lviv women’s wellness center: breast health promotion services l.s. gutsal director
TRANSCRIPT
Lviv Women’s Wellness Center:
Breast Health Promotion Services
L.S. Gutsal
Director
Operation
Diagnosis
Treatment
Education
Gynecological diseases
Prenatal diagnosis
Cervical pathology
All obstetric, gynecological, and breast conditions
Self-education
KBLZhD medical personnel education program
Patient education program
Educational program
Breast self-examination
Family planning Sexually transmitted
diseases
Partnership in birth giving
Psychological preparation to birth
givingPathological climax
Breast feeding
Director
Ultra-sound
2
Technician
1
Cosme-tologist-derma-tologist
1
Radiologist
2
Obstetrician-gynecologist
6
Oncologist-mammologist
1
Psychotherapist
1
Perinatologist
1
Sexopatho-logist
1
Nurses
10
Information coordinator
1
Medical registrar
1
Subordinate medical
personnel
6
Services Provided by the WWC
1. Specialist consultations:• obstetrician-gynecologist• oncogynecologist• oncologist-mammologist• sexopathologist• dermatologist• psychotherapist-psychologist
2. Breast screening and diagnostics
3. Ductography
4. Pneumocystography
5. Needle location of nonpalpable tumors using mammograph
6. Breast ultrasound examination
7. Breast aspiration biopsy with ultrasound monitoring followed by cytological examination
8. Breast aspiration cysts with ultrasound monitoring
Services Provided by the WWC
9. Wide-bore needle biopsy with ultrasound monitoring followed by cytological examination
10. Needle location of nonpalpable tumors with ultrasound monitoring
11. Excision (surgical) biopsy of nonpalpable tumors preceded by needle location with ultrasound or mammograph monitoring
12. Cytological examination of nipple discharge and aspirated fluid; histological examination of wide-bore needle and aspiration biopsies
Services Provided by the WWC
13. Out patient services for pregnant women:• complete set of laboratory tests• Ultrasound examination• alpha-fetoprotein• perinatologist-geneticist consultation 14. Colposcopy, biopsy of cervical erosions, electrical
coagulation of cervix, insertion and extraction of intrauterine devices, diagnostic abrasion of the cervical channel and uterine cavity, polypectomy, removal of condylomas, ambulatory treatment of gynecological diseases, hysterosalpingography, cytological examination of cervical channel discharge, and smear culturing
Services Provided by the WWC
15. Ultrasound examination:• pregnant women• gynecological patients• abdominal organs and kidneys• thyroid gland• transvaginal examination of gynecological patients• examination of children
Services Provided by the WWC
16. Sanitary education in all programs:• breast self-examination• partnership in birth giving• prevention of sexually transmitted diseases• prevention of osteoporosis• family planning
Services Provided by the WWC
Laboratory
1. Blood test
2. Urine test (qualitative)
3. Blood biochemistry in a Reflotron analyzer:• bilirubin• AST (aspartate aminotransferase)• ALT (alanine aminotransferase)• urea• glucose
• hemoglobin• cholesterol• HDL-cholesterol (high-density alpha-lipoproteins)• К+
4. Gynecological smear cytological examination
5. Gynecological smear cultures
Laboratory
6. Puncture biopsy of breast tumors
7. Puncture biopsy of breast cysts (centrifuge preparation)
8. Nipple discharge
9. Spermogram
Laboratory
Local out-patient clinic
Railway Ministry
healthcare facilities in
Lvov
Self-sustained
Regional cancer clinic
Health care facilities
Medical registry
Obstetrician-gynecologist
Surgeon (oncologist-
mammologist)
Psychotherapist
Ultrasound diagnostic techniques
Mammography Laboratory tests
Laboratory tests
Cytological examination of cervical smears
Vaginal smears
Cytological examination of
nipple discharge
Cytology of breast cyst punctate Intraoperational
rapid cytological examination
Blood chemistry
Urine tests in pregnant women
Ultrasound diagnostic suite
Prenatal diagnosis
Gynecological diseases
Separate diagnosis of uterine and ectopic pregnancy
Transvaginal examination
Preparation of patients for IVF
Breast ultrasound examination prior mammography
Cyst Neoplasm
Solid neoplasm
Intracystal neoplasm
Mammography
Biopsy
Biopsy
Puncture
Cyst
Breast Screening Program Report for 1998, 1999, and 2000 (through August)
I Total number of female patients examined, 2893- screening, 1388- diagnosis, 4505
II Mammography- total number of procedures, 4863- needle location of nonpalpable tumors, 59- ductography, 11
III Breast ultrasound examination, 1510- cyst aspiration with ultrasound monitoring, 206
IV Biopsy- aspiration of solid formations, 227- wide-bore needle biopsy for cytological
examination, 49- excision, 59
V Cytological examinations, 519
VI Histological examinations, 132
Breast Screening Program Report for 1998, 1999, and 2000 (through August)
Diagnoses
VII Healthy, 1605
VIII Gynecomastia- 12
IX Mastopathy- 4130- diffuse, 2848- nodal, 1282: cystic, 368
fibrous, 384
cystic-fibrous, 530
X Breast cancer, 146:
Stage I, 56 (preclinical form, 27)
Stage II, 53
Stage III, 31
Stage IV, 6
Diagnoses
Breast Screening Program Report for 2000
I Total female patients examined, 27704- railway employees, 21642- screening, 615- diagnosis, 3663
II Mammography- total number of procedures,- needle location of nonpalpable tumors, 14- ductography, 6
III Breast ultrasound examination, 729- cyst aspiration with ultrasound monitoring- 81
IV Biopsy - aspiration of solid formations, 108- with wide-bore needle for histological
examination, 14- excision, 22
V Cytological examinations, 388
VI Histological examinations, 36
Breast Screening Program Report for 2000
Diagnoses
VII Healthy, 731
VIII Gynecomastia, 2
IX Mastopathy- 4216- diffuse, 2775- nodal: cystic, 322
fibrous, 331
cystic-fibrous, 803
X Breast cancer, 72
Stage I, 44 (including 12 nonpalpable)
Stage II, 41
Stage III, 24
Stage IV, 4
Diagnoses
Early breast cancer diagnosis allowed us to:
1. Cure cancer in situ
2. Increase life span of cancer patients in stages I and II
3. Improve the patients’ quality of life over the longer life span by using the most effective approach: organ-preserving surgery combined with chemotherapy and radiotherapy
4. Alleviate psychosocial traumas caused by cancer to family members
5. Decrease treatment costs (government and private)
Early breast cancer diagnosis allowed us to:
Breast Screening Program Report for 2000
Mammography- 4278
• Diagnostics- 3663
• Screening- 615
1. Mastopathy
• Diffuse- 2775 (65,8%)
• Nodal- 1463 (34,7%)
- cystic- 322 (22%)
- fibrous- 331 (23%)
- cystic-fibrous- 803 (53,4%)
2. Breast Cancer- 72 (1,68%)
stage I- 44 (61,1%)
stage II- 41 (56,6%)
stage III- 24 (33,3%)
stage IV- 4 (5,5%)