Let's talk about breasts. This is an interesting topic. However, let's not stop at the conversation. Let's touch, explore, explore the subject. Bi kesane.

Eliza Dolecka, Zdrowie.gazeta.pl:

You call the breast professor “such no-man's land.” Por qué?

Prof. Marzena Dębska, specialist in gynecology and obstetrics:

- Breast cancer is the most common malignant tumor among women. In Poland, it is responsible for almost a quarter of cases and a dozen percent of deaths due to malignant tumors in women. Cáncer cada 1.5 horas Nipple (that is, breasts, and not, as is sometimes mistakenly believed - alone Warts) kills a Polish woman. The trend is unfortunately growing. It would seem that the concern for wellness Preventive treatment of the female breast must be a preventive priority for the general practitioner and anyone else to whom the patient goes. theirs studi . And it's not.

‍Who takes care of those breasts?

- First of all, gynecologists, although it is different with this. Many of my colleagues actually talk to patients about breasts, explain the importance of preventive examinations, refer women to mammography and ultrasound, some even to ultrasound themselves. However, I meet quite a few patients with whom no one has ever taken up this topic, let alone breast examination. Women often do not know where to go with a change in the breast.

‍No place to get a mammogram?

- The problem is more complex. Gynaecologists very rarely perform breast ultrasound, because it requires not only the right equipment, but also skill and some experience. They also do not have the competence to evaluate the results of mammography or resonance imaging - this is not their role at all, but radiologists. However, many times patients after performing specialized examinations return to gynecologists with a piece of paper and a recommendation that the gynecologist decides on a possible biopsy.

And how should it be?

- The one who performs the examination decides what to do next. After all, it is the doctor who performs mammography or ultrasound who knows best what he found during this examination and it is he who should take responsibility for it. There are many great radiologists in Poland who specialize in breast diagnosis. They do full diagnostics — from ultrasound, through mammography, resonance, including biopsy. They work with oncologists and refer patients to the best centers. But first you have to hit them.

So a lot depends on the gynecologist, who should guide the patient properly.

- Ez bawer dikim ku rola ginecologan pir berfireh e. A gynaecologist is a woman's primary care physician. A solo doktor a whom a healthy woman has a chance to go, who does not yet have any ailments. Tired, confused, they often do not go to another specialist for many years. It doesn't matter what a woman comes to the office with: after Contraceptive, with post-vacation intimate infection, abdominal pain. You have to take the opportunity to take care of her. I always ask then for the last cytology, examine the breasts. I also pay attention to other things, I ask about well-being. A mega-abnormality can be detected on the occasion of a gynecological visit: for example, anemia, skin diseases, changes within the abdominal cavity. Sometimes those that annoy a woman for many years, but she does nothing about it.

Aren't we taking care of ourselves?

- Kvinner bi gelemperî lênihêrîna tevahiya malbatê: zarok, mêr, dêûbav û hetta cîranan. Not about myself. They put themselves in last place. Illness in the family, aging parents, problems with children - all on the head of women. Even if they feel that something bad is happening, they postpone the visit to the doctor until their life is bearable. They often seek help only when it is too late. A cancer usually takes at least a few years to give symptoms that can no longer be ignored. And yet early recognition is often insurmountable. Women often deprive themselves of the chance of effective treatment.

There are stories about women who took great care of themselves, regularly examined, and yet were killed by breast cancer. What does the professor say to that?

- It's possible. Very rarely, but it happens that patients who remembered about preventive examinations and, despite a fairly early diagnosis, died. Sometimes medicine is powerless. Tumors are very malignant and resistant to treatment. Ez bi vê yekê re dijwar e, lê di heman demê de pêdivî ye ku meriv ji bîr bîne ku dermanên nû û dermanên nû hîn jî têne pêşve xistin. You cannot give up, or assume that it is better not to know. Als het meer zehmet om de situatie die een vrouw dat een vrouw kunt gemaakt, maar het niet ook een chance. J'ai mis à mis neighbor qu'il était l'última en la ginecine, et la dit, “Si John est à l'8 ans, que significa il y a 8 años atrás. She's like a smart, educated woman.

Why do we do this to ourselves?

- I think about it myself more than once. Even patients who regularly visit a gynecologist examine their breasts on a case-by-case basis. Sometimes they are motivated by a Mammobus-type action, other times by the news of the death of a friend. Frightened by the rush, they will go to examine themselves, and then forget about their breasts again, even for many years. The numbers do not appeal to the imagination. A mammography performed every two years for 20 years reduces the risk of death from breast cancer by 30 percent. Meanwhile, some ladies are afraid of the research because they believe that these “exposures” may be more dangerous than cancer. Bê guman, ev ne rast e. There are more fears, anyway.

Quali sono?

- That Biopsy It hurts that treatment is always associated with mutilation, and in general it does not help, because cancer is better not to move. In fact, a biopsy may not be pleasant, but it is tolerable. And it is essential, without it you can not start treatment. A a, a -, a nem, a nem. Rapid breast reconstruction is possible. The effectiveness of treatment at early diagnosis exceeds 90 percent. So why the thousands of deaths? Early diagnosis is, unfortunately, a rarity. We do not detect changes even a few centimeters in ourselves, because we avoid even self-examination.

‍Why self-examination, if it allows you to feel a change that is already about a centimeter, and on ultrasound or mammography, a much smaller tumors are detected, even nodules that are 2-3 mm?

- Breast self-examination is still the most important diagnostic tool, because most breast changes are still detected by their owners. Usually because they don't do other research. It also happens that the tumor grows rapidly and the lesion can develop dangerously in the period between imaging tests such as ultrasound or mammography. It is worth remembering that breast cancer does not necessarily manifest itself as a lump - it can be strange change on the skin, discharge from the nipple, ulceration. Any disturbing change needs to be clarified with the doctor. Unfortunately, young women do not have easy access to breast diagnostics under health insurance.

Por qué?

- The risk of developing breast cancer increases sharply after the age of 50, which is why actions to encourage mammography to apply to women in the 50-69 age range. At this age, you can be examined prophylactically, without any justification. For younger women, a specific reason is needed, a referral from a doctor. Meanwhile, you can get sick at any age, and the risk group for breast cancer includes all breast owners. Dans cours, cette risque varià, pero que me pas de focus en un groupe de haute risque.

Is it good that there is a lot of talk about the importance of family burden or the role of diagnostic tests in women using HRT?

- Of course, because it brings results. My observations show that women who have been found to have mutations BRCA 1 and 2A cancer, which increases the risk of developing female cancers, is examined regularly. Like patients who use hormone therapy during the period Menopause. Interestingly, in the case of the latter, contrary to popular belief, the risk of developing breast cancer increases only minimally. A, a. Unfortunately, women after breast cancer are not allowed to use hormones. I say, “unfortunately,” because the health gains, aside from the issues of well-being and comfort of life, are priceless.

What are the benefits of using hormones for women?

- En la edad de la scaración de las mujeres con hormonos, no es dice que hormonos se usa dopo menónio reduz la incidence de la demencia, incluindo a nexweşiya Alzheimer, nexweşiyên pergala dil, hin penceşêrên, mînakî, rûvî û laşê uterusê. Hormone therapy is also a very good way to prevent osteoporosis. Osteoporosis is another such “nobody's” disease. It is not very clear who takes care of it. And at the same time, hardly anyone knows that he is also a silent killer of women. A woman in her 50s has a comparable risk of dying from a femoral neck fracture as from breast cancer. There is such a regularity that women who use hormones regularly go to the doctor. In this regard, the prevention of many other diseases, including cervical cancer, is improved. A lot has been said about genetic testing and mutations, so women who are not at increased risk often feel exempt from ultrasound and mammography. This can cost them their lives, because cancer, unfortunately, attacks at any age and in any condition. Whether pregnant or during lactation.

Pregnancies and breastfeeding are treated rather as a cancer-free period. Moreover - reducing the risk of getting sick in the future.

- And yet women get sick and sometimes die, orphaning little children. There are pictures of children on the shelf in my office. I remember very well these siblings, two boys and a girl. Their mother died of extremely malignant breast cancer. These are unimaginable dramas. I hope that now they will happen less often, because for several years in Poland there have been recommendations that say that every pregnant woman should be recommended to undergo an ultrasound examination in the first or second trimester; this is mandatory for women after 35 years of age. Unfortunately, despite this, many people still believe that pregnant women can not be diagnosed, much less treated. That's not true. These types of myths cause the diagnosis of breast cancer in a pregnant woman to be often delayed up to several months.

Breast ultrasound in pregnancy? Het is dit dat in de 2e fase van de cycle het is niet aanbevolen.

- Ezmûnek ultrasonîk bi rastî pir dijwar e ku meriv dema ku pêsîr werimî, bi hormonan ve were guhertin, lê dîsa jî gengaz e û ji bo pitikê bi tevahî ewledar e. If necessary, mammography can be performed by covering the belly of a pregnant woman. In pregnancy, even chemotherapy can be given to protect the baby as much as possible. Unfortunately, knowledge of this is not common. In general, cancer is not thought about during this period of life. C'est une autre fois - quando une jeune femme fallait, elle très rare va a un doktor qui se remne de la sécurité de la fertilità, qui se peut être pregnant après recuperation et à la barne à un bambine. After cancer, there is life. A happy motherhood is also possible, provided that before starting cancer therapy, one thinks about the patient's future.

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One in eight women will develop breast cancer at some point in their lives. Every 1.5 hours, this cancer kills a Polish woman. It doesn't happen in a vacuum. It's about your family, your friends, you, us. And although we are aware that our pink editorial action has no chance of millions of clicks, we write about breast cancer because we think it is important. Take care of yourself and your health. Join us, explore yourself.