Analysis of the clinical indications for mammograms in Brazil from 2013 to 2014 by the unified health system

Abstract

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.