GYNECOLOGY SERVICES

• • Screening mammography is not recommended in women <40 years of age because the incidence of breast cancer is low in this age group and the “performance characteristics” of mammography are poor.
• Mammography is recommended every one or two years for women aged 50-69. This could also be recommended to women 40-49 years old after being informed about the benefits and potential consequences of false positives (or negative) findings.
• • Previously (until 2009), the relevant recommendation for screening mammograms was for women ≥40 years of age.
• • The previous recommendation was subsequently changed by several scientific societies and mammography screening was recommended in women ≥50 years of age. The American Cancer Society (ACS) challenged the recommendation with a “strong recommendation” to start screening mammograms at age 45. The results of the previous meta-analysis were confirmed by a recent large prospective study from the UK, which includes the as a bibliographic reference. This prospective study of nearly 161,000 women, at a follow-up of 23 years, concluded that starting mammograms at ≥40 years of age implies a reduction in mortality from breast cancer.
• • Mammographic screening is recommended for women 70-74 years of age and could be recommended for women ≥75 years of age if life expectancy is ≥10 years [2/C]. [2/C]Special recommendation (“qualified” recommendation) for mammographic screening, if the life expectancy is ≥10 years, ACS also does. However, in older women, this recommendation could also be made in women with a life expectancy of ≥5 years.
• In women with a strong family history of breast cancer and those with proven BRCA mutations, annual mammographic screening and MRI screening of breasts is recommended, e.g. first mammogram and 6 months after MRI.
• Self-examination is not recommended as a screening method for Medium-risk women.
• The role of clinical breast screening as part of screening in Medium-risk women is not well known because large randomized screening studies have included screening mammography together with clinical screening rather than separately. However, some contemporary sources recommend against the use of Clinical Breast Examination and this recommendation is valid in the USA and Canada, while recent data from France have reached the same conclusion.
• • Ultrasound examination of the breasts is mainly done for diagnostic reasons following a suspicious imaging or clinical finding.
• • Parallel mammographic and ultrasound screening, despite the increased sensitivity to the detection of suspected malignancy findings (i.e. the increase in the detection of breast cancers, especially in young women and women with dense breasts), would also entail an increase in false positive findings.

From the guidelines of the Hellenic Obstetrics Society No 62, May 2022.

See more at: https://hsog.gr/wp-content/uploads/2023/09/Νο-62-2.pdf

One of the main problems that concern the modern woman is the presence of a nodule in her breast, which suddenly invades her daily life and is a source of various emotions that can lead her from panic and fear to hiding.

But it does not mean that every lump found in the breast is necessarily malignant (cancer). In contrast, most lumps are benign tumors and do not threaten life. Fibroadenomas and benign cysts-fibrocystic mastopathy etc., belong to this category.

It is also possible to have findings on ultrasound or mammography without however being palpable.

The investigation is exclusively of the doctor, who can responsibly inform you and direct you for the appropriate screening (ultrasound*, mammography, FNA*, Core-Biopsy * or monitoring).

80% of cases occur in postmenopausal women. The risk of developing breast cancer increases with age.

The recent incidence rate is quite large to frightening and is that ” almost 1 in 9 women will develop breast cancer during their life.” Not all women are candidates for this disease. Statistics today, through the general population control, characterize some risk groups with an increased likelihood of developing breast cancer compared to the general population control.

*These tests are carried out in our clinic.

Two genes associated with breast cancer are BRCA1 and BRCA2.

These genes are present in 85% of families with 4 or more cases of breast cancer under the age of 60. But only 5% of all breast cancers are caused by genes. This is still under investigation by scientists.

Known factors that increase the risk of breast cancer are:

• The white race
• Sex
• Age
• History of breast cancer
• Proven benign breast disease from history
• Absence of breastfeeding for a long time
• Active use of hormone replacement therapy or contraceptives
• History of breast cancer in the family
• Women without or with few children
• Having children at older ages (especially over 30)
• Early puberty
• Menopause in old age
• Obesity (for postmenopausal women only)
• Consumption of increased amounts of alcohol

It should be stressed that risk factors are elements that indicate a greater likelihood of getting a particular disease and not a certainty of developing a disease. This means that one can collect several such factors and never get sick, and on the contrary someone else, without a single one, gets sick!

Obviously we can’t change either our family history, or our race or our age and our gender; they are passed on in our genes!

However, it is possible to reduce the risk of breast cancer by changing some of our habits, changing our lifestyle, such as:

• Balanced diet rich in vegetables and fruits (rich in vitamins).
• Restriction of alcohol consumption.
• Control body weight so that it does not increase

These are some important steps that every woman can take to prevent the onset of the disease.

Regarding the use of contraceptives or hormone replacement therapy it is wise to inform your doctor so that other possible risk factors are taken into account to make the best possible decision.

Preventive medicine and general screening of the population are the biggest factor in reducing breast cancer death along with the correct information-information of women.

Self-examination of the breasts should be done at very regular intervals (per month), usually after the age of 30, in the first 10 days of the cycle. The woman should first observe the breasts standing before the mirror with her hands on the hips pressing them slightly.

Asymmetry, the appearance of mass and skin retraction or nipple discharge can be detected. After being supine he can palpable each breast with the other hand.

A medical examination of the breasts-palpation – should be submitted to women every 2-3 years from the age of 20.

In practice, it is convenient to perform the check once a year in the context of the rest of the preventive gynecological check. It is very useful to perform breast ultrasound as an aid in palpation.

Mammography should be done every year after the age of 40.