COMPLEMENTAÇÃO MAMOGRAFIA - ULTRA-SONOGRAFIA

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COMPLEMENTAO MAMOGRAFIA - ULTRA-SONOGRAFIA. Complementao adequada Ndulo palpvel no identificado na mamografia (alta densidade do parnquima mamrio ou localizao em zonas cegas) Ndulo que pode ser um cisto (palpvel ou no palpvel) - PowerPoint PPT Presentation

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<ul><li><p>COMPLEMENTAO MAMOGRAFIA - ULTRA-SONOGRAFIA Complementao adequadaNdulo palpvel no identificado na mamografia (alta densidade do parnquima mamrio ou localizao em zonas cegas)Ndulo que pode ser um cisto (palpvel ou no palpvel)Assimetria difusa ou rea densa difusa que pode representar parnquima mamrio, leso slida ou leso cstica</p></li><li><p>Ndulo palpvel sem expresso na mamografia</p></li><li><p>Ndulo que pode ser cisto</p></li><li><p>Ndulo que pode ser cisto</p></li><li><p>rea densa</p></li><li><p>Assimetria difusa</p></li><li><p>COMPLEMENTAO MAMOGRAFIA - ULTRA-SONOGRAFIA Complementao inadequadaNdulos Categoria 2 e Categoria 5MicrocalcificaesDistoro focalPequenos ndulos de aspecto benigno, em mamas adiposasMama densa em paciente assintomtica (*)</p></li><li><p>Categoria 2</p></li><li><p>Distoro focal</p></li><li><p>Cedido pelo CMRJMicrocalcificaes</p></li><li><p>Ndulos pequenosem mama adiposa</p></li><li><p>Mama densa - paciente assintomtica</p></li><li><p>Mama densa - paciente assintomtica</p></li><li><p>COMPLEMENTAO MAMOGRAFIA - ULTRA-SONOGRAFIA Complementao obrigatria Para todas as mulheres com mamas densas?Somente para as mulheres do grupo de alto risco?Problemas a considerarGrande nmero de examesDiferena entre aparelhos e operadoresAumento de procedimentos de bipsiaGrande nmero de falso positivos</p></li><li><p>DADOS ESTATSTICOSCA MAMA principal causa morte por CA no prevenvel CA PULMOEUA cada ano CA MAMA diagnosticada 180.000 mulheres, morte 46.000RISCO - &gt; idade, aps 40 anos.ESTIMATIVA 1 mulher em 8 desenvolvem CA MAMA, 1 em 33 morrer.</p></li><li><p>FATORES ASSOCIADOS:Idade;Histrico familiar;Menarca precoce;Menopausa tardia;Nuliparidade;Primeira gestao a termo tardia</p></li><li><p>TRIAGEMPalpaoDeteco CA MAMAMAMOGRAFIA+ EXAME CLNICO</p></li><li><p>Tipos de mamografia1- MAMOGRAFIA DE TRIAGEM mulheres assintomticas detectar estgio precoce.2 MAMOGRAFIA DIAGNSTICA resolver problemas avaliar achados anormais da mama:_ massa palpvel_ secreo mamilar_ retrao mamilo_ alteraes da pele</p></li><li><p>MAMOGRAFIA NEGATIVANUNCA deve adiar a avaliao dos sintomas, aos achados suspeitos:_ massa mamria_ alteraes pele_ dor_ secreo espontnea pelo mamilo</p></li><li><p>CATipicamente aparecem massas estreladas com bordos espiculadosCA + PELE retrao CA cachos de microcalcificaes, sem massa estrelada,CA indicado assimetria amama</p></li><li><p>ANORMALIDADES BENIGNASVisveis;Calcificaes normais visualizadas: _ pele;_ artrias mama_ paredes cistos benignos </p></li><li><p>Fluxograma de AtendimentoExame Clnico da Mama</p></li><li><p>Resultados da mamografia e encaminhamentos</p><p>BIRDS 0= encaminhar para ecografia de mama</p><p>BIRADS I e II= normais/benignos- mamografia a cada dois anos aps os 40 anos</p><p>BIRADS III= Reavaliar em 6 meses</p><p>BIRADS IV e V= encaminhar para tratamento com mastologista ou oncologista.</p></li><li><p>Grf1</p><p>4.60280126488.03</p><p>4.58802801798.13</p><p>5.23387537858.62</p><p>4.76662166379.12</p><p>5.42370341369.56</p><p>6.38641692989.42</p><p>6.348095592610.06</p><p>5.055907143710.24</p><p>5.681855342410.89</p><p>5.965367301811.79</p><p>5.559411814210.78</p><p>5.2410.66</p><p>5.2111.85</p><p>4.911.57</p><p>93</p><p>94</p><p>95</p><p>96</p><p>97</p><p>98</p><p>99</p><p>00</p><p>01</p><p>02</p><p>03</p><p>Ano</p><p>Ca de colo do tero</p><p>Ca de mama</p><p>MORTALIDADE POR CNCER DE TERO PARAN-1993-2003</p><p>Plan6</p><p>1993199419951996199719981999200020012002200320042005</p><p>Ca de mama8.038.138.629.129.569.4210.0610.2410.8911.7910.7811.211.83</p><p>Plan6</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>0</p><p>Ca de mama</p><p>ano</p><p>coef por 100000 mulheres</p><p>Coeficiente de Mortalidade por Ca de mama Paran 1993-2005</p><p>Plan1</p><p>N de bitos e taxa de mortalidade por Ca de colo de tero - C53 em mulheres por RS e PR, 1993 a 2003</p><p>RS Res PR19931994199519961997199819992000200120022003200420052006</p><p>01. Reg. Sade Paranagu2.235.477.704.379.007.008.525.984.148.916.33</p><p>02. Reg. Sade Metropolitana6.205.807.707.487.189.867.685.447.056.316.56</p><p>03. Reg. Sade Ponta Grossa10.738.015.076.727.699.158.988.425.2710.044.40</p><p>04. Reg. Sade Irati4.304.255.600.000.005.655.601.372.726.755.36</p><p>05. Reg. Sade Guarapuava3.427.732.413.353.203.615.816.994.163.228.22</p><p>06. Reg. Sade Unio da Vitria1.412.792.744.090.003.995.253.910.006.398.87</p><p>07. Reg. Sade Pato Branco7.885.213.454.283.553.555.323.375.865.843.32</p><p>08. Reg. Sade Francisco Beltro1.843.674.904.873.744.993.122.494.385.022.51</p><p>09. Reg. Sade Foz do Iguau5.690.613.244.506.203.297.474.716.638.0010.78</p><p>10. Reg. Sade Cascavel4.141.833.643.163.954.365.643.817.139.154.95</p><p>11. Reg. Sade Campo Mouro3.644.674.172.592.903.544.205.185.263.544.78</p><p>12. Reg. Sade Umuarama2.882.186.492.153.173.234.122.322.342.373.19</p><p>13. Reg. Sade Cianorte1.701.700.001.691.676.591.636.393.176.317.86</p><p>14. Reg. Sade Paranava3.316.612.465.719.214.204.204.004.796.373.18</p><p>15. Reg. Sade Maring2.832.423.192.463.953.554.123.724.562.403.25</p><p>16. Reg. Sade Apucarana2.933.657.933.582.823.494.856.695.287.473.70</p><p>17. Reg. Sade Londrina4.884.516.274.816.566.209.026.627.795.965.16</p><p>18. Reg. Sade Cornlio Procpio5.866.566.493.587.676.946.216.332.388.774.00</p><p>19. Reg. Sade Jacarezinho2.973.712.231.473.077.709.284.434.432.216.64</p><p>20. Reg. Sade Toledo2.494.333.725.554.463.173.153.706.774.314.30</p><p>21. Reg. Sade Telmaco Borba0.000.002.636.533.956.522.581.275.076.302.51</p><p>22. Reg. Sade Ivaipor0.002.183.220.003.552.421.241.201.231.385.64</p><p>01. Reg. Sade Paranagu1.672.423.323.004.104.083.593.484.483.974.00</p><p>19931994199519961997199819992000200120022003</p><p>Ca de colo do tero4.604.595.234.775.426.396.355.065.685.975.565.245.214.9</p><p>Ca de mama8.038.138.629.129.569.4210.0610.2410.8911.7910.7810.6611.8511.57</p><p>Plan1</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>00</p><p>93</p><p>94</p><p>95</p><p>96</p><p>97</p><p>98</p><p>99</p><p>00</p><p>01</p><p>02</p><p>03</p><p>Ano</p><p>Ca de colo do tero</p><p>Ca de mama</p><p>MORTALIDADE POR CNCER DE TERO PARAN-1993-2003</p><p>mama</p><p>bitos Ca de mama em mulheres</p><p>RS Res PR1993populaocoef/100m1994populaocoef/100m1995populaocoef/100m1996populaocoef/100m1997populaocoef/100m1998populaocoef/100m1999populaocoef/100m2000populaocoef/100m2001populaocoef/100m2002populaocoef/100m2003populaocoef/100m2004populaocoef/100m2005populaocoef/100m</p><p>01. RS Paranagu7898187.795913375.477909367.704915664.3781111257.2091142137.88101173058.521511713112.8141206933.311312348810.53111264588.7017129,39413.1121360738.82</p><p>02. RS Metropolitana124114501110.83123117248310.49144115566112.46135116366411.60176132378313.30158135892211.63173139411812.41168143443811.71198147561313.42217150602114.41208153924313.511841,572,39911.7230164763613.96</p><p>03. RS Ponta Grossa2623303811.162523710010.542823650011.842623814010.922524692510.122625147410.34212560268.202926142111.09222657188.282726904610.043527257512.8428276,10510.13828410913.38</p><p>04. RS Irati76969610.042705232.844713675.606718618.357701089.985707807.065714477.0087306310.954736195.4387412810.7987461810.72375,1234.097624811.80</p><p>05. RS Guarapuava112047195.3762069402.90122075325.78162089697.66152189736.85142213536.322322372810.28122147155.59192162438.792421770111.02192190458.6726220,40711.8182235218.05</p><p>06. RS Unio da Vitria87087211.291716101.407729209.604734235.453740414.055751006.66117615514.443766703.91117743614.215782066.394789275.07479,6305.0108125812.31</p><p>07. RS Pato Branco31142822.63101150738.6971159006.0491167017.7141126373.5591127237.9891128147.9891187807.581211935710.0591199107.51111204529.138120,9786.691221847.37</p><p>08. RS Francisco Beltro71634574.2871633014.2961632093.6891643395.4881603904.9961602513.74111601426.87131604948.10131598968.131915949211.91151590739.4311158,6026.91615751310.16</p><p>09. RS Foz do Iguau91580415.6981632264.9041545022.5991555725.79111774646.2091824924.93121875176.40121910926.28161962058.15171999988.50162041427.8421208,27710.1162176337.35</p><p>10. RS Cascavel142175026.44142189006.40172197937.73192213158.59152276756.59152291536.5582306193.47202362808.46182384117.552724040911.23212423218.6723244,2429.4242485879.65</p><p>11. RS Campo Mouro91923954.6891928964.67101920605.2171933893.62101726725.79131696837.66131666847.80101736675.76171710689.94131694067.67141674448.3613165,4867.971610294.35</p><p>12. RS Umuarama131390879.35111378837.9881387075.7791396676.441612611412.6981237806.46121214479.8881295826.17101279367.8291266967.1091253127.1818123,98314.581209286.62</p><p>13. RS Cianorte2587463.4075884311.903586035.124590106.784599466.6796067414.836614219.7796261914.373629954.762633453.166636529.43863,98012.576471210.82</p><p>14. RS Paranava81208976.6241210213.31101217728.2191226157.3471194275.8691191747.55111189279.251812491714.411312521310.381312561610.3561259274.7610126,2667.91912696914.96</p><p>15. RS Maring202828937.07222897217.59272824609.56262844169.14293040989.543530987011.303931561812.36293229228.983432881910.345233343215.603633829710.6450343,18414.64035426611.29</p><p>16. RS Apucarana101364167.33131371079.481513865710.821713961712.18131418179.172014308013.981714434211.782314953215.381815142811.891716058210.591816207411.1122163,54213.52516686514.98</p><p>17. RS Londrina3534864810.045435445515.23333510299.405035345814.154436557812.044237115611.325037674013.275839272214.776539812316.335340266313.165240728512.7756411,91713.66442237315.15</p><p>18.RS Cornlio Procpio91366356.59111371358.02111387107.93121396718.59121304189.201412959110.80101287497.771612647212.65111258218.741512536411.971712485213.6219124,33315.3111231468.93</p><p>19. RS Jacarezinho91346076.6951347423.7171348245.1981357575.89131303019.9891298486.931312937910.05111354948.12121354498.861813553013.28121355398.858135,5535.91913559314.01</p><p>20. RS Toledo121608257.461716160310.52121611747.45151622889.2481570315.09111577906.9781585525.05131622928.01151624099.24121624927.381716260510.4513162,7018.01916291911.66</p><p>21. RS Telmaco Borba2746312.682751022.662759892.635765146.5387591310.544766605.227774149.045784486.37107890212.676793327.563797433.761280,15715.05810836.17</p><p>22. RS Ivaipor4929644.302917622.183930383.223936843.203845233.558827289.675809306.185832876.008814149.837723549.671709451.411069,56014.476640110.54</p><p>000000000001</p><p>Total34943451808.0335844027638.1337743753438.6240244056369.1243945909599.5643846504959.42474471007410.06494482603810.24533489276810.89583494521111.79539500052910.785655,055,81911.2613518104611.83</p><p>ca de mama feminina 1993</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+Total</p><p>01. Reg. Sade Paranagu01121207</p><p>02. Reg. Sade Metropolitana010223528209124</p><p>03. Reg. Sade Ponta Grossa122965126</p><p>04. Reg. Sade Irati00140207</p><p>05. Reg. Sade Guarapuava024131011</p><p>06. Reg. Sade Unio da Vitria10121308</p><p>07. Reg. Sade Pato Branco00030003</p><p>08. Reg. Sade Francisco Beltro00232007</p><p>09. Reg. Sade Foz do Iguau02212119</p><p>10. Reg. Sade Cascavel033141214</p><p>11. Reg. Sade Campo Mouro01202139</p><p>12. Reg. Sade Umuarama132331013</p><p>13. Reg. Sade Cianorte00011002</p><p>14. Reg. Sade Paranava01410208</p><p>15. Reg. Sade Maring127511320</p><p>16. Reg. Sade Apucarana011430110</p><p>17. Reg. Sade Londrina0379101535</p><p>18. Reg. Sade Cornlio Procpio00421209</p><p>19. Reg. Sade Jacarezinho01123209</p><p>20. Reg. Sade Toledo013322112</p><p>21. Reg. Sade Telmaco Borba01000012</p><p>22. Reg. Sade Ivaipor01020014</p><p>23. Reg. Saude Ignorado00000000</p><p>Total4356993734728349</p><p>ca de mama feminina 1994</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+IgnTotal</p><p>01. Reg. Sade Paranagu011111005</p><p>02. Reg. Sade Metropolitana3102632261691123</p><p>03. Reg. Sade Ponta Grossa0148561025</p><p>04. Reg. Sade Irati001001002</p><p>05. Reg. Sade Guarapuava004110006</p><p>06. Reg. Sade Unio da Vitria000010001</p><p>07. Reg. Sade Pato Branco0033400010</p><p>08. Reg. Sade Francisco Beltro011320007</p><p>09. Reg. Sade Foz do Iguau002321008</p><p>10. Reg. Sade Cascavel0036230014</p><p>11. Reg. Sade Campo Mouro007100109</p><p>12. Reg. Sade Umuarama0043121011</p><p>13. Reg. Sade Cianorte103102007</p><p>14. Reg. Sade Paranava010210004</p><p>15. Reg. Sade Maring1066243022</p><p>16. Reg. Sade Apucarana0116311013</p><p>17. Reg. Sade Londrina141717942054</p><p>18. Reg. Sade Cornlio Procpio0132311011</p><p>19. Reg. Sade Jacarezinho011021005</p><p>20. Reg. Sade Toledo0263321017</p><p>21. Reg. Sade Telmaco Borba000110002</p><p>22. Reg. Sade Ivaipor000101002</p><p>23. Reg. Saude Ignorado000000000</p><p>Total623931006946201358</p><p>ca de mama feminina 1995</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+Total</p><p>01. Reg. Sade Paranagu01141007</p><p>02. Reg. Sade Metropolitana2172832292214144</p><p>03. Reg. Sade Ponta Grossa023866328</p><p>04. Reg. Sade Irati00031004</p><p>05. Reg. Sade Guarapuava123401112</p><p>06. Reg. Sade Unio da Vitria00042107</p><p>07. Reg. Sade Pato Branco00401117</p><p>08. Reg. Sade Francisco Beltro02201106</p><p>09. Reg. Sade Foz do Iguau01300004</p><p>10. Reg. Sade Cascavel024423217</p><p>11. Reg. Sade Campo Mouro103132010</p><p>12. Reg. Sade Umuarama01041208</p><p>13. Reg. Sade Cianorte00011103</p><p>14. Reg. Sade Paranava035110010</p><p>15. Reg. Sade Maring0110961027</p><p>16. Reg. Sade Apucarana033242115</p><p>17. Reg. Sade Londrina1451092233</p><p>18. Reg. Sade Cornlio Procpio014230111</p><p>19. Reg. Sade Jacarezinho01012217</p><p>20. Reg. Sade Toledo033312012</p><p>21. Reg. Sade Telmaco Borba00011002</p><p>22. Reg. Sade Ivaipor00120003</p><p>23. Reg. Saude Ignorado00000000</p><p>Total5448296754926377</p><p>ca de mama feminina 1996</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+Total</p><p>01. Reg. Sade Paranagu01002104</p><p>02. Reg. Sade Metropolitana122632323012135</p><p>03. Reg. Sade Ponta Grossa0336103126</p><p>04. Reg. Sade Irati00202116</p><p>05. Reg. Sade Guarapuava014442116</p><p>06. Reg. Sade Unio da Vitria00100214</p><p>07. Reg. Sade Pato Branco00521109</p><p>08. Reg. Sade Francisco Beltro03112119</p><p>09. Reg. Sade Foz do Iguau01114119</p><p>10. Reg. Sade Cascavel044632019</p><p>11. Reg. Sade Campo Mouro02130107</p><p>12. Reg. Sade Umuarama02213019</p><p>13. Reg. Sade Cianorte01012004</p><p>14. Reg. Sade Paranava01322019</p><p>15. Reg. Sade Maring117337426</p><p>16. Reg. Sade Apucarana214441117</p><p>17. Reg. Sade Londrina1771397650</p><p>18. Reg. Sade Cornlio Procpio014113212</p><p>19. Reg. Sade Jacarezinho00221128</p><p>20. Reg. Sade Toledo033512115</p><p>21. Reg. Sade Telmaco Borba00220105</p><p>22. Reg. Sade Ivaipor00111003</p><p>23. Reg. Saude Ignorado00000000</p><p>Total5348390876736402</p><p>ca de mama fem 1997</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+IgnTotal</p><p>01. Reg. Sade Paranagu003112108</p><p>02. Reg. Sade Metropolitana2630444227251177</p><p>03. Reg. Sade Ponta Grossa0129661025</p><p>04. Reg. Sade Irati012130007</p><p>05. Reg. Sade Guarapuava0225321015</p><p>06. Reg. Sade Unio da Vitria011000103</p><p>07. Reg. Sade Pato Branco002101004</p><p>08. Reg. Sade Francisco Beltro003310108</p><p>09. Reg. Sade Foz do Iguau0141320011</p><p>10. Reg. Sade Cascavel1126230015</p><p>11. Reg. Sade Campo Mouro0244000010</p><p>12. Reg. Sade Umuarama0351322016</p><p>13. Reg. Sade Cianorte003100004</p><p>14. Reg. Sade Paranava010122107</p><p>15. Reg. Sade Maring01510751029</p><p>16. Reg. Sade Apucarana0244210013</p><p>17. Reg. Sade Londrina021214673044</p><p>18. Reg. Sade Cornlio Procpio0024411012</p><p>19. Reg. Sade Jacarezinho0042412013</p><p>20. Reg. Sade Toledo000143008</p><p>21. Reg. Sade Telmaco Borba012041008</p><p>22. Reg. Sade Ivaipor001020003</p><p>23. Reg. Saude Ignorado000000000</p><p>Total325931139966401440</p><p>ca de mama fem 1998</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+Total</p><p>01. Reg. Sade Paranagu00241209</p><p>02. Reg. Sade Metropolitana0184339202810158</p><p>03. Reg. Sade Ponta Grossa038753026</p><p>04. Reg. Sade Irati01000315</p><p>05. Reg. Sade Guarapuava031451014</p><p>06. Reg. Sade Unio da Vitria01120105</p><p>07. Reg. Sade Pato Branco01240119</p><p>08. Reg. Sade Francisco Beltro00112116</p><p>09. Reg. Sade Foz do Iguau10221309</p><p>10. Reg. Sade Cascavel003435015</p><p>11. Reg. Sade Campo Mouro112421213</p><p>12. Reg. Sade Umuarama00301408</p><p>13. Reg. Sade Cianorte03041109</p><p>14. Reg. Sade Paranava01213119</p><p>15. Reg. Sade Maring0510775135</p><p>16. Reg. Sade Apucarana113537020</p><p>17. Reg. Sade Londrina2012859642</p><p>18. Reg. Sade Cornlio Procpio021523114</p><p>19. Reg. Sade Jacarezinho01214019</p><p>20. Reg. Sade Toledo104311111</p><p>21. Reg. Sade Telmaco Borba01102004</p><p>22. Reg. Sade Ivaipor00331108</p><p>23. Reg. Saude Ignorado00000000</p><p>Total642106108698126438</p><p>ca de mama fem 1999</p><p>RS Res PR20-2930-3940-4950-5960-6970-7980 e+IgnTotal</p><p>01. Reg. Sade Paranagu1224100010</p><p>02. Reg. Sade Metropolitana2933394130181173</p><p>03. Reg. Sade Ponta Grossa02...</p></li></ul>