breast disease screening is must

1. Screening
When
where
why
Dr.
Kawita
Bapat

2.
Dr.
Kawita
Bapat
• MS FICOG
• Director Of One Centre For Gynecological Excellence
• Senior Practicing Obgyn At Indore
• One Day Hysterectomy Specialist
• FOGSI Affiliated Colposcopy Center
• Vice President (Elect) FOGSI,2021
• President Indore Menopause Society
• Vice President AMPOG
• President MP Chapter Of Vaginal Surgeons
• Secretory MP IAGE
• Executive Member ISAR
• Executive Member IAGE
• Chairperson Breast Committee FOGSI 16-18
• Past President OBGYN Society INDORE
• GOVRNING COUNCIL MEMBER ICOG
• Past President LIONS Club INDORE
• Award Winner Of Nayika Indore And Captain Of Industry
• bapatkawita@gmail.Com
• www.Onegynae.Com
• Bapat Hospital Bapat Choraha Sukhlia Indore
+919826055666

4. • Breast
cancer
is
an
increasing
health
problem
in
India.
• The
trend
of
rising
incidence
rates
is
likely
to
con9nue
due
to
further
changes
in
lifestyle
factors
such
as:
-­‐
Childbearing
-­‐
Dietary
habits
-­‐
Early
Menarche
-­‐
Late
Marriages
-­‐
Less
BreasBeeding
-­‐
Economic
evolu9on
of
country

5. JNCI:
Journal
of
the
Na1onal
Cancer
Ins1tute,
Volume
100,
Issue
18,
17
September
2008,
Pages
1270–1271,
hOps://doi.org/10.1093/jnci/djn303
• The current age-standardized rate is 19.1 per 100 000
per annum, but, in contrast to what is observed in
developed countries, the incidence rate peaks below
age 50. Stage distribution at presentation is less
favorable than in developed countries, with 50%–70%
of cases presenting for treatment being locally
advanced , and the availability and level of facilities for
treatment are variable ..

6. JNCI:
Journal
of
the
Na1onal
Cancer
Ins1tute,
Volume
100,
Issue
18,
17
September
2008,
Pages
1270–1271,
hOps://doi.org/10.1093/jnci/djn303
• Survival rates are consequently low , and
there is a clear need to improve the
availability and accessibility of facilities for
diagnosis and treatment, as well as education
and awareness .

7. Screening
test
should
be
• Easy
To
Use
• Cost
Effec9ve
• Available
• Accessible
• Reproducible
• Can
Be
Applied
In
The
Field
Set
Up,
• Good
Sensi9vity
And
Specificity
• Branded
awareness

8.
8
Clinical
and
self
breast
examina?on
Mammography
Gene?c
screening
Ultrasound
Magne?c
resonance
imaging
Molecular
breast
imaging

10. USPSTF
ACS
ACOG
Recommends
against
clinicians
teaching
women
how
to
perform
Breast
self-­‐
examina9on
Recommends
against
clinicians
teaching
women
how
to
perform
Breast
self
examina9on
Consider
Breast
self
examina?on
instruc?on
for
high-­‐risk
pa9ents.
Breast
self-­‐awareness
should
be
encouraged
and
can
include
Breast
self-­‐examina9on
Recommenda?ons
for
Breast
Cancer
Screening

11. Benefits
&
Harms
of
BSE

12. Gene9c
Screening
• One
or
more
rela9ves
with
breast
cancer
diagnosed
before
age
50
• Two
or
more
rela9ves
diagnosed
with
breast
cancer
at
any
age
• One
or
more
rela9ves
with
ovarian
cancer
• One
or
more
rela9ves
with
male
breast
cancer
• Two
or
more
rela9ves
with
prostate
cancer
or
pancrea9c
cancertwo
or
more
rela9ves
with
brca-­‐associated
cancers
• A
history
of
breast
cancer
at
A
young
age
in
two
or
more
blood
rela9ves,
such
as
your
parents,
siblings
or
children
• A
rela9ve
with
A
known
BRCA1
or
BRCA2
muta9on

15. mammogram
• Biennial
screening
mammography
is
recommended
for
women
in
the
50–74
years
age
group,
but
is
available
to
all
women
aged
over
40
years.
• Imaging
plays
a
major
role
in
the
diagnosis,
treatment,
and
follow-­‐up
of
breast
cancer.
• Findings
that
require
further
assessment
will
be
detected
both
at
screening
and
cura9ve
mammography

16. Digital
Mammogram
vs.
Tradi?onal
X-­‐Ray
Mammogram
Digital Mammogram Traditional X-Ray Mammogram

17. 17
Digital Mammogram MRI
Digital
Mammogram
vs.
MRI

18. USPTSF
• Biennial
screening
mammography
beginning
at
age
50.(B
Recommend)
• Evidence
is
insufficient
for
assessing
the
addi9onal
benefits
of
screening
mammography
in
women
past
age
74
• Annual
screening
mammography
beginning
at
age
45
with
an
op9on
to
begin
at
age
40.
Transi9on
to
biennial
screening
at
age
55
with
op9on
to
con9nue
annual
screening
• Con9nue
biennial
screening
mammography
for
as
long
as
a
woman
is
in
good
health
and
a
life
expectancy
of
has
at
least
10
years
• Annual
Screening
Mammography
beginning
at
age
40
• Women
aged
75
years
and
older
should
consult
with
their
physicians
to
decide
whether
or
not
to
con9nue
screening
mammography
Controversies
in
Mammography
ACS
ACOG

19. • Mammography
Screening
Increased
detec9on
of
precancerous
lesions
/
In-­‐situ
• 25%
of
newly
diagnosed
BC
cases
in
screening
is
DCIS.(FEA,
ADH)
• Biological
Significance
and
prac9cal
M/M
Big
challenge
and
s9ll
unclear
• Trials/Individual
studies
No
reduc9on
to
30-­‐45%
modest
decrease
in
BC
when
screened
every
1-­‐2
years
Controversies
in
Mammography

20. Key
methods
• Three-­‐dimensional
(3D)
Approaches
To
X‑ray
Mammography
(Digital
Breast
Tomosynthesis),
• Contrast-­‐enhanced
Mammography
• Quan9fiable
Ultrasound
Techniques
(E. G.,
Shear
Wave
Elastography)
•
• Func9onal
Magne9c
Resonance
Imaging
(Mri;
E. G.,
Contrast-­‐enhanced
MRI,
Diffusion-­‐weighted
Imaging).
• This
Review
Focuses
On
These
Techniques
And
Their
Poten9al
Use
In
The
Breast
Clinic.

21. Breast
imaging
workflow.
Boxes
represent
typical
steps
in
the
breast
imaging
workflow,
logical
steps
are
connected
by
arrows.
Circles
indicate
where
the
new
imaging
tools
discussed
in
this
ar9cle
can
be
of
help.
ARFI
acous9c
radia9on
force
impulse,
DBT
digital
breast
tomosynthesis,
DWI
diffusion-­‐weighted
imaging

22. Conclusion
• Benefits
of
Screening
• Screening
for
breast
cancer
means
looking
for
signs
of
breast
cancer
in
all
women,
even
if
they
have
no
symptoms.
• The
goal
of
screening
is
to
catch
cancers
early.
•
Early-­‐stage
cancers
are
easier
to
treat
than
later-­‐stage
cancers
• chance
of
survival
is
higher.
• Rou1ne
screening
for
breast
cancer
lowers
one’s
risk
of
dying
of
breast
cancer.

23. THANK
YOU