Portal CRítica has prepared a roadmap to help women who want to seek specialized support
The early diagnosis of breast cancer, in addition to favoring treatment, increases the chances of cure. As a result, it is essential for women to be aware of the three questions they save: Have you been watching your breasts? Have you already scheduled your annual exams ?; and Do you know your risk factors ?, theme of this year’s October Pink campaign.
To clarify these doubts, to know where to seek help and when to carry out exams aimed at breast health o CRÍTICA prepared the step by step of how consultations and treatments work through the public health network.
The mastologist of the Cecon Foundation (FCecon), Hilka Espírito Santo, recommends that from the age of 40, mammography should be performed annually, but girls should always be instructed to perform self-examination, so that they know their own bodies. The woman can find, up to 30% of the time, the presence of a lump or alteration from the touch or observation of the breasts.
According to the Municipal Health Secretariat (Semsa), the following must be observed:
• Nodule (lump), fixed and generally painless: it is the main manifestation of the disease, being present in about 90% of cases, when the cancer is perceived by the woman herself;
• Skin of the breast reddish, retracted or similar to orange peel;
• Changes in the nipple (nipple);
• Small nodules in the armpits or neck;
• Spontaneous discharge of abnormal fluid through the nipples.
The specialist nurse or general practitioner can check the changes. However, Hilka indicates that mammography for the risky age should be requested by the gynecologist, along with routine and preventive exams.
This consultation can be carried out free of charge in Manaus in the 291 Basic Health Units (UBS), in the river UBSs for the rural area and also in the 6 polyclinics scattered throughout the city, as well as in the UBS of municipalities in the interior of the state.
During the gynecological consultation, the breasts must be evaluated by the doctor. This touch should also be done in women under the age of 40. However, patients who have cases of cancer in the family, in turn, are considered people with a risk factor for the disease and, therefore, should be regularly evaluated by a mastologist. They should start performing imaging tests and tumor screening even before they are 40 years old.
Change in the identified breast and now?
After the evaluation of the gynecologist or mastologist, depending on age, complementary exams will be performed – ultrasound, mammography or biopsy. “If there are any changes in this mammogram or imaging exams, or even in the biopsy, it will be sent to the Cecon Foundation”, explains Hilka.
The scheduling of the mammography or breast ultrasound exam is done via SISREG with the presentation of an identity document, the Unified Health System card and a medical requirement.
The mastologist, warns that not all the nodule will be a cancer, therefore, in Fcecon will be done the mapping of the disease to prove the diagnosis. After confirmation, ‘staging’ begins, a term used to ascertain the size of the tumor, and the incidence of ‘metastasis’ is also analyzed, that is, whether the cancer cells have reached other parts of the body than the breast.
With these data, doctors assess the order of continuation of treatment, which can be initiated either by surgery or chemotherapy – in order to reduce the size of the nodule. Although it varies from case to case, the treatment of breast cancer usually takes about 6 to 8 months. At this stage, treatment such as radiotherapy or hormone therapy may also be required.
The areas most commonly affected by metastasis are the lungs, liver and bones which can increase treatment time and reduce the chances of a cure. The size of the tumor is also crucial for the prescription, or not, of more invasive treatments such as mastectomy, which consists in the total removal of the breasts affected by cancer, therefore the importance of early diagnosis.
“The smaller the tumor, the less aggressive it is, [tem] less chance of metastasis and less aggressive will be the treatment that this woman will do. A small one-centimeter tumor, I don’t need to remove her breast, but if there is a diagnosis in the five-centimeter tumor, the chance is much greater of having radical surgery ”, explains the doctor.
Despite being considered a chronic disease, the cure for breast cancer is a reality and according to the doctor, if the treatment is carried out correctly the patient’s longevity can be assured.
MYTHS AND TRUTHS
Can wearing a bra cause breast cancer?
No, bra does not give cancer, not even the art bra, this is not true.
Can using contraceptives increase the risk?
No. Contraceptives are used for many things. In addition to contraception, it can be used to prevent many diseases that this woman has. It is not harmful to the breast but it must be accompanied. What happens in relation to contraception itself, is that in hormonal therapy that the woman does in post-menopause or in pre-menopause with homonyms, her estimated risk after five years of using the medication increases and it is necessary to talk to the patient and explain the need to always check and evaluate the cost benefit.
Can menstruating earlier be a risk factor for the development of malignant breast tumors?
There is a risk factor when this patient menstruates too early and stops menstruating too late. These are risk factors, but we cannot say that this is what caused the cancer.
Does the woman’s lifestyle impact the diagnosis of breast cancer?
It’s actually even the campaign’s slogan, which involves several things. It is very important that the woman has a good diet that she exercises regularly. This is not only for breast, but for any type of disease.