Bakgrund: Bröstcancer är den vanligaste cancerdiagnosen hos kvinnor i Sverige. Behandlingar för bröstcancer kan vara strålbehandling, immunterapi, cytostatika och kirurgisk behandling som till exempel mastektomi. Mastektomi kan orsaka fysiska och psykiska besvär som påverkar hela kvinnans liv, där behandlingen medför en förändring i kroppen som förorsakar att kvinnans identitet och synen på sin kvinnlighet ändras. Syftet: Syftet var att beskriva kvinnors upplevelser efter mastektomi utifrån ett livsvärldsperspektiv. Metod: Denna litteraturöversikt är skriven enligt Fribergs modell med hjälp av 10 kvalitativa artiklar. Relevanta artiklar till studien söktes fram i tre olika databaser: Cinahl, Pubmed och Medline. Resultat: Första huvudtemat En förändrad kroppsuppfattning med två subtema: Upplevelser av att förlora bröstet och kvinnlighet och Upplevelser av den sexuella relationer med sin partner. Andra huvudtema är Behov av stöd med två subtema: Upplevelser av stöd och brist på stöd från nära relationer och Upplevelser av stöd och brist på stöd från vårdpersonal. Tredje huvudtemat är Betydelse av copongstrategier med två subteman: Upplevelser av att bli hjälpt av sin tron och Upplevelser av att normalisera och acceptera. Kvinnorna angav ofta att brösten var en del av deras kvinnlighet, moderskap och identitet. Vid förändring i kroppen till följd av borttaget bröst förorsakade att kvinnors syn på deras kroppsuppfattning och livsvärld påverkades negativt, där det skapade ett lidande. Slutsats: De framkom att kvinnorna tyckte att stöd från vården spelande en viktig roll för återhämtningen efter mastektomi. Därför det är viktigt att sjuksköterskan bedriver vården utifrån ett livsvärldsperspektiv. Sjuksköterskan är ansvarig för dessa kvinnors tillfriskande för att kunna främja hälsa och välbefinnande samt lindra lidande. / Background: Breast cancer is the most common cancer diagnosis in women in Sweden. Treatments for breast cancer can include radiotherapy, immunotherapy, cytostatics and surgical treatment such as mastectomy. Mastectomy can cause physical and psychological problems that affect the whole life of the woman, where the treatment brings about a change in the body which causes the woman's identity and view of her femininity to change. Aim: The aim was to describe women's experiences after mastectomy based on a life world perspective. Method: This literature review is written according to Friberg's model using 10 qualitative articles. Relevant articles for the study were searched for in three different ways databases: Cinahl, Pubmed and Medline. Result: First main theme A changed body image with two subthemes: Experiences of losing the breast and femininity and Experiences of the sexual relations with their partner. Other main theme is Need of support with two subthemes: Experiences of support and lack of support from close relationships and Experiences of support and lack of support from healthcare professionals. The third main theme is Meaning of coupon strategies with two subthemes: Experiences of being helped by one's throne and Experiences of normalizing and accepting. The women often indicated that the breasts were one part of their femininity, motherhood and identity. In case of change in the body as a result of removed breast caused women's view of their body image and life world was negatively affected, where it created suffering. Conclusion: They found that the women thought that support from healthcare played an important role in the recovery after mastectomy. It´s important that the nurse provides care from a life-world perspective. The nurse is responsible for these women's recovery in order to promote health and alleviate suffering.

Bakgrund: Bröstcancer är idag den vanligaste typen av cancer i världen hos kvinnor. Att drabbas av bröstcancer är en stor omställning i livet. Bra kontakt med omvårdnadspersonalen är viktigt för behandlingen och återhämtningen. Kvinnors upplevelser finns beskrivet i forskning och behöver sammanställas för att ge en överblick på kunskapsläget. Syfte: Syftet med denna litteraturstudie var att beskriva kvinnors upplevelse av att drabbas av bröstcancer, synen på omvårdnad och genomgå kirurgisk behandling.  Metod: Studien baserades på åtta studier som har genomförts med kvalitativ metod. Artiklarna kvalitetsgranskades med stöd av Olsson och Sörensens (2011) granskningstabell för att därefter analyseras med hjälp av Hsieh och Shannons (2005) analysmodell. Resultat: Resultatet kategoriserades i tre huvudteman: nyuppkomna känslor, kommunikation från omvårdnadspersonal och relationen med omvårdnadspersonalen med sammanlagt sex subteman. Kvinnorna som gjort kirurgisk behandling vid bröstcancer önskade stöd från omvårdnadspersonalen, förbättrad kommunikation och individanpassad information om operationen och vad som kommer hända sen. Konklusion: För att kunna ge kvinnorna bästa möjliga omvårdnad behöver omvårdnadspersonalen ha ett mer personcentrerat tankesätt med fokus på stöd och kommunikation samt ge individanpassad information. / Background: Breast cancer is the most common cancer among women all over the world. To be diagnosed with breast cancer is a big challenge. Good contact with healthcare professionals is important for treatment and recovery. The experience of women is described in research and need to be compiled to provide an overview of the state of knowledge  Aim: The purpose of this literature study was to examine women's experiences of suffering from breast cancer, their view of nursing care and undergoing surgical treatment. Methods: A qualitative method was used based on eight scientific articles reviewed with Olsson and Sörensen’s (2011) review table. The analysis process was inspired of Hsieh and Shannon’s (2005) analysis form. Results: The results were categorized into three main themes: new emotions, communication with nursing staff, and the relationship with nursing staff, altogether with six sub-themes. Women who have gone through surgical treatment due to breast cancer wanted support from the nursing staff, improved communication, personalized information about the surgery and what will happen post surgery. Conclusion: To be able to provide women with the best possible care, the nursing staff need to have a more person-centered mindset with a focus on support and communication and provide individualized information.

Thesis (MTh)--Stellenbosch University, 1993 / ENGLISH ABSTRACT: Seeing that breast cancer is the most common cancer in women and that it has such a high incidence that every woman should be aware of it, time has come for the theology, and especially for pastoral care, to provide some answers on the possible problems that accompany the illness. Treatment of breast cancer almost always include a degree of surgical intervention through which part of or a whole breast, and in extreme cases even the underlying tissue, is being removed. This procedure, to some extent, influences a woman's experience of her physique which in turn has an effect on the intimate space of her marriage. The mastectomy patient may experience that the operation, with all the psychological affects it has, disturbs her inner life rythm and that results in her relationships also being pressurised. The crisis of a mastectomy should be handled as a relationship crisis within a marriage, in which the husband can play an important therapeutic role. The husbands contribution will be greatly effected by: a) His commitment to the relationship and b) The correlation between his male identity, his sexuality and his perceptions of the female physique. Within the crisis of mastectomy, the woman's body-image should not be separated from her faith identity and the quality of her marriage - there exists a dynamic interaction between these three, which means that the handling of the crisis of a mastectomy is directly dependent on the quality if her loving relationship and on the way in which she experiences her faith. The faith factor plays an important role in the handling of the crisis, by creating a distance between the trauma of the loss and the way in which she experiences her identity. Pastoral care can play a vital role in the handling of the crisis of a mastectomy by means of guidance and support, as it proclaims the active presence of God through the marrid body of Jesus Christ. The husband of the mastectomy patient can, in his therapeutic role, be guided to be much more sensitive for the emotional needs of his wife, in regard to aspect of sexuality. This would give her the support she needs and work constructively towards the goal of healing. / AFRIKAANSE OPSOMMING: Aangesien borskanker die algemeenste kanker onder vroue is en dit sulke geweldige afmetings aangeneem het dat elke vrou daarmee moet rekening hou, het dit tyd geword dat die teologie, en met name die pastoraat, ditself ook ten opsigte van die moontlike problematiek wat daarmee saamgaan, moet verantwoord. Die behandeling van borskanker behels in die meerderheid van gevalle 'n mate van chirurgiese ingrepe waardeur 'n deel van of die hele bors, en in ekstreme gevalle ook die onderliggende weefsel, verwyder word. Hierdie prosedure oefen, in 'n mindere of meerdere mate, 'n invloed op die vrou se belewing van haar liggaamlikheid uit wat weer na die intieme band van die huwelik kan deurwerk. Die mastektomiepasiënt kan ervaar dat die operasie, met al die sielkundige effekte wat dit inhou, haar innerlike lewensritme versteur sodat die verhoudinge waarin sy leef ook onder druk geplaas word. Binne die huwelik sou 'n mens dan die krisis van 'n mastektomie as 'n verhoudingskrisis moet hanteer, waarin die eggenoot 'n belangrike terapeutiese funksie kan vervul. Die man se bydrae word egter deurslaggewend bepaal deur: a) Sy verbintenis aan die verhouding en b) Die korrelasie tussen sy manlike identiteit, seksualiteit en die persepsies met betrekking tot die liggaamlikheid van die vrou. Binne die krisis van 'n mastektomie kan die vrou se liggaamsbeeld nie van haar geloofsidentiteit en die kwaliteit van haar huwelik losgemaak word nie - hierdie drie staan in 'n interdinamiese verband en beteken dat die verwerking van die krisis van 'n mastektomie direk van die kwaliteit van die liefdesverhouding en die ervaring van geloof, afhang. In die verwerking van die krisis vervul die geloofsfaktor 'n deurslaggewende rol om afstand tussen die emosionele trauma van die verlies en die ervaring van identiteit te skep. Die pastoraat kan 'n belangrike funksie vervul ten opsigte van begeleiding en ondersteuning in die verwerking van die krisis van 'n mastektomie deurdat dit God se aktiewe betrokkenheid by die situasie, aan die hand van die liggaamlikheid van Jesus Christus, verkondig. As terapeut kan die eggenoot begelei word om, op die gebied van die seksuele, baie sterker op die emosionele behoeftes van die mastektomiepasiënt ingestel te wees, om haar sodoende te ondersteun en in die proses van heling mee te werk.

Os implantes mamários de silicone têm sido empregados, tanto nas cirurgias de aumento das mamas, quanto na reconstrução do tecido mamário após mastectomia. A segurança biológica dos implantes de silicone merece estudo relacionado aos processos de esterilização empregados, pois podem constituir-se em fator de comprometimento da estrutura química do polímero e, conseqüentemente, da biocompatibilidade. Este estudo consistiu na avaliação da biocompatibilidade de implantes mamários de silicone após terem sido submetidos aos processos de esterilização por calor seco, radiação gama e óxido de etileno. O parâmetro avaliado foi a viabilidade celular, empregando o método de difusão em agar e de captura do vermelho neutro. As amostras compreenderam implantes de silicone gel lisos, texturizados e revestidos com poliuretano e implantes texturizados pré-cheios com solução salina. Também foi realizado o teste de endotoxinas bacterianas pelo método do LAL e determinação da taxa de migração do gel de silicone (teste de bleed). Os três métodos de esterilização mostraram-se igualmente eficientes pela comprovação da condição de esterilidade dos implantes através de metodologia descrita na Farmacopéia Americana 27 edição. Os níveis de endotoxinas bacterianas dos implantes, também atenderam aos requisitos dos compêndios oficiais. Na avaliação da biocompatibilidade todos os implantes, independente dos processos de esterilização utilizados, apresentaram ausência de citotoxicidade. Os resultados do teste de bleed mostraram uma maior taxa de migração de gel para os implantes de superfície lisa em comparação com os implantes de superfície texturizada e revestida com poliuretano, quando esterilizados por calor seco. Ao comparar a taxa de migração do gel para os implantes de superfície lisa esterilizados por calor seco e óxido de etileno, obteve-se uma maior taxa de migração para aqueles implantes esterilizados por óxido de etileno. As diferentes avaliações realizadas neste estudo abrangeram aspectos biológicos, químicos e físicos relevantes para garantir um produto de boa qualidade e que, por assegurar a manutenção da característica de biocompatibilidade, resulta na segurança biológica deste tipo de implante. / Silicone breast implants have been widely used for mammary augmentation and reconstruction surgery. Biological safety of these implants can be damaged by sterilization methods. This study consisted of the biocompatibility assessment of breast implants through cell viability, employing the agar diffusion test and neutral red uptake. Four silicone breast implants were tested: smooth, textured, polyurethane covered silicone gel breast implant and textured saline-filled breast implant. Sterilization methods comprised dry-heat, ethylene oxide and γ-radiation. Detection of bacterial endotoxins employing LAL test and gel bleed was also performed. The three methods of sterilization revealed equally efficacious, through the sterility confirmation of implants employing methodology described in 27th edition of United States Pharmacopeia. At the same way the leveis of bacterial endotoxins of implants accorded with the pharmacopeial requirements. In theevaluation of biocompatibility ali the implants, independently of the sterilization process used, showed no cytotoxicity signals. The results of gel bleed revealed a higher migration rate from the smooth implants in comparison with the textured and polyurethane-covered implants sterilized by dry-heat. When was compared the gel migration of smooth implants sterilized by dry-heat and ethylene oxide, was obtained a higher rate of gel bleed of those implants sterilized by ethylene oxide. The different evaluations performed in this study comprised biological, chemical and physical aspects, that are relevant to assure a good quality product and by having maintained the characteristics of biocompatibility, resulted in the biological safety on this kind of implant.

INTRODUÇÃO: A mastectomia é um procedimento que pode gerar diversas repercussões tanto físicas quanto emocionais. Atualmente há uma tendência para que a reconstrução da mama seja realizada o quanto antes com o objetivo de amenizar o impacto psicológico da doença. Na literatura são escassos os estudos sobre os efeitos da mastectomia e da reconstrução mamária na postura. Ainda na literatura é possível observar que não há um consenso sobre a qualidade de vida, imagem corporal e autoestima em mulheres submetidas à mastectomia com e sem reconstrução da mama. OBJETIVO: Avaliar a postura, qualidade de vida, imagem corporal e autoestima em mulheres com mastectomia sem reconstrução e com reconstrução imediata da mama. METODOLOGIA: Participaram do estudo 76 mulheres com idade entre 35 e 70 anos diagnosticadas com câncer de mama e submetidas à mastectomia, sendo divididas em dois grupos: sem reconstrução da mama (MSR; n=38) e com reconstrução mamária imediata com retalho abdominal (M+RI; n=38). Para a avaliação da postura foram localizados e demarcados pontos anatômicos específicos para a obtenção de fotografias em vista anterior, posterior, lateral direita e esquerda. As fotografias foram analisadas pelo Software para Avaliação Postural (SAPO). Na avaliação da qualidade de vida foi utilizado o questionário Short- Form Health Survey; na imagem corporal o Questionário de Imagem Corporal após o Câncer de Mama e a autoestima foi avaliada pela Escala de Autoestima de Rosenberg. O nível de significância estabelecido foi de alfa= 0,05. RESULTADOS: Na avaliação postural o grupo MSR apresentou maior ângulo no alinhamento vertical do tronco, na vista lateral esquerda (4,2 vs. 3,1; p=0.05). Para as demais variáveis do alinhamento postural as diferenças não foram significativas. O grupo MSR apresentou na avaliação da qualidade de vida menor capacidade funcional (66,3 vs. 76,4; p=0,01). Na avaliação da imagem corporal e autoestima não foram encontradas diferenças estatisticamente significativas. CONCLUSÃO: As mulheres com mastectomia sem reconstrução mamária apresentam na vista lateral esquerda o ombro posicionado mais posteriormente em relação ao trocânter maior do fêmur, apontando para uma rotação de tronco e apresentam menor capacidade funcional na avaliação da qualidade de vida. Ter ou não realizado a reconstrução imediata da mama não comprometeu a imagem corporal e autoestima / INTRODUCTION: Mastectomy is a procedure that can generate diverse physical and emotional repercussions. Currently, there is a tendency to perform breast reconstruction as soon as possible in order to mitigate the psychological impact of the disease. There are few studies in the literature on the effects of mastectomy and breast reconstruction on body posture. However, it has been observed that there is no consensus regarding the quality of life, body image, and self-esteem of women undergoing mastectomy, with or without breast reconstruction. OBJECTIVE: The aim of this study was to evaluate posture, quality of life, body image, and self-esteem in women with mastectomy without reconstruction and with immediate breast reconstruction. METHODS: The study included 76 women, 35-70 years of age, who were diagnosed with breast cancer and underwent mastectomy. The women were divided into two groups: without breast reconstruction (MSR, n=38) and with immediate breast reconstruction with an abdominal flap (M+IR, n=38). To assess body posture, specific anatomical points for obtaining photographs were located and marked in anterior, posterior, and right and left side views. The photographs were analyzed using Postural Assessment Software (PAS/SAPO). The Short-Form Health Survey was used to assess quality of life, body image was assessed with the Questionnaire Body Image after Breast Cancer, and self-esteem was assessed with the Rosenberg Self-Esteem Scale. The significance level was set at alfa=0.05. RESULTS: A higher angle of vertical alignment of the trunk in the left lateral view was observed in the MSR postural assessment group (4.2 vs 3.1; p=0.05). Differences in the other postural alignment variables were not significant. Lower functional capacity in the quality of life assessment was also observed in the MSR group (66.3 vs. 76.4; p=0.01). No statistically significant differences were found in the body image and self-esteem assessments. CONCLUSION: In the left side view, women with mastectomy without breast reconstruction presented with the shoulder positioned more posteriorly in relation to the greater trochanter, indicating trunk rotation. In addition, they exhibited lower functional capacity in quality of life. Body image and self-esteem were not affected by whether or not breast reconstruction was performed

Os implantes mamários de silicone têm sido empregados, tanto nas cirurgias de aumento das mamas, quanto na reconstrução do tecido mamário após mastectomia. A segurança biológica dos implantes de silicone merece estudo relacionado aos processos de esterilização empregados, pois podem constituir-se em fator de comprometimento da estrutura química do polímero e, conseqüentemente, da biocompatibilidade. Este estudo consistiu na avaliação da biocompatibilidade de implantes mamários de silicone após terem sido submetidos aos processos de esterilização por calor seco, radiação gama e óxido de etileno. O parâmetro avaliado foi a viabilidade celular, empregando o método de difusão em agar e de captura do vermelho neutro. As amostras compreenderam implantes de silicone gel lisos, texturizados e revestidos com poliuretano e implantes texturizados pré-cheios com solução salina. Também foi realizado o teste de endotoxinas bacterianas pelo método do LAL e determinação da taxa de migração do gel de silicone (teste de bleed). Os três métodos de esterilização mostraram-se igualmente eficientes pela comprovação da condição de esterilidade dos implantes através de metodologia descrita na Farmacopéia Americana 27 edição. Os níveis de endotoxinas bacterianas dos implantes, também atenderam aos requisitos dos compêndios oficiais. Na avaliação da biocompatibilidade todos os implantes, independente dos processos de esterilização utilizados, apresentaram ausência de citotoxicidade. Os resultados do teste de bleed mostraram uma maior taxa de migração de gel para os implantes de superfície lisa em comparação com os implantes de superfície texturizada e revestida com poliuretano, quando esterilizados por calor seco. Ao comparar a taxa de migração do gel para os implantes de superfície lisa esterilizados por calor seco e óxido de etileno, obteve-se uma maior taxa de migração para aqueles implantes esterilizados por óxido de etileno. As diferentes avaliações realizadas neste estudo abrangeram aspectos biológicos, químicos e físicos relevantes para garantir um produto de boa qualidade e que, por assegurar a manutenção da característica de biocompatibilidade, resulta na segurança biológica deste tipo de implante. / Silicone breast implants have been widely used for mammary augmentation and reconstruction surgery. Biological safety of these implants can be damaged by sterilization methods. This study consisted of the biocompatibility assessment of breast implants through cell viability, employing the agar diffusion test and neutral red uptake. Four silicone breast implants were tested: smooth, textured, polyurethane covered silicone gel breast implant and textured saline-filled breast implant. Sterilization methods comprised dry-heat, ethylene oxide and γ-radiation. Detection of bacterial endotoxins employing LAL test and gel bleed was also performed. The three methods of sterilization revealed equally efficacious, through the sterility confirmation of implants employing methodology described in 27th edition of United States Pharmacopeia. At the same way the leveis of bacterial endotoxins of implants accorded with the pharmacopeial requirements. In theevaluation of biocompatibility ali the implants, independently of the sterilization process used, showed no cytotoxicity signals. The results of gel bleed revealed a higher migration rate from the smooth implants in comparison with the textured and polyurethane-covered implants sterilized by dry-heat. When was compared the gel migration of smooth implants sterilized by dry-heat and ethylene oxide, was obtained a higher rate of gel bleed of those implants sterilized by ethylene oxide. The different evaluations performed in this study comprised biological, chemical and physical aspects, that are relevant to assure a good quality product and by having maintained the characteristics of biocompatibility, resulted in the biological safety on this kind of implant.

Made available in DSpace on 2016-08-19T18:16:05Z (GMT). No. of bitstreams: 1 Dissertacao Karla.pdf: 856285 bytes, checksum: fcc2f4b0c80fa2c3867dcc02058c15a5 (MD5) Previous issue date: 2012-06-18 / The effects of the treatment of breast cancer on the quality of life have been widely discussed in the literature. However, little is known about the subject in northeastern Brazil. The purposewasto evaluatethequality of life of patients treated for breast cancer in Sao Luis, MA. We conducted a cross-sectional study with 197 women Who underwent breast surgery and were attended in a Oncology Reference Hospital in Maranhao. The study included women treated unilaterally, regardless of adjuvant therapy conducted or in progress, no other malignancy. The sociodemographic variables studied were: age, education, marital status, ethnicity and number of children. Variables related to treatment were type of surgery, time since surgery and neo-adjuvant and adjuvant therapy. Quality of life was assessed using the FACT-B, applied in one step by a team of trained researchers. The variables were presented as Mean and Standard Deviation. For the classification groups with more than three classes, we used the ANOVA orKruskal Wallis. For those with only two classes, we applied Student's t test when there was a normal distribution or Mann-Whitney test for nonparametric variables. To check the correlation between them and the scores of the domains, we applied the Pearson linear correlation test. The significance level adopted for all tests was &#945; less than or equal to 0,05.Withanaverage age of 53.02 years (SD ± 11,71), white (44,67%), school (46,19%), married or in consensual union (57,87%) and average of 3,17 children (SD±2,73), women underwent mastectomy (63,46%) or breast conserving surgery (36,54 %), less than 6 years of surgery (92,90%). Neo-adjuvant therapies were not adopted in the majority (86,30%), but 92,38% received adjuvant therapies. The average values through the FACT-B showed a tendency to good quality of life, and the Functional Domain was the most committed and the total score, the less committed. Age, education, marital status, ethnicity, type and duration of surgery and adjuvant therapies influenced the quality of life in at least one Domain or Score of questionnaire, and the relationships were more marked with the sub-scale breast cancer (p=0,0001) and the FACT-B total score (p=0,0001) and adjuvant therapy with sub-scale breast cancer (p<0,0001). Pearson said there was a positive correlation between Domains and the questionnaire Scores. Qualityoflifewas relatively good, but was negatively influenced by mastectomy, the shortest time since the surgery and adjuvant therapies. / Os efeitos do tratamento do câncer de mama sobre a qualidade de vida têm sido amplamente discutidos na literatura, entretanto, pouco se conhece sobre o assunto no Nordeste do Brasil. O objetivo deste estudo foi avaliar a qualidade de vida das pacientes tratadas de câncer de mama no município de São Luís-MA. Foi realizado um estudo de corte transversal com 197 mulheres submetidas a tratamento cirúrgico para o câncer de mama, assistidas no Instituto Maranhense de Oncologia Hospital Aldenora Bello. Foram incluídas no estudo, mulheres tratadas unilateralmente, independente da terapia coadjuvante realizada ou em andamento, sem outra neoplasia As variáveis sócio-demográficas estudadas foram: idade, escolaridade, estado civil, etnia e número de filhos. As variáveis relacionadas ao tratamento foram tipo de cirurgia, tempo desde a cirurgia e terapias neo-adjuvantes e adjuvantes. A qualidade de vida foi avaliada através do FACT-B, aplicado em etapa única por uma equipe de pesquisadores treinados. Para os grupos de variáveis com mais de três classes, foi utilizada a Anova ou Kruskal Wallis. Para aqueles de apenas duas classes, aplicou-se Teste t de Student quando houve distribuição normal ou Mann-Whitney para as variáveis não-paramétricas. Para verificação de Correlação entre si dos Domínios e dos Escores, foi aplicado o teste de Correlação Linear de Pearson. Os níveis de significância adotados para todos os testes foi de &#945; menor ou igual a 0.05. As mulheres apresentaram média de 53,02 anos (DP±11,71), tinham cor branca (44,67%), estavam no ensino fundamental (46,19%), eram casadas ou em união consensual (57,87%) e com uma média de 3,17 filhos (DP±2,73). Quanto à cirurgia, a maioria realizou tratamento radical (mastectomia) (63,46%) e um terço, cirurgia conservadora (36,54%) há menos de 6 anos (92,90%). Terapias neo-adjuvantes não foram adotadas na maioria (86,30%), porém 92,38% receberam tratamento adjuvante. Os valores médios encontrados através do FACT-B demonstram uma tendência para boa qualidade de vida, sendo que o Domínio Funcional foi o mais comprometido e o Escore Total, menos comprometido. Idade, escolaridade, estado civil, etnia, tipo e tempo de cirurgia e terapias adjuvantes influenciaram a qualidade de vida em pelo menos um Domínio ou Escore do questionário, sendo que as relações mais marcantes foram idade com a sub-escala câncer (p=0,0001) e com o escore total FACT-B (p=0,0001) e das terapias adjuvantes com a subescala câncer de mama (p<0,0001). A qualidade de vida encontrada foi relativamente boa, mas foi influenciada negativamente pela mastectomia, pelo menor tempo desde a cirurgia e pelas terapias adjuvantes.

Male breast cancer (MBC) is rare, and research on the predictors of MBC has been limited because of inadequate funding in and outside of the United States. One goal of this study was to eradicate the stereotyping of breast cancer as a female disease. The emergence of medical technology and education to benefit the public will help to ensure greater health awareness at the individual, community, and global levels. The purpose of this study was to understand the influence of the predictors of age; race (Black, White, and Other); and grade of cancer (I, II, or III) on the outcome of mastectomy in MBC. The study was guided by the social determinants of health model. A quantitative approach was used to analyze archival data from 2011 to 2013 in the Surveillance Epidemiology and End Results (SEER) database using SPSS v.23. Data from 427 MBC patients ages 18 years and older from the United States comprised the sample. The SEER data were analyzed using logistic regression analysis. Results showed that of the 427 cases of MBC that were analyzed, 55 had a diagnosis of Grade I, 190 had a diagnosis of Grade II, and 182 had a diagnosis of Grade III. For 3 years, 116 men had undergone mastectomy. Grade I cancer, Grade II cancer, and Grade III cancer were statistically insignificant predictors of mastectomy; however, age, race was a statistically significant predictor of mastectomy among White men with MBC. The results will contribute to social change initiatives by educating the public about the predictors of mastectomy in MBC patients. The results also will increase the current knowledge base by informing the public, clinical professionals, and patients about the relationship of the predictors of age; race; and grade of cancer (I, II, or III) on the outcome of mastectomy in MBC.

Theories are tools with which we critically analyze society‟s structure and understand experiences that are not our own. When theories no longer describe the narratives that they claim, we must update them. This thesis proposes to do just that. The trans theories of J. Halberstam and Jay Prosser will be analyzed using ten autobiographies written by self-identified FTM transsexuals and transmen. Prosser and Halberstam are two well-known theorists in the field of trans theory. J. Halberstam approaches FTM transsexuality from the perspective of a lesbian feminist, who has an understanding of transgender butch individuals. Jay Prosser writes from the perspective of being a FTM transsexual himself. I chose publications by these theorists because they had sections that focused specifically on FTM narratives, and they both used at least two of the autobiographies I use and they were published the same year. Therefore, I found them to be two theoretical frameworks that could be compared on several different levels. The publication dates of the ten narratives range from the 1970s to the early 2000s. Applicability of the theories will be measured by comparing them to what the autobiographers say about their lives. The tool of analysis will be five focus areas that are represented, to some degree, in each narrative. They are: Trying to fit into female roll/body/world; Discovering one is Trans/Coming Out; Acquiring Hormones and Sexual Reassignment Surgery; Trying to Establish/Re-establish a Confident Identity; and Romantic/Sexual Relationships.. I will discuss how helpful each theory is in accordance with these narratives. The aim of this thesis is to assess how well each theorist addresses the issue of transsexual identity. The field of transsexual research is still new and developing, there are many interesting parts of these narratives that can be delved into further. I will conclude by proposing a new trans theoretical view point that would better help one to understand the process of female-to-male transition. What one should take away from this thesis is that despite differences in sex and gender formation, these people are, like the rest of the world, trying to create an identity that they not only feel comfortable with as a representation of themselves, but also one that they can be proud of.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.