Come si calcola il rischio reale per il tumore al seno

Storie di Ragazze Fuori di Seno

 Pagina 1 di 939:  1  2  3  4  5  ...  935  936  937  938  939  Successivo » 

salvocatania
medico 

Hai una storia familiare (uno o più familiari) di tumori al seno e ovaio?
Una lunga storia di sintomi o esami controversi (es.esami istologici precedenti) che riguardano la salute del tuo seno?
Ti senti confusa e sopraffatta dalle notizie contrastanti che si leggono ogni giorno e vuoi sapere come distinguere un rischio che è importante da uno che non lo è?

Il calcolo del rischio di tumore della mammella non è una semplice curiosità, ma uno strumento importantissimo che può fornire alla paziente maggiore consapevolezza ed al medico una base per poter valutare eventuali monitoraggi intensivi o trattamenti preventivi nelle pazienti ad alto rischio. Oppure monitoraggi di minima in pazienti a basso rischio.

Dal mese di novembre 2010 ho organizzato delle giornate (una volta al mese) con incontri GRATUITI a Milano e a Lecco su prenotazione telefonica.
Per ulteriori informazioni consulta il mio sito http://www.senosalvo.com/come_si_calcola_rischio_reale.htm

____________________________________________________________________________

How to calculate the real risk

from http://www.senosalvo.com/come_si_calcola_rischio_reale.htm

There is no doubt that a complete screening of breast cancer should include, in addition to clinical examination, the ultrasound and mammography, a determination of individual risk. In fact, women who are identified as exposed to high risk, must be submitted to an individualized plan of surveillance as well as a series of preventive measures, if necessary, also defined by risk.

It 'so obvious that the calculation of the risk of breast cancer is not a mere curiosity, but a very important tool that can provide the patient more aware and the doctor a baseline to assess any Intensive monitoring and preventive treatments in patients at high risk. Or at least monitoring of patients at low risk.

Suffice it to think that such a scientific study, "Breast Cancer Prevention Trial (Fisher B, Costantino JP, Wickerham DL. - Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. - J. Natl Cancer Inst 1998; 90 (18) :1371-88) has shown that in healthy women, but high-risk, meaning a risk of developing breast cancer over 5 years to 1.7%, preventive therapy with tamoxifen, after a period of 4 years, 49% reduces the incidence of breast cancer .. In any case, can be very useful tips on simple lifestyle that significantly reduce the real risk of getting breast cancer.

http://www.senosalvo.com/il_cibo_delluomo.htm

http://www.senosalvo.com/menu_di_lunga_vita.htm

http://www.senosalvo.com/camminare_almeno_30_min_giorno.htm

The calculator Risk of breast cancer offers the choice between two methods of calculation: the Gail model and the model of the NSABP. The first, named after Dr. Mitchell H. Gail, along with other colleagues he has published several popular articles describing the scientific basis for the calculation of risk. The second calculation model was developed by the NSABP, an acronym for the National Surgical Adjuvant Breast and Bowel Project. The NSABP is a great organization that has conducted many important research studies. The NSABP is playing from the original model of Gail and modified it for research purposes.

Equally well known is the risk calculator at the National Cancer Institute: it has more decimal places of accuracy, but requires only 6 questions:

* The Breast Cancer Risk Assessment Tool Was designed for use by health professionals. If you are not a health professional, you are Encouraged to discuss the results and your personal risk of breast cancer with your doctor.

The tool * Should not be used to calculate breast cancer risk for women Who Have Already Had A diagnosis of breast cancer, lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS).

* The BCRA Risk Calculator May Be Periodically updated as new data or research Becomes available.

* Although the tool has Been used with success in clinics for women with strong family histories of breast cancer, more specific methods of estimating risk are appropriate for women to Have Known breast cancer-producing mutations in the BRCA1 or BRCA2 genes.

* Other Factors May Also Affect and risk are not accounted for by the tool. These factors include previous radiation therapy to the chest for the treatment of Hodgkin lymphoma or recent migration from a region with low breast cancer rates, Such as rural China. The tool's risk That Calculations assume a woman is screened for breast cancer as in the general U.S. population. A woman who does not Have to Have mammograms will Somewhat lower chances of a diagnosis of breast cancer.

* For information to help your cancer risk visit http://understandingrisk.cancer.gov Patients Understand. This interactive Web site will help your Patients Make Informed Decisions about how to Their lower risk.

The computer used by us using the Gail model, and is a slightly less perfect emulation of the risk calculator for breast cancer at the National Cancer Institute, however, adds additional risk factors and therefore it is more complete. Although this calculation is based on methods and statistics to calculate the risk of breast cancer published in scientific journals skilled, specific methods used were not controvalidati. Therefore, these data can be used only as a guideline for the monitoring program. The final results are estimates of a LOW, MEDIUM or HIGH risk of getting breast cancer very useful for the planning of surveillance in relation to the age of the patient.

http://www.senosalvo.com/approfondimenti/fattori_indicatori_carcinoma_mammario.htm

Major risk factors and their relative risk
VARIABLE RISK FACTOR
50 anni 6,5">Age '> 50 years 6.5
A family history of 1st degree relative <50 years 2.0
2 first degree relatives of 5.0
Previous breast irradiation Mamara <15 years 20.0
Hyperplasia 2.0
* Atypical 3.5
Mammographic Density 4.0
History hormone Menarche <11 years 3.0
54 anni 2,0">Menopause> 54 years 2.0
High-fat diet 1.2
Obesity in postmenopausal 1.2
Alcohol consumption 1.3

* If you are familiar with atypia are associated with conditions of synergy and the relative risk is doubled (RR = 9).

**: I fibrodenomi not increase the risk, except for those so-called "complex" (containing cysts, sclerosing adenosis, epithelial calcifications, or alteration of apocrine and papillary type) having a RR = 3. The radial scar RR = 2 and if hyperplasia is associated with RR = 3:

Note: If within ten years after the biopsy revealed hyperplasia with atypia does not manifest itself on a cancer risk is halved.

#1  
     

salvocatania
medico 
Se vuoi prenotare tramite telefono, fax o mail http://www.senosalvo.com/valutazione.htm
#2  
     

defalcovincenza
medico 
Trovo l'iniziativa interessante, utile e innovativa. Dovrebbe essere estesa in tutta Italia
#3  
     

salvocatania
medico 
How to calculate the real risk (*) from http://www.senosalvo.com/come_si_calcola_rischio_reale.htm There is no doubt that a complete screening of breast cancer should include, in addition to clinical examination, the ultrasound and mammography, a determination of individual risk. In fact, women who are identified as exposed to high risk, must be submitted to an individualized plan of surveillance as well as a series of preventive measures, if necessary, also defined by risk. It 'so obvious that the calculation of the risk of breast cancer is not a mere curiosity, but a very important tool that can provide the patient more aware and the doctor a baseline to assess any Intensive monitoring and preventive treatments in patients at high risk. Or at least monitoring of patients at low risk. Suffice it to think that such a scientific study, "Breast Cancer Prevention Trial (Fisher B, Costantino JP, Wickerham DL. - Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. - J. Natl Cancer Inst 1998; 90 (18) :1371-88) has shown that in healthy women, but high-risk, meaning a risk of developing breast cancer over 5 years to 1.7%, preventive therapy with tamoxifen, after a period of 4 years, 49% reduces the incidence of breast cancer .. In any case, can be very useful tips on simple lifestyle that significantly reduce the real risk of getting breast cancer. http://www.senosalvo.com/il_cibo_delluomo.htm http://www.senosalvo.com/menu_di_lunga_vita.htm http://www.senosalvo.com/camminare_almeno_30_min_giorno.htm The calculator Risk of breast cancer offers the choice between two methods of calculation: the Gail model and the model of the NSABP. The first, named after Dr. Mitchell H. Gail, along with other colleagues he has published several popular articles describing the scientific basis for the calculation of risk. The second calculation model was developed by the NSABP, an acronym for the National Surgical Adjuvant Breast and Bowel Project. The NSABP is a great organization that has conducted many important research studies. The NSABP is playing from the original model of Gail and modified it for research purposes. Equally well known is the risk calculator at the National Cancer Institute: it has more decimal places of accuracy, but requires only 6 questions: * The Breast Cancer Risk Assessment Tool Was designed for use by health professionals. If you are not a health professional, you are Encouraged to discuss the results and your personal risk of breast cancer with your doctor. The tool * Should not be used to calculate breast cancer risk for women Who Have Already Had A diagnosis of breast cancer, lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS). * The BCRA Risk Calculator May Be Periodically updated as new data or research Becomes available. * Although the tool has Been used with success in clinics for women with strong family histories of breast cancer, more specific methods of estimating risk are appropriate for women to Have Known breast cancer-producing mutations in the BRCA1 or BRCA2 genes. * Other Factors May Also Affect and risk are not accounted for by the tool. These factors include previous radiation therapy to the chest for the treatment of Hodgkin lymphoma or recent migration from a region with low breast cancer rates, Such as rural China. The tool's risk That Calculations assume a woman is screened for breast cancer as in the general U.S. population. A woman who does not Have to Have mammograms will Somewhat lower chances of a diagnosis of breast cancer. * For information to help your cancer risk visit http://understandingrisk.cancer.gov Patients Understand. This interactive Web site will help your Patients Make Informed Decisions about how to Their lower risk. The computer used by us using the Gail model, and is a slightly less perfect emulation of the risk calculator for breast cancer at the National Cancer Institute, however, adds additional risk factors and therefore it is more complete. Although this calculation is based on methods and statistics to calculate the risk of breast cancer published in scientific journals skilled, specific methods used were not controvalidati. Therefore, these data can be used only as a guideline for the monitoring program. The final results are estimates of a LOW, MEDIUM or HIGH risk of getting breast cancer very useful for the planning of surveillance in relation to the age of the patient. http://www.senosalvo.com/approfondimenti/fattori_indicatori_carcinoma_mammario.htm Major risk factors and their relative risk VARIABLE RISK FACTOR Age '> 50 years 6.5 A family history of 1st degree relative <50 years 2.0 2 first degree relatives of 5.0 Previous breast irradiation Mamara <15 years 20.0 Hyperplasia 2.0 * Atypical 3.5 Mammographic Density 4.0 History hormone Menarche <11 years 3.0 Menopause> 54 years 2.0 High-fat diet 1.2 Obesity in postmenopausal 1.2 Alcohol consumption 1.3 * If you are familiar with atypia are associated with conditions of synergy and the relative risk is doubled (RR = 9). **: I fibrodenomi not increase the risk, except for those so-called "complex" (containing cysts, sclerosing adenosis, epithelial calcifications, or alteration of apocrine and papillary type) having a RR = 3. The radial scar RR = 2 and if hyperplasia is associated with RR = 3: Note: If within ten years after the biopsy revealed hyperplasia with atypia does not manifest itself on a cancer risk is halved.
#4  
     

salvocatania
medico 
Poichè ricevo diverse mail e richieste di consulto sui fattori di rischio familiare per tumore al seno, riporto qui la scheda che faccio compilare prima dei mie incontri reali che precedono la visita. Prego tutti gli utenti che intendono chiedere consulti nella apposita sezione dei consulti di riportare i dati di questa scheda. ____________________________________________________________ http://www.senosalvo.com/pdf/scheda_visita.pdf
#5  
     

Ex Utente
utente 
Mi scusi ma nella tabella dei rischi che ha allegato si parla di precedenti familiari. Un medico mi ha detto che non si considerano come precedenti familiari quelli della linea paterna. Io ho trovato strana questa affermazione.
#6  
     

salvocatania
medico 
"Mater semper certa est, pater nunquam". Se teniamo conto di questo pre-GIUDIZIO allora ha ragione il collega che le ha dato questa informazione. Ma se questa informazione non l'abbiamo con certezza siamo obbligati a considerare sempre anche il padre perchè quello vero lo zampino genetico ce lo mette...eccome! http://www.medicitalia.it/minforma/senologia/64-fattori-indicatori-rischio-carcinoma-mammario.html Nella tabella da me allegata mi riferisco ai "parenti di I° grado". Ed il padre, quello vero, lo è ! (^___^)
#7  
     

salvocatania
medico 
#8  
     

FernandoBellizzi
psicologo 
Gentile Utente, senza offesa, ma a meno che Lei non abbia fatto un test genetico, su entrambi i genitori, non si ha neanche la certezza di non essere stati scambiati nell'ospedale! E c'è sempre la possibilità di essere stati adottati senza saperlo! Mi ha fatto venire in mente una puntata di Dr. House in cui Gregory vedendo le foto dei 6 figli di un uomo, quando poi parlava con la di lui moglie, gli ha detto che dalle foto era evidente che solo i primi 2 figli era del marito. E questo, sempre con tutto il rispetto, senza avere la certezza che la linea familiare sia *pura* anche quella dei nonni... Sa, nel studio dello psicologo vengono fuori tanti scheletri nell'armadio, per cui difficile avere certezza della propria purezza genetica! :)
#9  
     

salvocatania
medico 
Grazie mille Fernando per il contributo, ma io ritengo che quanto ci riferisce la nostra utente si riferisca a ben altro problema ancora più grave di quello della "presunta" paternità. E' molto diffusa purtroppo l'informazione, persino tra i medici, che la linea paterna non interferisca nel tramandare ai figli una ereditarietà o familiarità per tumore del seno (chissà per quale ragione !), ignorando che la trasmissione invece riguarda entrambi i genitori perchè l'altissimo rischio di contrarre la malattia tumorale dipende da una mutazione genetica nel corso della vita .
#10  
     

Ex Utente
utente 
No, non credo che il medico che mi ha dato questa informazione facesse riferimento al problema della vera o presunta paternità riguardo al rischio reale sul tumore al seno. Grazie ad entrambi per avermi chiarito il dubbio
#11  
     

Ex Utente
utente 
Mi scusi, ho letto la tabella dei rischi da lei allegata sul calcolo del rischio relativo. Da operata di tumore al seno e all'ovaio ho una curiosità cui non mi sanno dare spiegazioni. Per me che vuol dire che ho un rischio personale 4 per la mammella + un rischio personale 4 per l'ovaio ? Speriamo di no.
#12  
     

salvocatania
medico 
In un caso come il suo all'atto pratico serve poco il calcolo del rischio che è da considerare , come saprà bene, alto e non tanto per la somma dei singoli rischi relativi, ma perchè se può essere considerato sporadico il tumore del seno non si può certo considerare altrettanto quello dell'ovaio che è molto meno frequente del primo. In casi come il suo è indicata una consulenza genetica per valutare l'indicazione ai suoi familiari un test genetico. http://www.medicitalia.it/minforma/senologia/64-fattori-indicatori-rischio-carcinoma-mammario.html
#13  
     

Ex Utente
utente 
Per le figlie delle donne operate al seno prima dei 50 anni non sarebbe meglio fare un test genetico a tutte ?
#14  
     

salvocatania
medico 
Assolutamente no perchè i tumori ereditari sono solo il 5-7% e sono caratterizzati da mutazioni genetiche di predisposizione accertate che si trasmettono ai discendenti (Brca1,Brca2,Brcax...). E solo il 15-20% sono tumori familiari: aggregazione di più casi nella stessa famiglia senza che vi sia una evidente trasmissione della malattia da una generazione alla successiva o sia riconosciuto un gene responsabile. Ci sono dei criteri (es. criterio Asco) che si raccolgono nel corso di un colloquio e che vengono valutati prima di porre il sospetto di una predisposizione Per un approfondimento su questi criteri legga http://www.senosalvo.com/approfondimenti/i%20tumori%20sono%20ereditari.htm
#15  
     

 Pagina 1 di 939:  1  2  3  4  5  ...  935  936  937  938  939  Successivo » Top

Inserisci qui sotto tua risposta

Esegui l'accesso per inserire la tua risposta