PLANEJAMENTO E CONTROLE DA MANUTENÇÃO

Abstract

Burden of suffering Breast cancer is the most frequently diagnosed cancer and is the second leading cause of cancer death among women in the United States. Projected for 1996 are 184,300 new cases of breast cancer and 44,300 breast cancer deaths. The five-year survival rate is 84% for Caucasian, non-Hispanic women and 69% for African-American women.(1) Risk factors for breast cancer include age, family history (FH), and familial cancer syndrome (FCS), as well as hormonal factors such as early menarche, late menopause, late parity, and nulliparity; however, the majority of women with breast cancer have no known risk factors. Risk factors, pathogenesis, prognosis, and course differ significantly in premenopausal and postmenopausal breast cancer.(2) Description of preventive measures Mammography is one of several screening tools for detecting early breast cancer. Other measures, such as clinical and self-breast examinations, will be addressed in future practice policy statements. During mammography, the breast should be compressed and two views taken. Plain film or xeromammography are appropriate.(3) Sensitivity is dependent on the quality of the equipment, competence of the radiology staff, and the density of the breast tissue. Since implementation of the Mammography Quality Standards Act in 1994, all U.S. mammography centers must be certified by the Food and Drug Administration. Evidence of effectiveness Estimates of mammography sensitivity range from 75% to 90% with specificity from 90% to 95%. The positive predictive value of mammography for breast cancer ranges from 20% in women under age 50 to 60% to 80% in women age 50-69. Randomized clinical trials (RCTs) have demonstrated a 30% reduction in breast cancer mortality in women 50-69 years who are screened annually or biennially with mammograms. (4) The data on women under age 50 are less clear. Conclusions regarding the value of mammography in these women are