Objective: To elaborate an analysis of the character of mammograms performed in Brazil between 2013 and 2014 by the Unified Health System (SUS) in relation to the indication profile and the patients submitted to the examination in this period. Methodology: The data from the study originated from the Department of Informatics of the Unified Health System (DATASUS), in the database category of the Breast Cancer Information System (SISMAMA). It is based on a retrospective and quantitative cross-sectional study done in Brazil between 2013 and 2014 with a population composed of women of all age groups who underwent mammography during the evaluation period. Was used as analysis variables: the clinical indications of the exam, the age groups of the patients involved and their declared race. Results: In the study period, 4,041,101 mammograms were performed, of which 2,315,907 were in women aged 50-54 years. Of the races analyzed in the survey, only 642 women declare themselves indigenous, in contrast, 2,304,282 have relinquished this information. Of the total number of tests performed, 97.44% had a screening character, while 2.56% were intended for diagnosis. Women between the ages of 45 and 50 predominated with regard to diagnostic mammograms in the year in question, while those with 50-54 years of age were the majority on screening mammograms. Regarding the clinical indication of the test, 931,994 women had no prior clinical examination with a complementary indication, and 1,857,189 had never performed previous mammograms. Conclusion: Strategies for the early detection of breast cancer are based on premature diagnosis in symptomatic patients or screening in those who do not present symptoms. Routine physical examination by a health care professional as well as a detailed medical history are essential to perform the correct indications for complementary examinations and careful evaluation of the risk factors related to the neoplasia, and thus to reduce their false-positive and iatrogenic results caused by them. Under SUS, therefore, it is imperative to perform the basic physical examination of the breast to avoid unnecessary expenses with other methods of tracking.
Objectives: To identify new laboratory tests for prognosis and diagnosis of breast cancer. Methodology: Literature review, with search of articles in the databases PubMed and Medline, using the descriptors: new laboratory tests, breast cancer, prognosis, diagnosis. A total of 75 articles were selected, of which 41 were adequate for the review research. The inclusion criteria were more recent articles and of high theoretical value for this review. Results: The laboratory tests identified can be divided into three groups: the first is those that use computer engineering to form images, three-dimensional models of the breast and to track tumor cells. In the second are those that investigate gene and epigenic expressions. In the third group we have histochemical tests of specific substances associated with breast cancer. In the first group, there are several applications of computer technology, such as CellSearch System software and EPISPOT, which use specialized microscopy to identify tumor cells in breast tissue biopsies. Another example of joint work between pathology and computation are high-resolution imaging exams such as the US-CNBs, a highly-defined ultrasound examination, the ED-CSCT, an examination that uses X-ray scatter to calculate the type and the size of microcalcifications that can occur in breast cancer. Computer technology also enabled the creation of a three-dimensional model of the breast, enabling the physician to accurately visualize the tumor in the midst of tissue layers. In the second group, gene expression screening focuses on joint monitoring, observing the traditional genes, such as BRCA1/BRCA2 and Ki67, and other associated ones, such as the CA72-4 carcinogen antigen and the GRP94 and FN14 biomarkers, since their expression is directly associated with breast cancer. In addition to the genetic markers, epigenetic studies revealed a correlation between methylation of the RASSF1A and CDH1 gene promoters and the prognosis of metastasis in breast cancer. In the third group are improved histochemical tests, which guarantee greater accuracy and specificity, such as the use of chromogenic and fluorescent methods in the evaluation of the estrogen receptor, the automated use of the FISH protocol to reduce tumor cell damage, avoiding sample loss, the analysis of the organizing regions of the nucleus of a tumor cell, the change in the technique of histochemical staining for a better visualization of the endothelial growth factors 2. It is also worth noting the elaboration of new protocols for exams, such as for the analysis of the factor gene of endothelial growth 2. Conclusion: The evolution of technology allowed not only the creation of more specific exams but also the improvement of old techniques. In this way, there are now tools that help the physician in the accurate diagnosis and prognosis of breast cancer, allowing a more specific visualization of the health-disease process, that is, the tests allow to identify the uniqueness of the pathology that affects the individual, either by more accura...
Objective: To compare the prevalence of benign and malignant breast neoplasms in Brazil between 2010 and 2014. Methodology: This is a quantitative, population-based, cross-sectional study in Brazil between 2010 and 2014. A study population composed of cases of mammary neoplasia was used. Data were obtained from the DATASUS system, of secondary order, in the category of database in the Hospital Information System of SUS (SIH/SUS). It was used as variable year, sex, age, type and character of care. Results: In Brazil, between 2010 and 2014, benign and malignant breast neoplasms total 267,038 cases, with a progressive increase between the years. Half of the cases are concentrated in the southeast region, with 50.12%, followed by the northeast region, 21.70%, southern region, 19.84%, center-west, 5.41% and north, 2.89%. Of the total, 92.25% are malignant neoplasms of the breast. The female sex prevails over the male in the number of cases, with 98.34% versus 1.65%. In relation to age, there is a distribution in all age groups, prevailing in the larger ranges, such as 50 to 59 years, 26.55%, 40 to 49 years, 24.86%, 60 to 69 years, 18.95%, 30 to 39 years, 10.41%, 70 to 79 years, 9.91%. Many of the attendances are elective, 66.07%, and others as a matter of urgency, 33.92% and 64.89% are from the private network versus 35.10% of the public network. Conclusion: Breast neoplasms are very prevalent in Brazil and most of them are malignant. The southeastern region of Brazil presents the largest number of cases together with the female sex, but it is emphasized that they exist in the male sex. The most prevalent age groups are those over 30 years of age, but this does not prevent them from being found in the lower ranges, such as 20 to 29 years. Therefore, it is necessary to invest more in medical qualification programs, to rank hierarchically and to guarantee quick access to the secondary and tertiary centers for resolutive care, providing the tracking of the disease, aiming in the medium term a greater reduction of cancer mortality.
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