In principle, prevention strategies, prevention strategies are grouped into three major groups, namely the prevention of the environment, on pejamu, and the milestone. Almost every epidemiolog agree that the most effective prevention for the disease is not contagious health promotion and early detection. Similarly, in breast cancer, the prevention of other forms:
Primary prevention in the primary prevention of breast cancer is one form of health promotion as is done in the "healthy" through efforts to avoid the resignation of keterpaparan on various risk factors and implement healthy lifestyles.
Prevention of secondary made against individuals who have exposed to the risk of breast cancer. Each woman is normal and have normal menstrual cycle is a population at risk of breast cancer. Secondary prevention is done by making early detection. Some methods of early detection continues to progress. Screening through mammografi have claimed accuracy of 90% of all breast cancer sufferer, but keterpaparan continuously on mammografi in healthy women is one of the risk factors, the occurrence of breast cancer.
Therefore, screening with mammografi still can be done with some consideration include:
• Women who have reached the age of 40 years is recommended to do cancer risk assessement survey.
• In women with risk factors to get a referral to mammografi done every year.
• Women normally receive a referral mammografi every 2 years to reach the age of 50 years. Foster and Constanta found that breast cancer mortality by fewer women on the inspection realized (Breast Self-Examination) than not. Although aware of sensitivity to detect breast cancer is only 26%, when combined with mammografi the sensitivity to detect the early to be 75%.
Prevention participations usually directed at individuals who have suffered positive breast cancer. Handling the right people with breast cancer in accordance with stadiumnya will be able to reduce kecatatan and extend life expectancy sufferer. Prevention is an important place to improve the quality of life of people with the disease and prevent complications and to continue treatment.
Actions treatment can be the operation although no effect on the resilience of many people live. When the cancer has bermetastasis far, the action is done with chemotherapy sitostatika. At the stadium, the only form of treatment given simptomatik and are encouraged to seek alternative treatment.
Saturday, November 22, 2008
Treatment breast cancer
There are some cancer treatment breast cancer treatment that implementation depends on many stadium clinic disease (Tjindarbumi, 1994), namely:
Mastektomi Mastektomi is breast operations. There are 3 types of mastektomi (Hirshaut & Pressman, 1992):
Modified Radical Mastectomy, the removal of the entire breast surgery, breast network in the sternum, clavicle and rib bones, and benjolan around the armpit.
Total (Simple) Mastectomy, the removal of the entire breast surgery, but not the glands in the armpit.
Mastectomy serious, the operations part of the breast. Usually referred to as lumpectomy, the removal of the only on the network that contain cancer cells, not the entire breast. This operation is always followed by the provision of radiotherapy. Lumpectomy is usually recommended in patients with large tumornya less than 2 cm and located on the edge of the breast.
Illumination / radiation, the radiation is referred to the process of lighting on the areas affected by cancer by using X-rays and gamma rays, which aims to kill cancer cells remaining in the breast after the operation (Denton, 1996). The effects of this treatment the body to become weak, decreased appetite, the color of the skin around the breast to be black, and Hb and leukosit tend to decline as a result of radiation.
Chemotherapy Chemotherapy is the process of medication in the form of anti-cancer pill or capsule or liquid through Doofus which aims to kill cancer cells. Not only in breast cancer cells, but also in the whole body (Denton, 1996). The effects of chemotherapy patients are experiencing nausea and vomiting and hair fall because of the influence of drugs given during chemotherapy.
Mastektomi Mastektomi is breast operations. There are 3 types of mastektomi (Hirshaut & Pressman, 1992):
Modified Radical Mastectomy, the removal of the entire breast surgery, breast network in the sternum, clavicle and rib bones, and benjolan around the armpit.
Total (Simple) Mastectomy, the removal of the entire breast surgery, but not the glands in the armpit.
Mastectomy serious, the operations part of the breast. Usually referred to as lumpectomy, the removal of the only on the network that contain cancer cells, not the entire breast. This operation is always followed by the provision of radiotherapy. Lumpectomy is usually recommended in patients with large tumornya less than 2 cm and located on the edge of the breast.
Illumination / radiation, the radiation is referred to the process of lighting on the areas affected by cancer by using X-rays and gamma rays, which aims to kill cancer cells remaining in the breast after the operation (Denton, 1996). The effects of this treatment the body to become weak, decreased appetite, the color of the skin around the breast to be black, and Hb and leukosit tend to decline as a result of radiation.
Chemotherapy Chemotherapy is the process of medication in the form of anti-cancer pill or capsule or liquid through Doofus which aims to kill cancer cells. Not only in breast cancer cells, but also in the whole body (Denton, 1996). The effects of chemotherapy patients are experiencing nausea and vomiting and hair fall because of the influence of drugs given during chemotherapy.
Cancer
Disease with the fibrokistik In the women adenosis, fibroadenoma and fibrosis, there is no increased risk of breast cancer occurrence. In hiperplasis and papiloma, slightly increased the risk 1.5 to 2 times. Meanwhile, in the hiperplasia atipik, the risk increased to 5 times.
Obesity There is a positive relationship between body weight and body shape with breast cancer in women post-off. Variations of the frequency of cancer in these countries in West and not the West and frequency changes after the migration indicates that there is the influence of diet on the occurrence of this malignancy.
Consumption of fat consumption is estimated to be fat as a risk factor of the occurrence of breast cancer. Willet et al., Prospective study conducted during the 8 years the consumption of fat and fiber in conjunction with the risk of breast cancer in women age 34 to 59 years old.
Radiation Exposure with ionization radiation during or after the occurrence of pubertas increase the risk of breast cancer. From several studies conducted concluded that the risk of cancer related to radiation dose with the Linear and age when the occurrence of exposure.
Family history and genetic factors, family history is an important component in the history of the screening will be conducted for breast cancer. There is a growing risk of violence in this family of women who suffer breast cancer. In genetic studies found that breast cancer associated with certain genes. When there is a BRCA 1, a suseptibilitas breast cancer genes, the probability for breast cancer is 60% in the age of 50 years and 85% in the age of 70 years.
Obesity There is a positive relationship between body weight and body shape with breast cancer in women post-off. Variations of the frequency of cancer in these countries in West and not the West and frequency changes after the migration indicates that there is the influence of diet on the occurrence of this malignancy.
Consumption of fat consumption is estimated to be fat as a risk factor of the occurrence of breast cancer. Willet et al., Prospective study conducted during the 8 years the consumption of fat and fiber in conjunction with the risk of breast cancer in women age 34 to 59 years old.
Radiation Exposure with ionization radiation during or after the occurrence of pubertas increase the risk of breast cancer. From several studies conducted concluded that the risk of cancer related to radiation dose with the Linear and age when the occurrence of exposure.
Family history and genetic factors, family history is an important component in the history of the screening will be conducted for breast cancer. There is a growing risk of violence in this family of women who suffer breast cancer. In genetic studies found that breast cancer associated with certain genes. When there is a BRCA 1, a suseptibilitas breast cancer genes, the probability for breast cancer is 60% in the age of 50 years and 85% in the age of 70 years.
Risk Factors
According to the Risk Factors Moningke specific breast cancer is still not known, but there are many factors which is estimated to have contributed to the occurrence of breast cancer are:
Reproductive Characteristics of reproductive factors associated with the occurrence of breast cancer risk is nuliparitas, young age at menarche, off in the older age, pregnancy and the first in the age old. The main risk of breast cancer is increasing age. It is estimated, the period between the first occurrence of menstruation at the age of first pregnancy is a window of the initiation of breast cancer. The anatomy and functional, the breast will atrofi with increasing age. Less than 25% of breast cancers occur in the period before the off so early is estimated to cause tumors occur long before the occurrence of clinical changes.
The use of hormones, hormone exogen associated with the occurrence of breast cancer. Reports from the Harvard School of Public Health states that there is an increase of breast cancer, which means the users of estrogen replacement therapy. A metaanalisis stated that although there is no risk of breast cancer in the oral contraceptive users, women who use this drug for a long time have a higher risk for cancer experienced this before off.
Reproductive Characteristics of reproductive factors associated with the occurrence of breast cancer risk is nuliparitas, young age at menarche, off in the older age, pregnancy and the first in the age old. The main risk of breast cancer is increasing age. It is estimated, the period between the first occurrence of menstruation at the age of first pregnancy is a window of the initiation of breast cancer. The anatomy and functional, the breast will atrofi with increasing age. Less than 25% of breast cancers occur in the period before the off so early is estimated to cause tumors occur long before the occurrence of clinical changes.
The use of hormones, hormone exogen associated with the occurrence of breast cancer. Reports from the Harvard School of Public Health states that there is an increase of breast cancer, which means the users of estrogen replacement therapy. A metaanalisis stated that although there is no risk of breast cancer in the oral contraceptive users, women who use this drug for a long time have a higher risk for cancer experienced this before off.
Clinical symptoms
Clinical symptoms of clinical symptoms of breast cancer can be benjolan
• Generally, the breast form that is not benjolan pain in the breast. Benjolan was initially small, the longer the larger, and adheres to the skin or cause changes in the skin of the breast or nipple.
• erosion or eczema nipple Skin or nipple was becoming interested in (retraksi), pink or brownish-kecoklat to become oedema to the skin look like orange leather (peau d'orange), contract, or arising ulcer (ulkus) on the breast. Ulcer that the longer the increasingly large and deep that it can destroy the entire breast, often smelly, and easy bleeding.
• bleeding in the nipple.
• Pain or pain generally arise if a new tumor is large, has emerged sore, or if there is metastase to the bone-bone.
• Then arise lymph gland enlargement in the armpit, swelling (ederma) on the arm, and the spread of cancer throughout the body (Handoyo, 1990). Breast cancer is more easily identified with know Heagensen criteria operbilitas as follows:
• ederma there are broad in the breast skin (about 1 / 3 wide leather breast);
• nodul satellite on the skin of the breast;
• type of breast cancer mastitis karsinimatosa;
• there is a model parasternal ;
• there nodul supraklavikula;
• ederma of arms;
• the metastase far;
• and there are two of the signs Locally advanced, namely ulserasi skin, ederma skin, skin terfiksasi on the wall toraks, lymph gland aksila more than 2.5 cm in berdiameter , And lymph gland aksila cohere
• Generally, the breast form that is not benjolan pain in the breast. Benjolan was initially small, the longer the larger, and adheres to the skin or cause changes in the skin of the breast or nipple.
• erosion or eczema nipple Skin or nipple was becoming interested in (retraksi), pink or brownish-kecoklat to become oedema to the skin look like orange leather (peau d'orange), contract, or arising ulcer (ulkus) on the breast. Ulcer that the longer the increasingly large and deep that it can destroy the entire breast, often smelly, and easy bleeding.
• bleeding in the nipple.
• Pain or pain generally arise if a new tumor is large, has emerged sore, or if there is metastase to the bone-bone.
• Then arise lymph gland enlargement in the armpit, swelling (ederma) on the arm, and the spread of cancer throughout the body (Handoyo, 1990). Breast cancer is more easily identified with know Heagensen criteria operbilitas as follows:
• ederma there are broad in the breast skin (about 1 / 3 wide leather breast);
• nodul satellite on the skin of the breast;
• type of breast cancer mastitis karsinimatosa;
• there is a model parasternal ;
• there nodul supraklavikula;
• ederma of arms;
• the metastase far;
• and there are two of the signs Locally advanced, namely ulserasi skin, ederma skin, skin terfiksasi on the wall toraks, lymph gland aksila more than 2.5 cm in berdiameter , And lymph gland aksila cohere
Stadium cancer
After each faktot T,. N, M is established, the third factor is then merged and acquired stadium cancer as follows:
* Stadium 0: T0 N0 M0
* Stadium 1: T1 N0 M0
* Stadium II A: T0 N1 M0 / T1 N1 M0 / T2 N0 M0
* Stadium II B: T2 N1 M0 / T3 N0 M0
* Stadium III A: T0 N2 M0 / T1 N2 M0 / T2 N2 M0 / T3 N1 M0 / T2 N2 M0
* Stadium III B: T4 N0 M0 / T4 N1 M0 / T4 N2 M0
* Stadium III C: Each T N3 M0
* IV Stadium: Each Each T-N-M1
* Stadium 0: T0 N0 M0
* Stadium 1: T1 N0 M0
* Stadium II A: T0 N1 M0 / T1 N1 M0 / T2 N0 M0
* Stadium II B: T2 N1 M0 / T3 N0 M0
* Stadium III A: T0 N2 M0 / T1 N2 M0 / T2 N2 M0 / T3 N1 M0 / T2 N2 M0
* Stadium III B: T4 N0 M0 / T4 N1 M0 / T4 N2 M0
* Stadium III C: Each T N3 M0
* IV Stadium: Each Each T-N-M1
In breast cancer, TNM assessment as follows:
In breast cancer, TNM assessment as follows:
• T (tumor size), the size of the tumor:
T * 0: not found the primary tumor
T * 1: the size of the tumor diameter of 2 cm or less
* Q 2: the size of the tumor diameter of between 2-5 cm
* Q 3: diameter of the tumor size> 5 cm
* Q 4: does the size of tumors, but there is the spread to the skin or chest wall or both, can be a sore, ederma or swelling, skin redness or a breast benjolan small skin tumors outside the main
• N (node), the regional lymph glands (KGB):
N * 0: there is no Metastasis in the armpit at the regional KGB / aksilla
N * 1: there Metastasis to the KGB aksilla that can still be moved
N * 2: there Metastasis to the KGB aksilla difficult moved
N * 3: there Metastasis to the KGB in the clavicle (supraclavicula) or the KGB in the mammary International in the bone near the sternum
• M (Metastasis), the spread of far:
* M x: Metastasis far can not be assessed
* M 0: there is not much Metastasis
M * 1: there are far Metastasis
• T (tumor size), the size of the tumor:
T * 0: not found the primary tumor
T * 1: the size of the tumor diameter of 2 cm or less
* Q 2: the size of the tumor diameter of between 2-5 cm
* Q 3: diameter of the tumor size> 5 cm
* Q 4: does the size of tumors, but there is the spread to the skin or chest wall or both, can be a sore, ederma or swelling, skin redness or a breast benjolan small skin tumors outside the main
• N (node), the regional lymph glands (KGB):
N * 0: there is no Metastasis in the armpit at the regional KGB / aksilla
N * 1: there Metastasis to the KGB aksilla that can still be moved
N * 2: there Metastasis to the KGB aksilla difficult moved
N * 3: there Metastasis to the KGB in the clavicle (supraclavicula) or the KGB in the mammary International in the bone near the sternum
• M (Metastasis), the spread of far:
* M x: Metastasis far can not be assessed
* M 0: there is not much Metastasis
M * 1: there are far Metastasis
Breast cancer
Breast cancer is breast cancer on the network. This is the most common type of cancer that women suffer. Men can also contract breast cancer, although the probability is smaller than 1 in 1000. The most common treatment is surgery and, if necessary followed by chemotherapy and radiation.
Cancer is a condition in which cells have lost control and the normal mechanisms, so that growth is not normal, fast and not restrained. (http://www.mediasehat.com/utama07.php)
Breast cancer (Carcinoma mammae) is a malignant disease that neoplasma derived from the parenchyma. This disease by Word Health Organization (WHO) to be included in the International Classification of Diseases (ICD) with the code number 17 (http://www.tempo.co.id/medika/arsip/082002/pus-3.htm
Patofisiologi
Tuesday transformation-formed cancer cells from normal cells in a complex process called transformation, which consists of the initiation and promotion phase.
at the initiation stage occurs a change in the genetic material of cells that provoke the cells to become malignant. Changes in the genetic material of cells is caused by an agent called Carcinogen, which can form chemicals, viruses, radiation (irradiation) or sunlight.
but not all cells have the same sensitivity to a Carcinogen. aberration in the genetic material of cells or other called promoter, causing the cells more vulnerable to a Carcinogen. even physical interference menahunpun can make cells become more sensitive to experience a malignancy.
on the stage of the campaign, a cell that has experienced a change initiatives will become malignant.
Cells not pass through initiation stage will not be affected by the campaign. because it required several factors to the occurrence of violence (a combination of the sensitive cells and a Carcinogen).
Stadium Stadium cancer is a disease condition results from a doctor diagnose a disease when the cancer patient who suffered, is the extent to which the level of the spread of cancer is better to the organ or tissue around and far into the spread of the Stadium is only known in the malignant tumor or cancer and not in the tumor tame.
To determine a stadium, should be conducted clinical examination and inspection by the other supporting histopatologi or PA, X-rays, USG, and, if possible with the CT scan, etc. scintigrafi. Many ways to determine the stadium, but for many the most current stadium cancer is based on the TNM classification system recommended by the UICC (International Union Against Cancer from the WHO or the World Health Organization) / AJCC (American Joint Committee on cancer sponsored by the American Cancer Society and the American College of Surgeons).
In the TNM system of assessed three main factors, namely "Q", namely tumor size or tumor size, "N", namely node or regional lymph glands and "M" Metastasis is the spread or distant. The third factor Q, N, M votes either be done before clinical operations, also conducted after the operation and inspection histopatologi (PA)
Cancer is a condition in which cells have lost control and the normal mechanisms, so that growth is not normal, fast and not restrained. (http://www.mediasehat.com/utama07.php)
Breast cancer (Carcinoma mammae) is a malignant disease that neoplasma derived from the parenchyma. This disease by Word Health Organization (WHO) to be included in the International Classification of Diseases (ICD) with the code number 17 (http://www.tempo.co.id/medika/arsip/082002/pus-3.htm
Patofisiologi
Tuesday transformation-formed cancer cells from normal cells in a complex process called transformation, which consists of the initiation and promotion phase.
at the initiation stage occurs a change in the genetic material of cells that provoke the cells to become malignant. Changes in the genetic material of cells is caused by an agent called Carcinogen, which can form chemicals, viruses, radiation (irradiation) or sunlight.
but not all cells have the same sensitivity to a Carcinogen. aberration in the genetic material of cells or other called promoter, causing the cells more vulnerable to a Carcinogen. even physical interference menahunpun can make cells become more sensitive to experience a malignancy.
on the stage of the campaign, a cell that has experienced a change initiatives will become malignant.
Cells not pass through initiation stage will not be affected by the campaign. because it required several factors to the occurrence of violence (a combination of the sensitive cells and a Carcinogen).
Stadium Stadium cancer is a disease condition results from a doctor diagnose a disease when the cancer patient who suffered, is the extent to which the level of the spread of cancer is better to the organ or tissue around and far into the spread of the Stadium is only known in the malignant tumor or cancer and not in the tumor tame.
To determine a stadium, should be conducted clinical examination and inspection by the other supporting histopatologi or PA, X-rays, USG, and, if possible with the CT scan, etc. scintigrafi. Many ways to determine the stadium, but for many the most current stadium cancer is based on the TNM classification system recommended by the UICC (International Union Against Cancer from the WHO or the World Health Organization) / AJCC (American Joint Committee on cancer sponsored by the American Cancer Society and the American College of Surgeons).
In the TNM system of assessed three main factors, namely "Q", namely tumor size or tumor size, "N", namely node or regional lymph glands and "M" Metastasis is the spread or distant. The third factor Q, N, M votes either be done before clinical operations, also conducted after the operation and inspection histopatologi (PA)
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