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1
MAMMOGRAPHY
RADIOGRAPHIC IMAGING OF THE BREAST
Part 2 -Statistics

A mammogram can find breast cancer when it is very
small -- 2 to 3 years before you can feel it.
 No screening tool is 100% effective. Good quality
mammograms can find 85-90% of cancers
2
Regular breast screening can find cancer when it
is small which means:
 there
is a better chance of treating the
cancer successfully
 it
is less likely to spread
 there
may be more treatment options
3
MAMMOGRAM

REMAINS THE SINGLE MOST
SENSITIVE TECHNIQUE IN DETECTION
OF BREAST CANCER (ACR)
OTHER MODALITIES:
 ULTRASOUND
 MRI
 OTHER - thermography
4
PATIENT FEARS
PAINFUL
FIND
SOMETHING
WRONG / DENIAL
UNINFORMED
“causes cancer”
5
RISK FACTORS
 SEX
99% WOMEN
 1 % MEN
 AGE – INCREASE WITH
AGE*
 YOUNGER WOMENFASTER GROWING CELLS
6
MORE RISK FACTORS
 HISTORY
PREGNANCY & ABORTIONS
 OBESTIY
 EARLY MENSES
 LATE MENOPAUSE

7
ACS GUIDLINES
women age 40 to 49 have a routine
screening mammogram
 every one to two years


with the first one beginning at age 40

BASELINE - for comparison
8




Breast cancer – ACS
Yearly mammograms are recommended starting at age 40 and
continuing for as long as a woman is in good health.
Clinical breast exam (CBE) should be part of a periodic health exam,
about every 3 years for women in their 20s and 30s and every year
for women 40 and over.
Women should know how their breasts normally feel and report any
breast change promptly to their health care providers. Breast selfexam (BSE) is an option for women starting in their 20s.
Women at high risk (greater than 20% lifetime risk) should get an
MRI and a mammogram every year. Women at moderately
increased risk (15% to 20% lifetime risk) should talk with their
doctors about the benefits and limitations of adding MRI screening
to their yearly mammogram. Yearly MRI screening is not
recommended for women whose lifetime risk of breast cancer is less
than 15%.
9
EDUCATION
– breast self exam MONTHLY
 CBE –clinical breast exam –
 3-6 months
 MAMMOGRAM – ANUALLY *
BEGIN AGE 35
 BSE
10
Best Time For BSE
The American Cancer Society urges women
to perform breast self-examination (BSE)
once a month

about a week after the menstrual period

Post-menopausal women should choose a
set day, such as the first of the month, to
practice self-examination.
11








Begin by looking at your breasts in the
mirror with your shoulders straight and
your arms on your hips.
Here's what you should look for:
Breasts that are their usual size,
shape, and color.
Breasts that are evenly shaped without
visible distortion or swelling.
If you see any of the following
changes, bring them to your doctor's
attention:
Dimpling, puckering, or bulging of the
skin.
A nipple that has changed position or
become inverted (pushed inward
instead of sticking out).
Redness, soreness, rash, or swelling.
12
13
14
Some cancers are not found
until they reach this size
A mammogram can find
cancer when it is only this size
15
16
Cancer statistics
Breast cancer strikes about 180,000
American women yearly
 and kills about 44,000
 Next to skin cancer, breast cancer is the
most frequently diagnosed cancer in
women in the United States
 It is second only to lung cancer in cancerrelated deaths

17
RISK
 "Lifetime
risk is the likelihood
that a newborn girl will develop
breast cancer sometime during
her entire life.
 The
1-in-9 statistic does not
apply to women of all ages
18
RISK VS REALITY
chance of being diagnosed with breast cancer




30-year-old woman has a 2% (1 in 50) in the
next 20 years
a 40-year-old has a 4.5% (1 in 20)
50-year-old woman's risk of developing invasive
breast cancer--the most serious kind--in the next
5 to 20 years
ranged anywhere from 1 in 15 to 1 in 133
depending on her ethnicity.
19
four major ethnic group
Asian/Pacific Islanders
Hispanic
African American
Caucasian
20
"For women currently aged 50
the estimated risk of developing invasive breast cancer within 5 years
0.8% (1 in 133) among Hispanics
 1.3% (1 in 75) among Caucasians
Within the next 20 years
 3.7% (1 in 27) among Hispanics
 6.6% (1 in 15) among Caucasians
 5% (1 in 20) among African Americans
 3.9% (1 in 26) among Asian/Pacific Islanders

21
TYPES OF BREAST TISSUE
can you name them?
22






15 – 30 YO
NO CHILDREN OVER 30
PREGNANT/LACTATING
UNDER 25 –
ULTRSOUND
RECOMMENDED
Why?
What does US show?
19-year-old woman who has never been
pregnant. Note the dense glandular
tissues with small amounts of fat
POSITION?
FIBROGLADULAR (DENSE)
23




AVERAGE DENSITY
50% FATTY 50 %
GLANDULAR
30 – 50 YRS OLD
YOUNG WOMEN W/
3 PREGNANCIES
FIBRO-FATTY
POSITION?
24
POSITION?





MINIMAL DENSITY =
FATTY
OVER 50 YRS OLD
POSTMENOPAUSAL
ATROPHIC
MALE BREAST
CHILD BREAST
FATTY
68-year-old woman.
Most of the glandular tissue is atrophic