Screening of Gynecological Cancer

Reproductive health

Cancer Definition

The abnormal growth of cells without normal control of body.

Types of Cancer1. Malignant Cancer2. Benign Cancer

The Importance of Screening Early screening maximizes the possibility of early diagnosis

Improves the treatment options available

Increases women's survival rates and decreases mortality

Decreases health services cost

Sites of Gynecological CancerBreast CancerCervical CancerEndometrial CancerOvarian CancerVulvar cancer

Breast Cancer

It is one of the common cancers among women including Jordanian women about 800 cases are diagnosed yearly (National Cancer Registery )

Risk Factors of Breast Cancer

Women more than 40 years old Family history of breast cancerPrevious history of breast cancerNo history of pregnancy or first pregnancy

after the age of thirty Never breast feeding a child Long term postmenopausal combined

estrogen and progesterone hormonal therapy

Being obese or overweight after menopauseHistory of overdose of radiation to the chest

Signs and Symptoms of Breast CancerPresence of mass or lumpChange in the color or

temperature of breast tissueChange in breast size or shapeAbnormal secretions from the

nipple Inversion of the nipple or change

in the direction of the nipple Skin erosion or ulceration

Screening Tools of Breast Cancer

1. Monthly self breast examination

2. Clinical breast examination

3. Mammography

4. Magnetic Resonance Imaging (MRI)

Monthly Self Breast Examination It is a method for detecting breast mass

early through inspection and palpation

It is recommended to perform it monthly

Done after the onset of menstrual period one week

If the woman is pregnant or menopause it is performed on the same day each month

Nurses Role Educator

Care provider

Counselor

Researcher

Advocate

Procedure of Self Breast Examination

Clinical Breast Examination

Examination of breasts by health care provider such as nurses or physicians

Remember

Self breast examination is not alone enough to detect breast cancer , it is associated with mammography

Mammography It is an effective screening tool of

breast cancer It detects about 90 % of breast

cancer in women who are symptoms free

It is more accurate in postmenopausal women

It is a soft tissue X-ray image of the breasts taken with out the injection of contrast medium

When to Do Mammography Once to all women before the age of 40

Every 1 to 2 year for women age 40 and older

What Time To Do MammographyAfter the menstrual period till the middle of the month

In menopause , at the same appointment every 1-2 years

It is not recommended to have mammography during pregnancy and lactation

Preparation for Mammography To refrain from applying lotions powders , deodorants or cosmetics substances Exposure of the upper part of the body

Procedure of Mammography

Mammography

Remember

The risk of radiation exposure with mammography is low , therefore it doesn’t increase the risk of breast cancer.

Magnetic Resonance Imaging (MRI)

It is recommended in younger women who are at high risk for breast cancer

Magnetic Resonance Imaging (MRI)

Cervical Cancer

It is the second most common cancer in women , it is a preventable disease if it is diagnosed early because it is slow growing

Risk Factors of Cervical CancerHistory of multiple sexual partners

History of immunosuppressive therapy (chemotherapy ) or immunocompromised state (HIV)

Coitus at an early age Long term oral contraceptive use

Smoking

Screening of Cervical CancerPap smear It is used to screen for the presence of cellular abnormalities by obtaining a sample containing cells from the cervix

It is the method f choice for cervical cancer screening

When to have Pap smear When the women reach the age of

21 ACOG recommended repeat Pap

smear for women between the ages f 21 and 29 every two years .

For women aged 30 years and older , who have had three consecutive negative Pap smears , may extend the interval to every

three years

Procedure of Pap smear

Procedure of Pap smear

Procedure of Pap smear

Remember The women should have avoiding any thing in her vagina for 24 hour in order not to interfere with the accuracy of the test

Endometrial Cancer o One of the most common female

genital cancero Has a high rate of cure , if it is

detected early

Risk Factors of Endometrial CancerIncreased age Obesity Nulliparity History of infertility Menstrual irregularities History of diabetes HpertensionEarly menarche or late

menopause

Remember

Majority of endometrial cancer occurs in postmenopausal women

Signs and symptoms Vaginal bleeding in postmenopausal women not treated with hormone therapy

Screening of Endometrial Cancer Pap smear Pelvic ultrasound to evaluate thickness of endometrium

Endometrial biopsy

Ovarian CancerIt is the most fatal f all cancers ,

it is difficult to diagnose and often spread throughout the pelvis before it is detected

Risk Factors of Ovarian CancerIncreased age

Nulliparity

History of breast cancer

Early menarche or late menopause

Signs and Symptoms of Ovarian CancerIncreased abdominal size

Difficulty eating

Abdominal or pelvic pain

Dyspareunia

Irregular bleeding

Delayed menstruation

Screening of Ovarian Cancer o Have annual ultrasound

examination o CA 125 blood test (a protein

that may indicate the presence of certain gynecological cancer)

Remember

If a palpable mass is noted on routine pelvic examination radiography or ultrasonography is used to confirm diagnosis

Vulvar Cancer

It makes up 3% to 5% of all female genital cancer.

Risk Factors of Vulvar CancerChronic vulvar inflammation Smoking

Diabetes Immunosuppression History of lower genital cancer

Signs and Symptoms of Vulvar Cancer

The woman may be presented with:• Pruritus • Lump• Flat lesion which is itching, burning and painful

Screening of Vulvar Cancer

A microscope is designed to look at the vulva and cervix to evaluate tissues

Coloscopy

Any Questions

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