
- •Р ак молочной железы
- •Клиническое обследование молочных желез:
- •Самообследование
- •Симптомы рака молочной железы (di (*))
- •Узел или узлы
- •Сбор анамнеза и пальпация молочных желез.
- •Выделения из сосков
- •Сбор анамнеза и пальпация молочных желез.
- •Узел/узлы нет Старше 50 лет нет Из одного протока нет Характер выделений Кровянистые или обильные Чистые и скудные
- •Боль в молочных железах
- •Специализированная помощь
- •Ведение семейным врачом после оперативного лечения
- •Литература
- •4 Для всех методов диагностики и лечения установлены степени научной доказанности
Литература
Использованные клинические рекомендации:
Финская группа по изучению рака молочной железы. Рекомендации по диагностике рака молочной железы. 1999.
Финская группа по изучению рака молочной железы. Лечение рака молочной железы. 1999.
Guideline for the early detection of breast cancer. Alberta Clinical Practice Guidelines. 1999.
Guidelines for the referral of patients with breast problems. NHS Breast Screening Programme & The Cancer Research Campaign.
Australian Clinical Practice Guidelines For The Management Of Early Breast Cancer: Second Edition (1999).
Breast Cancer Guidelines. RNZCGP. 1999.
The Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. Canada 1998.
Оригинальные исследования
Kerlikowske K, Grady D, Rubin SM, Sandrock C, Ernster VL. Efficacy of screening mammography. A meta-analysis. JAMA 1995 Jan 11;273(2):149-154.
Baker LH. Breast cancer detection demonstration project: five year summary report. Cancer J Clin 1982;32: 194-225
Hicks MJ, Davis JR, Layton JM et al. Sensitivity of mammography and physical examination of the breast for detecting breast cancer. JAMA 1979;242:2080-2083
Shapiro S. Evidence on screening for breast cancer from a randomised trial. Cancer 1977;39 (suppl):2772-2782
Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and surgery in early breast cancer: an overview of the randomized trials. N Engl J Med 1995;335:1444-55.
Veronesi U, Banfi A, Salvadori B et al. Breast conservation is the treatment of choice in small breast cancer: long term results of a randomised trial. Eur J Cancer 1990;26:668-70.
Fisher B, Redmond C, Poisson R et al. Eight-year results of a randomised clinical trial comparing total mastectomy and lumpectomy with or without radiation in the treatment of breast cancer. N Engl J Med 1989;320:822-8.
Blichert-Toft M. A Danish randomised trial comparing breast conservation with mastectomy in mammary carcinoma. Brit J Cancer 1990;62(S12):15.
Rosselli Del Turco M, Palli D, Cariddi A et al. Intensive diagnostic follow-up after treatment of primary breast cancer. JAMA 1994;271:1593-7.
The GIVIO Investigators. Impact of follow-up testing on survival and health related quality of life in breast cancer patients. JAMA 1994;271:1587-92.
Orel SG, Troupin RH, Patterson EA, Fowble BL. Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection. Radiology1992;183:201-6.
Kennedy MJ, Abeloff MD. Management of locally recurrent breast cancer. Cancer 1993;71:2395-409.
Devitt JE. How breast cancer presents. Canadian Medical Association Journal 1983 Ju1;29(1):43-47
Saunders KJ, Pilgrim CA, Pennypacker HS. Increased proficiency of search in breast self examination. Cancer 1986 Dec 1;58(11):2531-2537
Fletcher SW, O’Malley MS. Clinical breast examination. Hospital Practice (Office Edition). 1986 May 30;21(5A):80,82-84,89