Detección temprana y diagnóstico del cáncer mamario

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The etiology of breast cancer is based on different factors such as:

Age: since the risk increases after menopause (median age 52 years) and reaches its peak around 80 years. In most of epithelial carcinomas, when a logarithmic graph of incidence with respect to age, appears a straight line increase with every year of life passed in breast cancer happens something similar, but the slope is performed decreases starting at the age of menopause. Likewise, ages who have an important impact on the incidence of breast cancer are age of menarche, age at first full-term pregnancy, and age of menopause.

Geographic variation: as mentioned at the beginning, breast cancer increases their morbidity and mortality rates in the developing country, compared with developed, from my point of view has to do with the economic aspect, and the investment made the country for prevention, diagnosis and treatment of disease. However several sources mention that the differences may be based on environmental factors such as diet, reproductive patterns and feeding habits.

Race and ethnicity: this factor is the subject of multiple investigations, and are considered caused by a combination of genetic differences and social factors such as lifestyle choices and access to healthcare.

There is also evidence that the disease is hormone-dependent, it has been observed that in women without functioning ovaries who never receive estrogen therapy, without the disease. Here we may note the significant amount of morbidity in women compared to men, which is close to 150: 1.

Breast cancer can be considered a disease that affects people universally, and different countries have taken preventive measures in Mexico is performed according to the Official Mexican Standard NOM-041-SSA2-2002, for the prevention, diagnosis, treatment, control and surveillance of breast cancer. Which classifies prevention in primary, secondary and tertiary.

In primary prevention education is given to people at risk, as over 40, obese, nulligravida, a family history. Secondary prevention includes self-examination which is very important to detect abnormalities early and starts from menarche between the seventh and tenth day of onset of bleeding, monthly. Within this includes medical prevention that women 25 years and annual mammography being done to women 40 to 49 years every 1 or 2 years from age 50 must be done annually.

Once identified breast disease is channeled immediately to the second level of care for different diagnostic methods confirmation form.

Tertiary prevention includes reconstructive psychological rehabilitation, aesthetics and women receiving surgical treatment, chemotherapy, radiotherapy or hormone therapy, as warranted.

In Mexico breast cancer is often identified by palpating a tumor, which determines an advanced stage of the disease, so the information that the public is given to make an impact their lives, to prevent more advanced cases disease, also should be extended mainly in populations with socio-cultural and economic needs.

Early diagnosis is based on different methods, which include mammography, ultrasound, magnetic resonance imaging and positron emission tomography. It given the capabilities of each country, has all or any of the above methods.

When the disease is detected in early stages, it is possible to apply the most effective therapeutic measures and cure patients before the disease spreads. When detected in later stages the most you can do is give a palliative treatment.

X-ray mammography is performed in X-ray machines, specially designed to carry out these studies. These images obtained can be analog or digitized which are of higher quality, but its price is higher and a mixture of both, which is not of such high quality. The test performed on women at risk, is called mammography screening, which has determined a change in mortality statistics and achieve a better quality of life in patients who have undergone the disease. Conclusively it shows that mammography has reduced from 25 to 30% mortality due to cancer, when annual screening is performed in women over 50 years.

Once you have identified a suspect result, it is recommended to send a specialist and perform other complementary studies such as ultrasonography, which can determine whether it is a solid or liquid mass (cyst) and can also identify the increased risk of malignancy, for which it must be supported by histopathologic methods.

MRI is another diagnostic method used infrequently due to its high cost, is a nonionizing method that has the highest number of visual benefits and also identify with contrast media "neovascularity" of tumors. A method that is not yet available in Mexico is the positron emission tomography, which is a mixture of computed tomography nuclear medicine, is one of the most advanced methods, and involves administering a radiopharmaceutical intravenously, which accumulates in malignant cells thus can be quantified, and having the aspect ratio of carcinoma.

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Bibliografía:

Dan L. Longo, Dennis L. Kasper, J. Larry Jameson, Anthony S. Fauci, Stephen L. Hauser, Joseph Loscalzov. “Harrison Principios de Medicina Interna”, Capítulo 90 Cáncer de mama, 18a edición, Mc Graw Hill, USA, 2012, Vol.1 pag. 754-763.

Robbins y Cotran “Patología estructural y funcional” Capítulo 18, Aparato genital femenino y mama, 8a edición, El Sevier. España, 2012 Pag. 704-714.

NORMA Oficial Mexicana NOM-041-SSA2-2002, Para la prevención, diagnóstico, tratamiento, control y vigilancia epidemiológica del cáncer de mama. Disponible en: http://www.salud.gob.mx/unidades/cdi/nom/041ssa202.html

ESTADÍSTICAS A PROPÓSITO DEL… DÍA MUNDIAL DE LA LUCHA CONTRA EL CÁNCER DE MAMA, disponible en: http://www.inegi.org.mx/saladeprensa/aproposito/2015/mama0.pdf