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Cancer Definition
The abnormal growth of cells without normal control of body.
Types of Cancer1. Malignant Cancer2. Benign Cancer
The Importance of Screening Early screening maximizes the possibility of early diagnosis
Improves the treatment options available
Increases women's survival rates and decreases mortality
Decreases health services cost
Sites of Gynecological CancerBreast CancerCervical CancerEndometrial CancerOvarian CancerVulvar cancer
Breast Cancer
It is one of the common cancers among women including Jordanian women about 800 cases are diagnosed yearly (National Cancer Registery )
Risk Factors of Breast Cancer
Women more than 40 years old Family history of breast cancerPrevious history of breast cancerNo history of pregnancy or first pregnancy
after the age of thirty Never breast feeding a child Long term postmenopausal combined
estrogen and progesterone hormonal therapy
Being obese or overweight after menopauseHistory of overdose of radiation to the chest
Signs and Symptoms of Breast CancerPresence of mass or lumpChange in the color or
temperature of breast tissueChange in breast size or shapeAbnormal secretions from the
nipple Inversion of the nipple or change
in the direction of the nipple Skin erosion or ulceration
Screening Tools of Breast Cancer
1. Monthly self breast examination
2. Clinical breast examination
3. Mammography
4. Magnetic Resonance Imaging (MRI)
Monthly Self Breast Examination It is a method for detecting breast mass
early through inspection and palpation
It is recommended to perform it monthly
Done after the onset of menstrual period one week
If the woman is pregnant or menopause it is performed on the same day each month
Clinical Breast Examination
Examination of breasts by health care provider such as nurses or physicians
Remember
Self breast examination is not alone enough to detect breast cancer , it is associated with mammography
Mammography It is an effective screening tool of
breast cancer It detects about 90 % of breast
cancer in women who are symptoms free
It is more accurate in postmenopausal women
It is a soft tissue X-ray image of the breasts taken with out the injection of contrast medium
When to Do Mammography Once to all women before the age of 40
Every 1 to 2 year for women age 40 and older
What Time To Do MammographyAfter the menstrual period till the middle of the month
In menopause , at the same appointment every 1-2 years
It is not recommended to have mammography during pregnancy and lactation
Preparation for Mammography To refrain from applying lotions powders , deodorants or cosmetics substances Exposure of the upper part of the body
Remember
The risk of radiation exposure with mammography is low , therefore it doesn’t increase the risk of breast cancer.
Magnetic Resonance Imaging (MRI)
It is recommended in younger women who are at high risk for breast cancer
Cervical Cancer
It is the second most common cancer in women , it is a preventable disease if it is diagnosed early because it is slow growing
Risk Factors of Cervical CancerHistory of multiple sexual partners
History of immunosuppressive therapy (chemotherapy ) or immunocompromised state (HIV)
Coitus at an early age Long term oral contraceptive use
Smoking
Screening of Cervical CancerPap smear It is used to screen for the presence of cellular abnormalities by obtaining a sample containing cells from the cervix
It is the method f choice for cervical cancer screening
When to have Pap smear When the women reach the age of
21 ACOG recommended repeat Pap
smear for women between the ages f 21 and 29 every two years .
For women aged 30 years and older , who have had three consecutive negative Pap smears , may extend the interval to every
three years
Remember The women should have avoiding any thing in her vagina for 24 hour in order not to interfere with the accuracy of the test
Endometrial Cancer o One of the most common female
genital cancero Has a high rate of cure , if it is
detected early
Risk Factors of Endometrial CancerIncreased age Obesity Nulliparity History of infertility Menstrual irregularities History of diabetes HpertensionEarly menarche or late
menopause
Remember
Majority of endometrial cancer occurs in postmenopausal women
Signs and symptoms Vaginal bleeding in postmenopausal women not treated with hormone therapy
Screening of Endometrial Cancer Pap smear Pelvic ultrasound to evaluate thickness of endometrium
Endometrial biopsy
Ovarian CancerIt is the most fatal f all cancers ,
it is difficult to diagnose and often spread throughout the pelvis before it is detected
Risk Factors of Ovarian CancerIncreased age
Nulliparity
History of breast cancer
Early menarche or late menopause
Signs and Symptoms of Ovarian CancerIncreased abdominal size
Difficulty eating
Abdominal or pelvic pain
Dyspareunia
Irregular bleeding
Delayed menstruation
Screening of Ovarian Cancer o Have annual ultrasound
examination o CA 125 blood test (a protein
that may indicate the presence of certain gynecological cancer)
Remember
If a palpable mass is noted on routine pelvic examination radiography or ultrasonography is used to confirm diagnosis
Risk Factors of Vulvar CancerChronic vulvar inflammation Smoking
Diabetes Immunosuppression History of lower genital cancer
Signs and Symptoms of Vulvar Cancer
The woman may be presented with:• Pruritus • Lump• Flat lesion which is itching, burning and painful
Screening of Vulvar Cancer
A microscope is designed to look at the vulva and cervix to evaluate tissues