Dibdibang usapan para sa kababaihan

1. Dr. Sheila Sobredo-Demecillo
FELLOW,
Philippine College of Physicians
ASSOCIATE FELLOW,
Philippine Society of Medical Oncology

2. USAPAN
Dibdibang
para sa
Kababaihan

3. Cancer in women
Breast cancer
Gynecologic cancer

4. 1. Breast
2. Cervix
3. Lung
4. Colon/Rectum
5. Ovary
6. Thyroid
7. Liver
8. Leukemia
9. Uterus
10. Stomach
10 Leading Sites of Cancer
in (Females) Most common cancer sites
(both sexes)
1) Lung
2) breast
3) Colorectal
Leading Sites of cancer in males
1) Lung
2) Liver
3) Colorectal

5. ➢ Cells- building blocks of a tissue/organ
➢ Normal cells – orderly growth
➢ Abnormal cells - forms a mass (bukol)
➢ benign or malignant)
➢ Benign - cyst, noncancareous
➢ malignant - abnormal , uncontrolled, spread, metastasise
What is a cell?

7. KANSER SA SUSO
• Ang Pilipinas ang isa sa may pinakamataas na antas ng may
Kanser sa Suso sa buong Asya
• Isa sa kada 13 Filipina ang may tyansang magka Kanser sa
Suso

8. ANATOMY OF THE BREAST
• The female breast lies
between the 2nd and 6th ribs.
• 2/3 of it is superficial to the
pectoralis major, 1/3 to the
serratus ant.
• Components: glandular tissue,
fibrous tissue, fat tissue
ANO ANG KAILANGAN GAWIN?
MAGING PAMILYAR SA INYONG SUSO

9. TWO TYPES OF BREAST EXAMINATION
• Self breast examination (SBE): a screening method used
in an attempt to detect early breast cancer. The method
involves the woman herself looking at and feeling each
breast for possible lumps, distortions or swelling.
• Physician/Clinical breast examination (CBE): a breast
examination done by a health professional (doctor,
nurse, health provider)

10. SELF BREAST EXAMINATION
• Step 1. Begin
by looking at
your breast in
the mirror with
your shoulder
straight and
your arms on
the hips

11. WHAT TO INSPECT
• The appearance of the skin
• The size and symmetry of the breast
• The contour of the breast
• The Nipple
• the size and shape
• any rash, ulceration or discharge
• the direction in which they point

12. APPEARANCE OF THE SKIN

13. SIZE, SYMMETRY, CONTOUR OF THE BREAST
Hands Pressed Against Hips Leaning Forward

14. SIZE,SYMMETRY,CONTOUR OF THE BREAST
Arms at the Sides Arms Raised

15. STEP 2: RAISE YOUR HANDS AND
LOOK FOR THE SAME CHANGES

16. STEP 3: THE NIPPLE

17. STEP 4:
PALPATION (KAPA)
• Next, feel your
breasts while
l y i n g d o w n ,
using your right
hand to feel
your left breast
and then your
left hand to feel
y o u r r i g h t
breast.

18. HOW TO PALPATE ONE’S BREAST
Using the tip of three fingers Palpation…
• Use a firm, smooth
touch with the first
few finger pads of
your hand, keeping
the fingers flat and
together.

19. PALPATING THE BREAST
• Use a circular motion about the size of a
quarter.
• Cover the entire breast from top to bottom,
side to side ---- from collarbone to the top of
the abdomen and from the armpit to the
cleavage of the breast.

20. WAYS OF PALPATING THE BREAST
• Circles. Begin at the nipple, moving in a larger and larger
circles until you reach the outer edge of the breast.
• Lines. You can also move your fingers up and down vertically,
in rows. This up and down approach seems to work best with
most women.
• Wedges. Starting at the outer edge of the breast, move your
fingers toward the nipple and back to the edge. Check whole
breast covering one small wedge shaped section at a time.

21. METHODS OF BREAST PALPATION

22. THREE LEVELS OF PRESSURE TO EXAMINE
THE BREAST:
• Light Pressure: to examine the tissue closest
to the skin.
• Medium Pressure: to feel a little deeper
• Firm Pressure: to feel deeper tissue closer to
the chest wall.

23. BREAST PALPATION: “UP AND DOWN
APPROACH”

24. BREAST PALPATION…
• Finally, feel your breast while you are standing or
sitting.
• Many women, find that the easiest way to feel their
breast is when their skin is wet and slippery so they
like to these steps in the shower.
• Cover your entire breast using the same hand
movements described in step 4.

25. BREAST PALPATION IN THE SHOWER.

26. 5-7days after the start of your period. That's when your
breasts are least likely to be tender or swollen.
➢ Your breast tissue undergoes changes each month
during your menstrual cycle. Changes in hormone levels
associated with menstruation cause your breasts to
swell.
➢ Once your period starts, the swelling subsides and your
breasts return to normal.
What's the best time for breast self-exams?

27. PHYSICIAN/CLINICAL
BREAST EXAMINATION
PAGSUSURI SA SUSO NG ISANG
DOKTOR OR HEALTHWORKER

28. GENERAL APPROACH
• Understand that the patient could be
embarassed.
• Communicate with your patient.
• Be gentle.
• Better to examine a week or two after
menstration.

29. GET A SHORT HISTORY
• Pain
• Lump
• Diffuse Swelling
• Nipple discharge
• Risk Factor

30. INSPECTION
• Disrobed up to the waist in the sitting position.
• Look for the appearance of the skin.
• The size and symmetry of the breast.
• The contour of the breast.
• The nipple : size and shape; the direction in which it
points; any rash or ulceration; any discharge

31. STEP 1: DISROBED UP TO THE WAIST IN THE
SITTING POSITION
DO INSPECTION WITH BOTH ARMS RAISED.

32. PHYSICIAN BREAST
EXAMINATION
STEP 2: PALPATION
Lying position with a
small pillow under
the patient’s
shoulder on the side
to be examined
Ask her to rest her
arm over her head.

33. PHYSICIAN BREAST
EXAMINATION:
PALPATION
Proceed quadrant by
quadrant, not to
forget the areola and
the tail 0f the axilla.

34. PALPATE FOR NODULES
• Location (by quadrant or by clock)
• Size in cm.
• Shape and Consistency
• Delineation
• Tenderness
• Consistency

35. PHYSICIAN BREAST
EXAMINATION
THE NIPPLE
Discharge:
Milky: hypothyroidism
prolactinoma, drugs
Bloody: papilloma,
Paget’s Disease

36. PHYSICIAN BREAST
EXAMINATION:
THE AXILLA
•The patient’s forearm is
rested across the
examiner’s forearm.
•An alternative is to ask
the patient to rest their
hand on the examiner’s
shoulder.

37. PHYSICIAN BREAST
EXAMINATION: THE
AXILLA
The purpose is to search
for lymph nodes.
Complete the Lymph
node (kulani) search by
examining the
supraclavicular and
infraclavicular area.

38. CANCER
SITE
POPUL
ATION
PROCEDURE FREQUENCY
B
R
E
A
S
T
Women
20 y.o.
BSE Starting early 20’s,women be told of
benefits/limitations of BSE, emphasizing
prompt reporting of any new breast Sx’s
to a health prof. Those who chose BSE
receive instruction& have technique
reviewed during periodic health exam.
It’s acceptable for women to choose
not to do or do BSE regularly.
Women
20-39
y.o.
CBE Women at 20’s&30’s, recommended that
CBE be part of periodic health exam, at
least every 3yrs. Asxtic women ≥40yo
should receive CBE as part of periodic
health exam preferable annually
ACS 2017 RECOMMENDATIONS for BREAST CA
SCREENING
CA CANCER J CLIN 2017

39. ANONG KAILANGAN GAWIN?
✓ Magpa Konsulta sa Doktor
✓ Sa mga babae edad 40 years pataas –
• Magpa-Mammogram taon-taon (Ayon sa World Health Organization (WHO)
• Ang mammography ay mabisang pangsala o pang tuklas ng mga bagong kaso ng
kanser sa Suso kumpara sa Self-physical and Clinical Breast Examination.
• Ultrasound of the breast- pat me suspetsa na budok

40. MAMMOGRAM

41. Women should do the exam once a month
If they:
➢have gone through menopause
➢Are pregnant
➢Are breastfeeding
➢Have breast implants

42. ANONG KAILANGAN GAWIN?
✓ Maging Malusog
• Umiwas sa paninigarilyo at pag-inom ng alak
• Umiwas sa masyadong mataas sa asukal at ma mantikang pagkain
• Mag exercise regularly

43. TREATMENT OF BREAST CANCER
➢Surgery
➢Chemotherapy
➢Radiation
➢Supportive care
● Pain control
● Nutritional support
● Nursing care

44. ➢ Oncology
the study of tumors or masses
➢ Oncologist
the person who treats the disease
➢ Cancer therapy team
➢ Medical oncologist
➢ Surgical oncologist
➢ Radiation oncologist

45. 1) surgery

46. 2) chemotherapy

47. 3) radiotherapy

48. 4) Palliative treatment
● Pain control
● Nutritional support
● Nursing care
● Other supportive care

49. Questions?

50. TAKE HOME MESSAGE
• Pakatapos maintindihan at matutunan ang pagsusuring suso, ito
ay dapat din ituro sa iba, sa magkamaganak, kaopisina,
kasambahaykapuso at kapamilya
• Layunin ng pagtuturo nito ang magkaroon ng kaalaman upang
mapunang maagaang mga problema sa suso katulad ng breast
kanser.
• MAGTULUNGAN TAYO.
• Ang mga oncologist (medical/radiation/gyncology/surgical) at
• Ang PSMO ay KAAGAPAY NYO. !

52. Thank You!!!