Breast Cancer
The main risk factor is the personal history of breast cancer or background of the same in one or more direct relatives of first degree, especially if happened at early ages and bilateral, which makes the risk increase 3 to 10 times the normal population, with a risk of incidence of 13.1 % for white women in the USA and a 9.6 % for women afro-american.
The more early is the diagnosis, the greater the likelihood of healing, with opportunity for therapeutic procedures conservatives are not mutilantes, to lower costs for the patient and medical institutions involved.
METHODS OF DETECTING EARLY
1- SELF-EXAMINATION OR BREAST SELF.
It is very important in the early diagnosis of breast cancer, it is estimated that 65 percent of all the breast nodules are discovered by the breast self.
It is essential educate prior to the patients on its importance, objective basis and technique of self, so that the same becomes effective, taking into account that the mode of presentation more frequent breast cancer, is like a painless nodule, located mainly in the quadrant superexterno in a 50 percent of the cases, 20% to level the central area and in smaller proportion in the remaining quadrants breast.
It should do monthly in any woman who starts menstruating (menarche), about 10 days later in the same and in the women women once a month. The technique of breast self includes:
A: inspection bilateral mammary what makes the patient stop foot, compared to a mirror, looking asymmetries, eritemas, retractions or ulceraciones of mammary skin, areola or nipple. B: palpation bilateral mammary is performed by hand fills, which must be done in three positions, standing, sitting and lying (with a small pillow under the shoulder).
It must examine all of the breast in a systematic way, in different directions, transverse vertical, radio and circular, including armpit in search of areas induladas or nodules. C: compression of nipples to rule out presence of secretions.
The breast self should not be abandoned, although beyond availability of mammography, because some cancers not breast are detected by mammography, but if the palpation, patients who regularly as technical, manage generally a stadium early from his illness.
2- REVIEW CLINICO OF THE BREAST
The makes the doctor and includes:
a- interrogation (background hereditary, personal, clinical data on the current illness if any).
b- inspection of skin and complex areola – nipple.
c- palpation breast to assess in case of injury, location, size, characteristic of the tumor, including in addition the consideration of armpit, supraclavicular region, cervical and for-external, looking for possible adenopathy (nodes).
The American Cancer Society” recommends a clinical examination annual breast to all women over age 40 and every 3 years women under 40 years from the menarche (1era menstruation).
3-MAMMOGRAPHY
The fundamental importance of the mammography is in the early detection of breast cancer, the screening mamografico, achieves a reduction in mortality close to 30 per cent, proving to be significantly more accurate, that the clinical examination, in the detection of cancers small or minimal.
When the method is implemented in the form optima, sensitivity and specificity may exceed 90 per cent is reproducible and effective cost, associating with a quotient irrigation/reduced profit.
The review mamografico is simple and does not represent major drawback for the patient must be made in the first half of the menstrual cycle, bilaterally and in different projections (skull flow, mediolateral, oblique, etc.).
The mammography to detect minor injuries to 5 mm in diameter, in many cases carcinomas in situ, clinically hidden no palpable, which currently represent about 20 percent of all cases of breast cancer.
This early detection, amending the natural history of the disease, significantly improving survival and the quality of life of the patients. The reduction in mortality from breast cancer depends on the detection of injuries minimum, before that takes place the spread systematically.
The mammogram detected about 85 percent of the cancers of the breast, most of them can be viewed on mammography, before be palpable, identifies malignancies clinically hidden, as evidenced, with microcalcifications grouped, asymmetries in the breast density, architectural distortion or clinical lesions palpable, in the form of tumor masses densely espiculadas.
The risks of radiation associated to the study mamografico is generally considered insignificant. THE AMERICAN CANCER SOCIETY, recommends the study mamografico and clinical examination annual breast in any woman from the 40 years, in patients with high-risk family, it could initiate the detection mamografíca, at earlier ages, with a mammogram basis from the 35 years.








