Carcinoma Papilar Mamario Infiltrante Ulcerovegetante

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.

Carcinoma Mamario Ductal Infiltrante y Ectasia de Conductos Galactoforos

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.

Carcinoma Mamario Apocrino Infiltrante

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.

The colorectal carcinoma is more prevalent in the urban population, in males of whites, the multiparity exerts a protective effect on women, although the tumors of location hayloft right, are more frequent in women, the incidence of colorectal carcinoma increases rapidly from the 40 years, peaking between 60 and 80 years.

Poliposis Colonica con Adenocarcinoma Ulcerovegetante Rectal

The geographical difference in the incidence, seems attributable to the diet, deficit the fibers, excesses in the consumption of unsaturated fats, cholesterol and refined sugars, in a body with susceptibility genetically determined to develop injuries polypoid adenomatosas single or multiple, according to epidemiological evidence, clinics, morphological, genetic and molecular the point as precursors of the most colorectal carcinomas and on them can develop the alteration precancerous histological, called dysplasia, whose progression leads to a transformation tumor malignant.

Secondary prevention, detection or early screening of colorectal carcinoma

The colorectal carcinoma constitutes a health problem, responsible for a large number of deaths in western countries and potentially curable if detected in an early stage premalignant (polyp colonico adenomatous dysplastic). The polyps multiple are associated with a more frequently in cancer that polyps unique (up to 8 times).

Within the tests recommended by the American Cancer Society, the screening of colorectal cancer in asymptomatic individuals and without personal or family history of cancer are as follows, from 50 years:

Poliposis Colonica con Adenocarcinoma Ulcerovegetante Rectal

1) Test occult blood faecal material (annual).

2) Rectal (prior to the study endoscopic).

3) Rectosigmoidoscopia flexible (every 5 years).

4) Colonoscopy (every 10 years).

5) Barium enema double contrast (every 5 or 10 years).

The top, the sequence and frequency of the same, must be evaluad by the specialist according to the patient groups of low, medium and something risk, the latter are those with a personal history and/or family by colorectal carcinoma, people with ulcerative colitis or patients with genetic syndrome of polyposis ( polyposis adenomatosas family, juvenile polyposis family, syndrome of colorectal cancer hereditary not polypoid, syndrome of adenoma plane hereditary, etc. ), in which the surveillance has to be very close, because of the high risk of developing colorectal carcinoma.

Before these stimuli chronic not controlled or treaties (agent carcinogenic and co-factors) normal cell begins to suffer modifications kernel-cytoplasmic and architectural, known as precancerous lesions or precursors of invasive cancer of the cervix, this being the last that kills the patient.

Some women with precancerous lesions develop cancer with a recurrences that ranges from 20 % 60 % , process that often takes years, but sometimes can occur in a short time, especially in patients with weakened immune systems, such as those who suffer an organ transplants since the immunosuppressive treatment to which are subject to lessen the rejection, the makes prone at the same, the carriers of neoplasia, e.g.: Lymphomas, which still regimes of chemotherapy or patients with infection by HIV (human immunodeficiency Human – AIDS).

However, most of these lesions, once detected early, disappeared after a regular monitoring and control cytology (Pap) and a proper medical treatment-gynecological.

Only a minority of them, as the precancerous lesions or squamous intraepithelial high degree (CIN 2 – CIN 3), that by not responding to medical treatment or be very extensive, needed to cure the removal quirurgica complete of the same in the form of a cone, hence the name of surgical procedure quotation, for which can be used numerous methods, being the most common thermocoagulation, cryosurgery, laser and loop. The material or piece of conizacion is placed in a liquid fixative (formalin) for the conservation and sent to the pathologist for the study of microscopic himself and the definitive diagnosis.

A Pap Smear or exfoliative cytology cervical must be made on a regular basis in any woman who began their sexual activity or after the 18 to 20 years, on an annual, (as doctor), which permits to detect and diagnose time precancerous lesions, with a medical treatment appropriate gynecological achieves the prevention of the most cancers of the cervix.

The literature medica was using to over the years different terms to call the precancerous lesions, the first and universally accepted was DYSPLASIA, introduced in cytology in 1949 by Dr. George Papanicolaou, of which bears his name the technique of exfoliative cytology cervical commonly known as Pap Smear, which allows us to detect clearly such precancerous lesions or dysplasias, in order to stop its evolution achieving reduce the incidence of cervical cancer and save many lives.

The cell dysplasia or precancerous to be observed under a microscope, evidence alterations kernel-cytoplasmic and architectural, with greater size of the kernels (cariomegalia), which is progressive action as it aggravates or evolves over time the dysplasia, as well as in the intensity in the color of the same (hipercromasia), increase in the divisions cellular, some abnormal (mitosis atypical) among other alterations, due to changes in the content of DNA in cells displásicas .

The same are graded according to the level they occupy in the squamous epithelium concerned:

- Mild Dysplasia or CIN 1 (if they affect a lower third of the epithelium).

- Dysplasia Moderate or CIN 2 (if they affect the two-thirds of basal epithelium).

- Severe Dysplasia-Carcinoma In Situ-CIN 3 (if they affect all the thickness of the epithelium).

It is estimated that a CIN high-grade progresses to a invasive carcinoma in a variable period of 10 to 12 years.

Cuello Uterino Normal

It is the bottom and close the uterus that connects the body of the uterus with the vagina..

The uterus or matrix is a hollow organ, in the form of pear, aimed at preserving and nurture the product of conception (embryo – fetus) and to expel at the time, located on the part but lower abdomen of women (pelvis) between the bladder or rectum.

The cervix form a channel (endocervical canal) that leads into the vagina, which leads to the outside of the body.

The cervix, for the most extension, is covered by a epithelium cells flat, which are stratified as flakes, hence its name squamous epithelium, which continues in vagina and is the first image that has the gynecologist by placing the speculate intravaginal.

This portion of the cervix neighbor to vagina is called ectocervix or exocervix. The internal part, the cervix is called endocervix, which is the importance of a through so-called through endocervical. The endocervix this consists of a cylindrical epithelium columnar, with glands that produce clear mucus filante (mucus pre-ovulatory).

The union or “shock” of both epithelia (squamous epithelium ectocervical and columnar endocervical glandular) is called union escamo-columnar or processing area, located generally at the level of external hole of the cervix, being the place where originates 95 % of the cancers of the cervix.

The cervical cancer or cervical is today one of the most common neoplasms of female genital tract, in most countries, is the 2nd cancer more frequent in women around the world, the percentage of affectation depends on the characteristics of the populations in which it is performed the study.

Carcinoma Escamoso Invasor de Cuello Uterino

There are significant differences at international level, which depend on the various cultural attitudes of the different communities toward sexual habits, for example: in the Jews and Muslims, in whom the practice of male circumcision achieves a better sexual hygiene in the man and hence a smaller percentage of cancers of the cervix in their women.

It also implementation by some governments of policies of health education programs and mass screening or early detection of cervical cancer that include gynecological exams and full studies Smears, succeed as in the developed countries, reduce significantly the indices of incidence rate and mortality of cervical cancer, thanks to the implementation of the same.

1) The squamous cell carcinoma,          2) The adenocarcinoma.  

1) The squamous cell carcinoma constituted as said his name, by squamous cells that resemble the squamous cells of ectocervix or exocervix, but malignant. Is the most common, around 90 %.

2) The adenocarcinoma develops in the glandular cells producing mucus of endocervix, at the level of endocervical canal, in a percentage of about 8 %.

Less frequent are other tumors of cervix, that have the characteristics of both types of epithelium, the scaly and glandular, so-called carcinomas adenosquamous or mixed.

It is imperative and urgent measures of health education mass to the community, in order to change behaviors unhealthy and correct or eliminate risk factors of cervical cancer, but in an era of greater sexual liberation and in which we live and the beginning of the same to ages ever more early, sometimes with ignorance of basic measures of prophylaxis or prevention, due to shortcomings educational and enormous problems socio-cultural and economic.

When the cells keep dividing when not needed, they generate a mass of tissue called TUMOR, which can be benign or malignant.

Fibroadenoma Mamario

The bening tumors are are not cancerous, not infiltrate to other tissues, nor does it spread to other parts of the body (metastasis), it is generally defined either of the adjacent structures can operate (dry) and not reappear (recurrences).

The benign tumors are not a threat to life.

 The malignant tumors are cancerous, the cancer cells generally has a great capacity for cell division (mitosis normal and abnormal), forming a cell mass that grows in autonomously, without regulation and in a disorderly way, by loss of the normal mechanisms of control.

Carcinoma Mamario Ductal Infiltrante

These malignant tumors can develop into any tissue, of any body and at any age.

The cancer cells to become uncontrollable can invade and damage tissues and organs adjacent to the tumor, or infiltrate through blood vessels or lymph nodes to the blood stream, to produce implants secondary in other tissues or organs adjacent or away, which is called METASTASIS (tumor dissemination).

Carcinoma Renal a celulas claras con área de necrosis tumoral e invasion del tejido adiposo perirrenal

The kidney cancer also known as kidney cancer affects more than 28,000 people in the United States, representing 2.5 percent to 3 percent of all the malignant tumors, being more frequent in men between 50 and 70 years. The malignant tumor classic is the renal cell carcinoma to clear cell. In children the type more frequent is the Wilms’ tumor.

The kidney cancer can be cured if detected early, (small tumor and located) however the symptoms often, there is no evidence until the tumor reaches large dimensions or da metastases (tumor invasion to lymph vessels or blood which vehiculiza these cells to different locations).

The renal cell carcinoma to clear cell can affect any portion of the kidney, usually appears in the poles kidney, dominate the upper pole, tend to be unilateral and unique, rarely bilateral.

Are masses tumor 3cm to 15 cm in diameter, white yellowish, sometimes with areas necroticas hemorrhagic, which have a tendency to invade the renal vein, with an extension of further to inferior vena cava, or by metastasis to lungs more than 50 per cent, bones 33%, liver 18 per cent to 35 per cent, adrenal gland 19%, kidney contralateral 7.5%, soft parts 8% to 36 per cent, central nervous system 1 percent to 8 per cent, have been described metastases in almost all organs and sites of the body, sometimes in locations very rare, as eyes, vagina, parpado, nose, distal end of finger.

Factors of irrigation of renal cancer

Age: particularly affects over 50 years.

Sex: men have a little more than twice as likely (2.3%) of tumor development as women. Race: the risk of whites is 1.1 times greater than the black. Smoking: irrigation of smokers is 1.5 to 2.5 times higher, that non-smokers.

Obesity: a 20 percent of these cancers is associated with obesity and the diet rich in fat.

Industrial Operators: as the exposure of workers to leather (tannery and shoe factory) asbestos, cadmium, lead acetate (newspaper printing) organic solvents (oil) have been associated with the emergence of carcinomas in kidney cells.

Urbanization: kidney cancer is more common in urban residents (exposure to industrial operators).

Carcinoma Renal a Celulas Claras con Invasion Venosa hiliar y del tejido Adiposo Perirrenal

Pathology prior kidney

Kidney failure and chronic dialysis: are likely to develop renal cell carcinoma patients with more than 3 years of dialysis, which tends to be multi and bilateral. Nefropatia by phenacetin: has a higher incidence of renal cell carcinoma. Family History of renal cell carcinoma: the disease Von Hippel-Lindau is a genetic disorder, with a high incidence of kidney cancer (50%).

Clinical Presentation

Signs and symptoms:

• Hematuria (blood in urine) 60 per cent.
• Abdominal Pain or lumbar 40 per cent.
• Abdominal mass 45 per cent.
• Lost involuntary weight.
• Fatigue.
• Anemia.
• Recurrent Fever.
• High blood pressure (hypertension).
• Legs or ankles swollen.

Methods of diagnosis of renal cell carcinoma

Includes various types of tests and procedures:

• History.
• Physical examination.
• Analysis of complete laboratory and specific.
• Diagnosis by images: chest x-ray and centellograma bone, to detect metastasis.
• Plate simple abdomen.
• Pyelogram intravenous: consists of the intravenous injection of dye, which filters quickly to urine, achieving obtain to post an x-ray (image) of renal pelvis and ureters.