 50 and 69 years old should have a mammographic exam every two years. “So, you have two years to take this exam. The WHO considers that some months will not cause major disasters in this detection ”. He cautioned, however, that if a woman observes any sign or symptom on her breast, the WHO guidance is just the opposite. “Don’t wait a single day. Leave the house and look for a health professional to be examined and do all the tests that he asks for. So, the women not leaving the house was absolutely correct ”.
According to the executive director of the Cancer Foundation, Luiz Augusto Maltoni, a survey carried out by the institution found that there was an 84% reduction in mammography exams during the pandemic, this year, compared to last year. He stressed that women should not, however, stop seeking medical services when they have any symptoms. “Especially those who are already diagnosed with cancer, so as not to interrupt the treatment, taking all the precautions, such as wearing a mask, among others.”
According to an Inca estimate, 66,280 new cases of breast cancer are expected in Brazil this year. The institution, linked to the Ministry of Health, reported that 17,572 women died of breast cancer in the country in 2018. As medical services are returning to work with more flexible activities, Liz Almeida’s recommendation is that women reschedule their exams. “The idea that women are going to die from this is false,” he assured, referring to the months when they stopped going to the gynecologist or mastologist. “Is fake news”.
The Inca doctor noted that breast cancer cases in younger women are rare and, in general, they happen when there is a connection with hereditary factors. “They are usually more aggressive cancers. But they are rare ”, he reiterated. So he said it made no sense to send women between the ages of 30 and 39 to undergo routine breast cancer screening because a single case would be discovered among hundreds of women. This is not good because radiation is a risk factor for breast cancer. In addition, unnecessary queues would form that would delay the examination for those who really need it.
Luiz Augusto Maltoni also said that there is no scientific evidence that younger women have more aggressive breast cancer. “In reality, it makes no sense to go out for women under 50 years of age.” On the other hand, he warned that if a woman, even a young woman, presents symptoms, such as lumps, discharge from the breast, she must seek a specialized medical service and carry out the necessary tests to clarify the case. “But not a call for tracking.”
Liz Almeida explained that tracking was a strategy designed to prevent deaths. It involves mammography, biopsy and entry into treatment, with the aim of detecting breast cancer early so that the woman can quickly start treatment and have surgery, after the disease is confirmed by biopsy. Younger women have a denser, more fibrous breast, while older women, who are in menopause, have an adipose breast. Therefore, the chance of errors in the mammography of younger women is greater. But if a woman under the age of 50 feels something different in her breasts, she should go to the doctor, she recommends.
Attention to bodies
The general guideline is that women pay attention to their bodies. At the sign of any lump or dark spot on the breast, or even a change in the intestinal rhythm, for example, you should go to the doctor because it must be a benign lesion. “But it doesn’t pay to see,” said the head of the Inca’s Prevention and Surveillance Coordination. “Go there, book your appointment and take the exam”.
Research shows that despite the October Pink movement, which warns against breast cancer prevention, there has been great disinformation for more than 15 years. Of the total women interviewed, 63% are unaware that breastfeeding is a protective factor against the disease. “Breastfeeding is a factor that reduces the risk of breast cancer,” recalled Liz. The practice protects the child from a series of diseases, as the mother is passing her antibodies to her. “Where is the maternal instinct of these women?” Asked the doctor.
The survey also reveals that 37% of women believe that cancer is only developed by those who have had a case in the family. Liz Almeida said that this is “another legend”. He explained that it is true that there is a hereditary factor for all types of cancer, but this usually occurs with a small portion of the population. In the case of breast cancer, this would represent between 5% and 10%. “So, you see that 90% to 95% have nothing to do with it.”
According to the research, disease prevention is still late among Brazilian women. Although 72% of the women consulted said they go to the gynecologist or mastologist regularly, at least once a year, and 75% reported that they talk to their doctor about the importance of having periodic examinations, one in four female representatives said they did not speak to the doctor about prevention and 12% do not usually address the subject.
This year, the Ministry of Health centralized the series of events related to the Pink October. On the next 8th, a press conference is scheduled for the director general of Inca, Ana Cristina Pinho Mendes Pereira, about breast cancer.
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