Box 13. Healthcare and care in breast disorders.

General goal: acquisition of competencies related to the care of women with breast disorders.
LEVEL	COMPETENCIES	COMPONENTS
R1	- Demonstrates knowledge of the most common benign and malignant breast disorders (cyclic and noncyclic breast pain, fibrocystic breast changes, cysts and lumps, nipple discharge and breast cancer);	K
	- Performs assessment, formulates differential diagnosis and provides initial treatment in common benign breast disorders (cyclic and noncyclic breast pain, fibrocystic breast changes, cysts and lumps, nipple discharge and breast cancer);	K / S
	- Identifies women with breast cancer risk factors in primary care settings by using clinical information and breast cancer (BC) risk assessment models, and provides a care plan for follow-up these patients;	K / S
	- Guides the breast cancer screening in primary care settings and properly interprets imaging results using the BI-RADS classification;	K / S
	- Performs low-complexity procedures (puncture of cysts or abscesses, including ultrasound-guided puncture);	K / S
R2	- Demonstrates knowledge of the breast cancer treatment options and the treatment sequence pacing;	K
	- Performs initial investigation procedures of breast disorders (puncture/aspiration biopsy of cysts and breast lumps, percutaneous core-needle breast biopsy under direct visualization);	S
	- Performs low-complexity surgical procedures in the treatment of benign mammary disorders (duct excision, palpable lump excision);	S
	- Provides care plans, follow-up and referral for patients with abnormalities in clinical examination, mammography or ultrasound, and when necessary, indicates the appropriate type of biopsy;	K / S / A
R3	- Purposes primary prevention measures for high-risk breast cancer patients;	K / S
	- Uses multidisciplinary and hierarchical approach (at primary, secondary and tertiary levels of care) for patients with complex breast diseases;	K / S / A
	- Performs high-complexity surgical procedures in the treatment of breast diseases, such as segmental resection, total mastectomy (simple) and accessory axillary breast excision, non-palpable lesions biopsy, fistulectomy and surgical approach to the treatment for gynecomastia;	S
	- Provides appropriate assistance and follow-up in the postoperative period of breast surgeries (cancer or not);	K / S
	- Purposes follow-up measures for patients undergoing breast cancer treatment;	K / S

Abbreviations: A, attitudes; K, knowledge; S, skills.