Mamografia: o olhar de mulheres sobre o exame de rastreamento do câncer de mama

Abstract

Among the chronic noncommunicable diseases, breast cancer is the most diagnosed among women worldwide and in Brazil. Social inequalities influence its prognosis and, therefore, health promotion and disease prevention actions must meet the Social Determinants of Health (SDH). In the screening of this disease, the mammography exam is used, however, some barriers may influence its realization. This is a field research, exploratory, descriptive, and qualitative approach, which aims to analyze women's views on screening mammography. The study took place at the specialized outpatient clinic of the Januário Cicco Maternity School and data were collected by means of interviews with a semi-structured script in women aged 50 to 69 years. Interview data were coded, summarized, systematized and analyzed using the ATLAS.ti desktop version software, with Bardin's Thematic Analysis, originating three categories of analysis: access to mammography; knowledge regarding mammography; and experiences in undergoing mammography. The speeches reported facilities and barriers for access to the exam and, as a way of overcoming the challenges, women have resorted to the private sector. It is observed, on one hand, the distorted perception of the exam as a form of prevention and, on the other, the conception that the exam seeks the early detection of cancer. The experiences during the exam vary from calm moments to the most traumatic, especially due to the discomfort of the pain. The absence of pain, having breastfed, and the practice of breast self-examination were reasons for postponing the exam. The SDH have influenced this scenario, where, depending on aspects such as income, schooling, and race, there are different realities regarding the performance of the exam. Prevention and health promotion actions need to act on SDH in order to overcome the inequities that affect the performance of the exam. Based on the findings of the study, and meeting the requirements of the Professional Master's Degree, a didactic instructional material was elaborated as a technical product in the format of a booklet. The material developed, aimed at users and containing information to be used in educational activities, has the potential to cause an impact both on the institution where the study was carried out and on the different health services focused on women's health care, as it dialogues with the main weaknesses pointed out by the users through their personal experiences and knowledge on the path taken for the mammography screening. As a limitation of the research, it is pointed out that it was carried out exclusively in a specialized outpatient clinic, thus recognizing that the study involving other scenarios, such as primary care, may bring other contributions.