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Breast cancer surveillance: practices identified by managers in Primary Care

Abstract

Objective

To analyze the breast cancer management practices identified by Primary Health Care managers.

Methods

This is a descriptive, cross-sectional study, carried out with 24 Health Units managers in Primary Care, of different configurations (traditional, Family Health Strategy and Basic Health Units with Family Health teams) and contemplating small, medium and large units, located in a city in the countryside of São Paulo. An instrument was used to identify screening and detection actions for breast cancer, with 32 questions and sub-items, according to the actions determined by the breast cancer management program in Brazil. The analysis was based on Donabedian Model’s structure and process attributes.

Results

With regard to breast cancer management actions, all managers, 24 (100%), stated that they established priority in referring women with altered mammography and Clinical Breast Examination, and requesting mammography for women in the high-risk group. As for obstacles in the execution of these actions, most, 13 (54.2%), managers pointed out difficulties faced by the services, with a predominance of lack of health professionals and excessive demand.

Conclusion

The Primary Care Health Units have carried out actions to manage breast cancer, but there are behaviors that do not comply with the Ministry of Health’s proposals. There is a need for greater implementation of educational actions, as the focus is curative. Also, greater investments are needed to increase preventive measures and enhance access to screening tests.

Breast neoplasms; Primary health care; Health management; Mass screening; Family health strategy; Surveillance; Health centers

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br