Oncology

Prevention of breast cancer

In recent years the incidence of breast cancer (BC) has increased significantly. According to the National cancer registry of Ukraine in 2016, was 708,7 new cases of breast cancer per 100 thousand population, of which 75.8 per cent of patients with i-II stage, and 14.4 % with stage III and 7.7% IV. The figures are disappointing.

With the modern pace of life, chronic stress and family responsibilities women forget about themselves. Forget or do not want to give yourself the time to undergo preventive examination by a gynecologist and mammologist. Sometimes this leads to fatal consequences.

Preventive examinations of girls are planning to assess puberty in the 10-11 and 16 years (according to the order of MOZ of Ukraine from 29.11. 2002 No. 434.). Family doctors will conduct a detailed survey in 18-year-old women to assess genetic risk of breast cancer. With 20 years recommended breast self-exams at 7-14 day menstrual cycle.

Methods of prevention of breast cancer.

Primary prevention consists of providing information regarding the avoidance of risk factors:

  • special attention in the critical relative with breast cancer age periods after age 40;
  • the control of body weight;
  • minimizing harmful habits (Smoking, alcohol);
  • regular sex life, first child no later than 28-30 years, breastfeeding the baby for at least a year;
  • early detection and treatment of gynecological diseases, controlled hormonal contraception;
  • the treatment of liver diseases, thyroid, diabetes;
  • prevention of exposure to adverse environmental factors (excessive solace stimulating physiotherapy and drugs) to avoid stress.

Secondary prevention:

  • regular breast self examinations starting at 20 years of age;
  • early detection dishormonal diseases of mammary glands;
  • examination by a mammologist-oncologist once a year;
  • Breast ultrasound women up to 40 years once a year (in the absence of pathology);
  • mammography for women after 40 years.

The main risk factors of breast cancer:

  • age 40 years or more.
  • cystic changes in the breast (mastitis), injury of the breast;
  • reproductive disorders, abortion after age 35, natural-feeding child less than 5 months, infertility, early (before 12 years) or later (after 16 years) beginning menstruation early (before 45 years) or late (after 53 years) menopause;
  • breast cancer in close relatives (mother, sister, daughter, maternal grandmother) or other cancer disease in the patient;
  • endocrine disorders (thyroid disease, diabetes, obesity of the II-nd and III-rd degree), concomitant diseases (hypertension, liver disease);
  • diseases of the reproductive organs, tumors of the uterus and annexes, inflammatory diseases, menstrual disorders, uterine bleeding.

After collecting anamnestic data concerning risk factors formed a group of patients who are subject to mandatory referral for a mammogram.

Mammography is one of the leading and effective methods of early diagnostics of breast pathology, the diagnosis of various forms of breast cancer. This method allows to detect the tumor size of 0.3 cm, and also to differentiate malignant and benign tumors.

Decide when you need to carry out mammography screening.

To 35 years, mammography is not assigned, if not for that testimony, and it is more expedient to appoint an ultrasound.

If there is a family history of breast cancer mammography is recommended 1 every 1-2 years (regularly examining the Breasts themselves, and in the doctor’s office), starting at 35 years of age.

35-40 is the primary mammography for determination of the structural component of the breast tissue.

40-49 is performed depending on indications.

50-69 years, mammography is carried out 1 time in 2 years.

Why is it important to undergo mammography after 40 years?

A gradual decline in hormonal activity of the ovaries leads to involutive (irreversible) changes in the glandular structures of the breast. Therefore, 60% of identified cases of breast cancer reaches its maximum at 45 years. Issues of hormone replacement therapy is decided only after mammography research [1, pp. 160-161].

Mammography is not appointed during pregnancy and during lactation.

There are often questions as to who should examine the mammary glands?

Breast examination is carried out before referral for mammography research by a General practitioner, family doctor, gynecologist, nurse practitioner, nurse, held special training in health care institutions, providing primary medical care.

1. Tatarchuk T. F. Endokrinnaja gynecology (clinical essays). Part 1 / T .F. Tatarchuk, J. P. Solsky. – K., 2003. – 300 p.

2. The clinical Protocol of primary, secondary (specialized), tertiary (highly specialized) medical care “breast Cancer” (order of MH of Ukraine from June 30, 2015 №396).

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