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Meme hastalıklarına yaklaşım: "Meme kanseri için risk değerlendirmesi ve tarama stratejileri"

Approach to common breast diseases: risk evaluation and screening strategies for breast cancer

Journal Name:

  • Türkiye Aile Hekimliği Dergisi

Publication Year:

  • 2008
DOI: 
doi:10.2399/tahd.08.009

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
During the last decade, both the incidence and mortality rates of breast cancer have declined. Population based mammography screening has contributed to this improvement. Large scale screening studies have reported that a 25-30% decrease in breast cancer specific mortality was seen when women underwent programmed mammographic screening. Nevertheless, the awareness of women has contributed to this achievement beyond these efforts. Since 2002, significant decrease in the inci¬dence of newly diagnosed breast cancer has also been observed, overwhelmingly in postmenapousal women. Less prescribing the hormone replacement thought to be the primary factor for this decline, since this therapy was shown to increase the risk of breast cancer in postmenapousal women. These improvements made risk factors and their assessment for breast cancer a nec¬essary issue. After the studies which reported that chemopreven-tion and risk reducing surgery significantly decrease the risk of developing breast cancer, risk assessment and counselling became an important health service in countries with high inci¬dence of the disease. In this review, the author will provide expla¬nation about how each factor should be regarded in risk assess¬ment and the pitfalls of counselling a women with high risk. Furthermore, the details of national screening guidelines for breast cancer in Turkey will be given.
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Abstract (Original Language): 
Meme kanseri insidansı ve bu kansere bağlı ölüm oranları son on yılda düşmüştür. Ölüm oranının azalmasının nedenleri arasında meme kanserini daha erken evrede tanıyabilmek için yapılan ma-mografik taramanın etkinliği gösterilmektedir. Taramanın meme kanserine bağlı ölüm oranını %25-30 oranında azalttığı saptanmıştır. Ancak ölüm oranının azalmasında bu kanser hakkındaki farkındalığın artması da etkili olmaktadır. Ölüm oranının azalması¬nın ötesinde son beş yıldır meme kanseri insidansında da belirgin bir düşüş kayıt edilmektedir. Bu düşüş daha çok postmenapozal kadınlarda göze çarpmaktadır. Bu durum postmenapozal kadınla¬rın hormon replasman tedavisini eskisi kadar yaygın olarak kullan¬mamasına bağlanmaktadır. Bu gelişmeler kadınların meme kanse¬ri için varolan risklerinin saptanması ve mümkün ise bu risk faktör¬lerini yaşamlarından uzaklaştırmaları konusunu gündeme getir¬mektedir. Bugün dünyada meme kanseri insidansının yüksek oldu¬ğu ülkelerde "risk analizi ve danışmanlığı" rutin sağlık hizmeti içe¬risinde yerini almaktadır. Bu ünitelerde kadınların rasyonel risk öl¬çümleri yapılmakta ve risk düzeylerine göre tavsiyelerde bulunul¬maktadır. Etkin risk azaltıcı yöntemler arasında kemoprevensiyon ve profilaktik ameliyatlar yer almaktadır. Bu derlemede sağlıklı ka¬dınları meme kanseri riski açısından değerlendirilerek, kimlerin risk analizi ve danışmanlığına ihtiyacı olduğunu ayırt etmesine yardımcı olacak bilgiler verilmeye çalışılacaktır. Ayrıca ortalama riske sa¬hip kadınlara uygulanması tavsiye olunan ulusal tarama standart¬larımız aktarılacaktır.
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