Prevenção

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A prevenção não deve focar apenas nos fatores de risco associados ao câncer de mama, mas também nos fatores de proteção. Alguns fatores que aumentam o risco para desenvolver a doença, como obesidade na pós-menopausa, exposição à radiação em altas doses, exposição à pesticidas, terapias de reposição hormonal, sedentarismo, alcoolismo e tabagismo são passíveis de intervenção; outros fatores como sexo feminino, envelhecimento, início da menstruação antes dos 12 anos, menopausa tardia, gravidez após 35 anos, história familiar para câncer de ovário ou de mama, alta densidade mamária e mutações genéticas (BRCA1, BRCA2, PALB B2 e outros genes importantes) não podem ser modificados.

Considerando os fatores passíveis de intervenção, é possível prevenir o câncer adotando e mantendo hábitos de vida saudáveis. Estima-se que por meio da alimentação, nutrição e atividade física é possível reduzir em até 28% o risco de se desenvolver a doença.

Os fatores imutáveis, é aconselhável orientação médica para identificar a possível presença de uma predisposição genética hereditária, e com base nesta avaliação, adoção de medidas redutoras de risco.

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O rastreamento do câncer de mama na população geral é baseado na realização periódica da mamografia em mulheres assintomáticas. Ela é capaz de identificar lesões em fase inicial com o objetivo de reduzir mortalidade pela doença (as chances de cura do câncer de mama podem chegar até a 100% dos casos, se detectados precocemente).

De acordo com a Sociedade Brasileira de Mastologia (SBM) e as principais sociedades médicas norte-americanas recomendam que a mulher faça uma consulta ao mastologista uma vez por ano, além de realizar a mamografia também anualmente, sobretudo as mulheres a partir dos 40 anos, ao longo da vida.

Em pacientes que tem um risco aumentado (conforme exemplificado na postagem anterior) recomenda-se que a mamografia e que os métodos de imagem sejam feitos, de um modo geral, 10 anos antes do familiar mais próximo, mais jovem, teve o diagnóstico. Na faixa etária abaixo dos 40 anos não se recomenda apenas mamografia por ser menos sensível em mulheres jovens devido à alta densidade do parênquima mamário. Muito mais do que a mamografia, é recomendado Ressonância Magnética e ultrassonografia de mamas.

Dados recentes da SBM revelam queda acentuada do número de mamografias realizadas pelo SUS. A meta recomendada pela Organização Mundial de Saúde (OMS) é de 70%, no ranking de cobertura de mamografia no país, o Rio Grande do Sul ocupa o 8 lugar, com 202.234 exames realizados em 2015 (26,9%).

Fique atenta caso sua mamografia não seja solicitada conforme as nossas diretrizes, e consulte um profissional habilitado!

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O autoexame pode indicar alterações nas mamas e muitas vezes é o alerta para que as pacientes procurem atendimento médico.

Ele deve ser realizado uma vez a cada mês, na semana seguinte ao término da menstruação. As mulheres que não menstruam devem determinar um dia específico para repetir o autoexame todo o mês.

Lembrando que ele não é um método diagnóstico, não substitui a mamografia e nem a consulta ao mastologista.

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Alteração no tamanho ou na forma da mama; vermelhidão e/ou coceira ao redor do mamilo (bico do seio); secreção mamária espontânea (sem apertar); inchaço na axila ou ao redor da clavívula; nódulo ou caroço na mama que está sempre presente e não diminui de tamanho; afundamento da mama, endurecimento ou enrugamento da pele (casca de laranja); inversão súbita do mamilo; dor constante na mama ou na axila.

O diagnóstico precoce ainda é a melhor forma de evitar os efeitos devastadores da doença, aumentar as chances de cura e fazer tratamentos menos agressivos.

Ressaltamos que, embora esses sintomas sejam considerados de alerta, eles não são necessariamente indicadores da existência do câncer, podendo decorrer de patologias benignas.

Dúvidas? Recorra ao mastologista!

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