O conhecimento e a prática do autoexame das mamas e sua associação com os fatores prognósticos, o tratamento cirúrgico e a sobrevida em mulheres com câncer de mama

Abstract

Introduction: Despite its unclear efficacy for preventing breast cancer-related mortality, breast self-examination (BSE) remains a useful technique because it is simple, inexpensive, and promotes self-awareness. Furthermore, this technique is important in developing countries with limited breast cancer screening programs. Objective: Analyze the influence of BSE knowledge and practice on surgical treatment and survival of women with breast cancer and their association with prognostic factors for tumors. Methods: This retrospective cohort study evaluated 272 women who were diagnosed with breast cancer, in the period from 1993 to 2004, in the Breast Cancer Program of the School of Medicine of the Universidade Federal de Goiás, in Goiânia, GO, Brazil, followed until 2015. Data regarding BSE knowledge and practice were correlated with the other variables studied: age, number of affected axillary lymph nodes, tumor size, histological type, histological grade, strogen receptors, progesteron receptors, HER-2 status, surgical treatment, overall survival, locoregional disease-free survival, and distant disease-free survival. Results: A total of 177 women (79%) knew of BSE and, among these, 131 (74%) practiced it. The average age of the women who knew of or practiced BSE was significantly lower than that of the women who were unaware of or did not practice it (p = 0.003 and p = 0.001, respectively). Women who knew of BSE had smaller tumors (p = 0.03). Overall survival was higher for women who knew of BSE, but with no impact on the practice of this exam. No significant statistical differences were found between the women who knew of BSE or who were unaware of it or between those who practiced or did not practice it regarding the other prognostic factors, overall survival, locoregional disease-free survival, distant disease-free survival, and surgical treatment. Conclusions: Younger women were more likely to know of and practice BSE. Women who knew of BSE had smaller tumors. However, BSE knowledge or practice did not influence on the prognostic factors such as lymph node involvement, histological type, and histological grade, and could not increase the number of conservative surgeries. Overall survival, locoregional disease-free survival, and distant disease-free survival were not influenced by BSE.