prevention and control of breast cancer
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Prevention and Control of Breast Cancer
Dr Rajkumar PatilAsstt.Prof.,Community MedicineAVMCH,Pondicherry
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Epidemiology of Breast cancer
• Global Incidence: 9 lac/yr ; deaths:3.5 lac/yr (approx)• In females:
Commonest in Developed countries
2nd common in India
Risk FactorsAge: • 35- 50 yr • Mean age of occurrence in India:42 yr,
in developed countries:53 yr• Bimodal trend: dip at 45,increase after 65
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• Family history of Breast cancer
• Parity: elderly primigravida, nullipara
• Early menarche & late menopause
• Hormonal: Elevated estrogen & progesterone
levels, OCP intake(before 25 yrs)
• Marital status: Unmarried
• Higher SES: Delayed age of marriage
• Prior breast biopsy & radiation
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Prevention and control of Breast cancer
Primary prevention • Maintain a healthy weight• Regular physical activity • Average age at menarche can be increased by:Reduced fat intake before menarcheStrenuous exercise to inhibit ovulation
Secondary prevention • Early detection by Screening• Treatment
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Screening for breast cancer
• Breast self examination(BSE)• Examination by physician• Thermography• Mammography
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American Cancer Society Recommendations
• Mammogram– Yearly for women over 40 years of age
• Clinical breast exam– Performed by a doctor– Every 3 years for women 20 to 39– Yearly for women over 40 years of age
• Breast self-exam (BSE)– Monthly
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Breast Self-Exam (BSE)
When to do BSE?• Before menopause– 2-3 days after menstrual period
• After menopause - Pick the same day every month
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Breast Self-Exam
• Feel gently for any lumps or changes under the skin by fingers
In the Shower
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Breast Self-Exam(BSE)
• Place arms at sides & clasp behind your head Look for:
– unusual discharge– dimpling – changes in skin texture– changes in shape
• Squeeze both nipples and look for discharge
Before a Mirror
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Breast Self-Exam
Lying Down
Lie flat on your back
Move fingers in an up & down pattern
Rest your arm on a firm surface
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Abnormal Breast Changes
Notify your
Doctor
Lump in the breast
Changes in breast size or shape
Nipple dischargeor tenderness
Changes in theskin of the breast
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The lump is more likely to be cancerous if :
• It is hard and is not discrete• It is fixed in the breast; it does not move • The overlying skin show–dimpling–peau d'orange–nipple retraction
Breast Self Examination
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Mammography
• X-ray of the breast to detect breast cancer• Can detect a breast lump before it can
be felt• Mammograms reduce the risk of dying from breast cancer
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Disadvantages of Mammography
• Exposure to radiation (500 milliroentgen)
• Mammography does not find all cancersSensitivity is 83-97%, depending on age
• Mammography has a relatively high false positive rate (5-10 cases per case detected)
• Mammography requires skilled manpower
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Thank You…