Neoplasia maligna ginecológica: incidencia en el nuevo milenio: experiencia del servicio oncológico hospitalario (IVSS) / Gynecological malignant neoplasm: incidence in the new millennium: experience of the hospital oncology service (IVSS)

Conocer los indicadores de salud, como una forma de evaluar calidad del servicio que una institución presta a la población. La incidencia, prevalencia y tasas de mortalidad, son tres elementos básicos a conocer, esto permite planificar priorizar las necesidades de una determinada población, mejorando la optimización de recursos y conocer en que eslabón de la historia natural de la enfermedad se puede actuar. Queremos determinar la incidencia registrada en nuestro servicio, desde el 2000 hasta el 2015, de cada una de las patologías malignas atendidas. Un total de 1 824 historias de un universo de 4 911; las restantes no pudieron ser revisadas, por su desincorporación del archivo activo. Apreciamos que la patología con mayor incidencia fue el cáncer de cuello uterino, con un pequeño orcentaje (10 %) iagnosticado en estadio I. Seguidamente encontramos al cáncer de endometrio representando un 12 % de los casos. Dentro de la patología de ovario, el carcinoma epitelial representó el 75 %. El carcinoma de trompa de Falopio solo el 0,3 % de todas las patologías malignas del área inecológica, similar a lo eportado en la literatura mundial. Igualmente el cáncer de vulva, vagina y sarcoma uterino, representaron un escaso porcentaje de incidencia. Este trabajo constituye una fase inicial de investigaciones futuras, en las cuales se deben calcular tasas de upervivencia y período libre de enfermedad, además de incentivar la actualización anual, para evitar sub-registro por la pérdida de datos.(AU)

To know health indicators, is a way to assess the quality of service an institution provides to the population. The incidence, the prevalence and the mortality rates are three basic known elements, which allow you to plan and prioritize the needs of a given population, the improving resource optimization and know that link the natural history of the disease can act. With our research we want to determine the impact registered in our department from the year 2000 to the year 2015, each of the malignant athologies treated. A total of 1 824 stories of a universe of 4 911 were reviewed; the other could not be reviewed by the divestiture of the active file. However, with the data analyzed appreciate that the disease was highest incidence was the cervical cancer, with a small percentage (8 %) diagnosed with stage I, and then found the endometrial cancer representing 12 % of cases. Within pathology ovarian epithelial carcinoma he represented the most frequent with 75 %. The Fallopian tube carcinoma represented only 0.3 % of all malignant gynecological pathologies area, similar to that reported in the literature. Likewise cancer of the vulva, the vagina and the uterine sarcoma, accounted for a small percentage of incidences. This paper is an initial phase of future investigations, which must be calculated survival rates and the disease-free period, in addition to encouraging the annual update, to avoid underreporting by data loss.(AU)

Características clínico-epidemiológicas y manejo del cáncer endometrial (2010-2013) / Clinical-epidemiological characteristics and management of endometrial cancer (2010-2013)

Introducción: el cáncer de endometrio ha incrementado su incidencia y se asocia a factores de riesgo presentes en muchas mujeres en la perimenopausia. El síntoma más común es el sangramiento y la modalidad de tratamiento más empleada es la cirugía. Objetivo: caracterizar el cáncer endometrial en el Hospital América Arias desde enero de 2010 hasta junio de 2013. Métodos: se realizó un estudio descriptivo en el Hospital América Arias, desde 1ro de enero de 2010 hasta el 30 de junio de 2013. Se incluyó el total las pacientes con sangramiento uterino anormal en la etapa peri y posmenopáusico a partir de 40 años de edad. Las pacientes con diagnóstico histopatológico de cáncer endometrial constituyeron la muestra (n= 49). Resultados: la edad promedio de las pacientes fue de 60,8 ± 9,9 años. Presentaban sobrepeso 30,6 por ciento, y 44,9 por ciento eran obesas. El examen histopatológico posquirúrgico muestra que la lesión estuvo limitada al endometrio en 14,3 por ciento de las pacientes; pero hubo invasión de los dos tercios externos del miometrio en 61,2 por ciento de ellas. La extensión al cuello y a los anejos uterinos fue de 38,8 por ciento y 22,4 por ciento respectivamente. Conclusiones: existe una tendencia a la aparición del adenocarcinoma endometrial en edades cada vez más avanzadas. Se asocia a factores de riesgo como obesidad, infertilidad y el uso de terapia hormonal de remplazo. Además de la cirugía, algunas pacientes requirieron tratamiento oncológico específico(AU)

Introduction: The incidence of endometrial cancer has increased and it is associated with risk factors present in many perimenopausewomen. The most common symptom is bleeding and the most widely used treatment modality is surgery. Objective: Characterize endometrial cancer at America Arias Hospital from January 2010 to June 2013. Methods: A descriptive study was conductedat America Arias Hospital, from 1 January 2010 to 30 June 2013. The total included over 40 year patients with abnormal uterine bleeding in perimenopausal and postmenopausal. Patients with histopathologic diagnosis of endometrial cancer constituted the sample (n= 49). Results: The mean age of patients was 60.8 ± 9.9 years. 30.6 percent were overweight and 44.9 percent were obese. Postoperative histopathologic examination shows that the lesion was limited to the endometrium in 14.3 percent of patients, but there was invasion of the two outer thirds of the myometrium in 61.2 percent. The extension cervix and adnexa was 38.8 percent and 22.4 percent, respectively. Conclusions: There is a tendency to the appearance of endometrial adenocarcinoma at increasingly advanced ages. It is associated with risk factors such as obesity, infertility, and the use of hormone replacement therapy. In addition to surgery, some patients required specific cancer treatment(AU)

The epidemiologic status of gynecologic cancer in Thailand / 부인종양

Between the years of 2010–2012, it was estimated there were a total of 112,392 new cases of cancers in Thailand, thus, the total age-standardized rate (ASR) per 100,000 is 137.6. In regards to the most prevalent types of cancer in female, breast cancer has the highest ASR, followed by cervical cancer (ASR=14.4); liver and bile duct cancer; colon and rectum cancer; trachea, bronchus and lung cancer; ovarian cancer (ASR=6.0); thyroid cancer; non-Hodgkin lymphoma and uterine cancer (ASR=4.3). The trend of cervical cancer in Thailand is decreasing, one key factor in making this possible was the employment of dual tract strategy (Pap smear and visual inspection with acetic acid [VIA]) by the government in 2005. In the future, the government is also considering integrating human papillomavirus (HPV) vaccination into the national immunization program, which may assist in the prevention of cervical cancer. By studying the statistical data of gynecologic cancer, it will be possible to formulate measures for the prevention, control and treatment of gynecologic cancer. Eventually, it will potentially improve the quality of life (QoL) of patients as well as decrease the mortality rate caused by gynecologic cancer.

Comparison of age- standard incidence rate trends of gynecologic and breast cancer in Iran and other countries

Female cancer, especially breast and gynecologic cancers are considered multistage disease, highly influenced by risk and protective factors and/or screening preventive modalities. Consequences of all these factors result in the trend of change over time. In this comparative study, based on data of national cancer registry of Iran 2004 published by Iranian Ministry of Health, age - standard incidence rate [ASR] according to the world population was calculated in all reported gynecologic and breast cancers. Source of all subjects are pathologic based. In the next step, the calculated ASR of Iran and those of the other countries in 2004 were compared to GLOBOCAN ASR reports of 2008. In Iran ASR of breast cancer 2004 [24.93] changed to 18.4 in 2008. Ovarian cancer ASR of 2004, 3.07 was 3.1 in 2008. Endometrial cancer ASR in 2004 [2.29] was 1.7 in 2008. Cervical cancer ASR of 1.71 in 2004 was 2.2 in 2008. In Iran incidence trend of breast and endometrium are decreasing in the same direction of USA and Australia. Increasing trend of ovary and cervix ASR in Iran is in the inverse direction of USA and Australia which are decreasing. Future studies to find out the same trend or any changes, might develop these findings and improve consequent practical decisions based on results of this study and complementary future studies

Avaliação da incidência do câncer ginecológico e das lesões precursoras em pacientes portadoras de HIV / Evaluation of the incidence of gynaecological cancer and precursor lesions in HIV patients

Esta revisão sistemática tem como objetivo demonstrar a incidência do câncer ginecológico e de suas lesões precursoras em mulheres que vivem com HIV/AIDS. Foi realizada ampla pesquisa nas bases de dados, MedLine-PubmMed, Scielo-Lilacs e Embase. Após a aplicação dos critérios de elegibilidade, foram incluídos 15 estudos que pesquisaram a incidência de lesões intraepiteliais vulvares, vaginais e cervicais, bem como de carcinomas de mama, endométrio, ovário, vulva, vagina e colo uterino. Observou-se que mulheres infectadas por HIV têm maior risco de apresentarem lesões de vulva, vagina e colo, assim como câncer desses sítios. Por outro lado, essas mulheres apresentam menor incidência de carcinomas mamários, endometriais e ovarianos do que a população feminina geral.(AU)

The aim of this systematic review is to demonstrate the incidence of gynaecological cancer and intraepithelial lesions among women living with HIV/AIDS. A broad research has been done in MedLine-PubMed, Scielo-Lilacs and Embase databases. Fifteen studies that described the incidence of vulvar, vaginal and cervical intraepithelial lesions, as well as breast, ovary, endometrial, vulva, vagina and uterine cervical cancer met the inclusion criteria. Women living with HIV have a greater risk to develop vulvar, vaginal and cervical intraepithelial lesions, as well as cancer in these sites. However, they present a lower incidence of breast, endometrial and ovarian cancer than the general female population.(AU)

Evaluation of the Quality of Life of Gynecological Cancer Patients Submitted to Antineoplastic Chemotherapy / Avaliação da qualidade de vida de portadoras de câncer ginecológico, submetidas à quimioterapia antineoplásica / Evaluación de la calidad de vida de portadoras de cáncer ginecológico, sometidas a quimioterapia antineoplásica

This study aimed to evaluate the quality of life of female gynecological cancer patients submitted to antineoplastic chemotherapy Between August 2007 and April 2009, 50 patients who were undergoing chemotherapy at an outpatient chemotherapy unit in Uberaba - MG were interviewed, by applying the instrument of evaluation of Quality of Life of the World Health Organization, WHOQOL-BREF. The results showed that the domain most affected was the Physical and the more preserved, the Social, with the mean of the general quality of life above the means obtained in other studies. All domains correlated significantly with the general quality of life. It was evident then that the quality of life of these women is satisfactory, however it is suggested that the domains with lower scores be the targets of more accurate observations during multi-professional interventions in order to provide a better quality of life during the chemotherapy treatment.

Este estudo teve como objetivo avaliar a qualidade de vida de mulheres portadoras de câncer ginecológico, submetidas à quimioterapia antineoplásica. Foram entrevistadas 50 pacientes, no período de agosto de 2007 a abril de 2009, que estavam em tratamento quimioterápico em um ambulatório de quimioterapia de Uberaba, MG, mediante aplicação do instrumento de avaliação de Qualidade de Vida da Organização Mundial da Saúde-WHOQOL-bref. Os resultados apontaram que o domínio mais comprometido foi o físico e o mais preservado, o social, sendo que a qualidade de vida geral obteve média acima da obtida em outros estudos. Todos os domínios correlacionaram-se significativamente com a qualidade de vida geral. Pode-se evidenciar, então, que a qualidade de vida dessas mulheres é satisfatória; entretanto, sugere-se que os domínios com escores mais baixos sejam alvo de observações mais acuradas, durante as intervenções multiprofissionais, a fim de se proporcionar melhor qualidade de vida durante o tratamento quimioterápico.

Este estudio tuvo como objetivo evaluar la calidad de vida de mujeres portadoras de cáncer ginecológico sometidas a quimioterapia antineoplásica. Fueron entrevistadas 50 pacientes en el período de agosto de 2007 a abril de 2009 que estaban en tratamiento quimioterapéutico en un ambulatorio de quimioterapia de Uberaba-MG, mediante la aplicación del instrumento de evaluación de Calidad de Vida de la Organización Mundial de la Salud-WHOQOL-bref. Los resultados apuntaron que el dominio más comprometido fue el físico y el más preservado, el social, siendo que la calidad de vida general obtuvo un promedio superior al obtenido en otros estudios. Todos los dominios se correlacionaron significativamente con la calidad de vida general. Se puede evidenciar, entonces, que la calidad de vida de esas mujeres fue satisfactoria; sin embargo se sugiere que los dominios con puntajes más bajos sean examinados con observaciones más exactas durante las intervenciones multiprofesionales, a fin de proporcionar una mejor calidad de vida durante el tratamiento quimioterapéutico.

Perfil de pacientes com câncer ginecológico em tratamento quimioterápico / Profile of patients with gynecological cancer under chemotherapy / Perfíl de pacientes con cáncer ginecológico bajo tratamiento quimioterápico

Estudo do perfil sócio-epidemiológico demográfico das pacientes em tratamento quimioterápico por câncer na Enfermaria de Ginecologia e Obstetrícia do HE-UFTM, apresentado no período de 1998 a 2006. Estudo retrospectivo cuja coleta de dados foi realizada a partir de dados existentes no prontuário. Foi construído banco de dados no programa Epi-info, utilizando-se para análise distribuição simples, mediana com valores entre máxima e mínima e desvio padrão. A amostra foi constituída por 321 porntuários. Os dados dos pacientes revelaram faixa etária mais incidente 46 a 50 anos, 45 por cento dos casos de câncer foi de mama, o quimioterápico mais utilizado foi ciclofosfamida em 173 tratamentos. Houve aumento na frequência do câncer de mama. Conclui-se que houve mudança no perfil das pacientes.

A study of socio-epimiological demographic profile of patients in chemotherapy for cancer in the Gynecology and Obstetrical Ward in HE- UFTM, presented in the periodo from 1998 to 2006. Retrospective study whose data collection was obtained from health records It was built a data base using Epi-Info. Data analysis considered simple distribution, mediacy with value between the maximum and the minimum and stand deviation. The sample was constituted of 321 health records; the more incident age group was 46 to 50 years-old; breast cancer was the most noticed cancer (45 percent); the chemotherapy most used was ciclofosfamida, in 173 treatments; had an increase in breast cancer. It was concluded that had a change in the patient's profile.

Estudio del perfil socio-epidemiológico demográfico de las pacientes en tratamiento quimioterapico por cáncer en la Enfermería de Ginecología y Obstetricia del HE-UFTM, presentado en lo periodo de 1998 al 2006. Estudio retrospectivo cuya recolleción de datos, fue realizada en el prontuario. Fue construido banco de dados en el programa Epi-info, se utilizó para analice distribución simple, mediana con valores entre máxima y mínima y desvío padrón. La muestra fue constituida de 321 prontuarios. La faja de edad los pacientes más incidente fue de 46 a 50 años, 45 por ciento de los casos de cáncer fue el de mama, el quimioterapico mas utilizado fue ciclofosfamida, en 173 tratamientos; hubo aumento en la frecuencia del cáncer de mama. Se concluyó que hubo un cambio en el perfil de las pacientes.

Carga del cáncer ginecológico en Cuba / Burden of gynecological cancer in Cuba

Objetivos Describir la carga integral asociada a localizaciones ginecológicas de cáncer como son: mama, cuello de útero, endometrio y ovario, para Cuba, sus provincias y el Municipio Especial Isla de la Juventud, para los años 1990, 1995, 2000 y 2002. Métodos Se utilizó el indicador Años de Vida Ajustados por Discapacidad, obtenido como la suma de los Años de Vida Potencial Perdidos por mortalidad y los Años de Vida Potencial Perdidos por morbilidad. Los primeros se calcularon a partir de los estimados de Esperanza de Vida y los segundos, de las severidades, la incidencia y la duración promedio. Resultados El cáncer localizado en mama mostró la mayor carga por mortalidad y por morbilidad de manera consistente en los cuatro años para el país. La evolución de los Años de Vida Potencial Perdidos por mortalidad prematura por localización, fue ascendente en los años estudiados en las cuatro localizaciones ginecológicas. Las defunciones en edades más tempranas se debieron al cáncer de cuello. Excepto endometrio, el resto de las localizaciones incrementó su carga por morbilidad de 1990 al 2002. La carga integral aumentó en los años estudiados de 3,58 a 4,54, de 1,62 a 2,42, de 1,72 a 2,03 y de 0,86 a 0,88 por 1 000, para mama, cuello, endometrio y ovario, respectivamente. Se identificaron diferencias entre provincias, dentro de las que vale destacar la mayor carga integral por cáncer de mama en Ciudad de La Habana (6,72 por 1 000) y por cáncer de cuello en Camagüey y las provincias orientales. Conclusiones La evolución desfavorable de la carga del cáncer ginecológico en Cuba en los años estudiados fue a expensas tanto de la mortalidad como de la morbilidad.

Objectives To describe the comprehensive burden associated to gynecological cancer locations such as breast, uterine neck, endometrium and ovary for Cuba, its provinces and special municipality Isla de la Juventud during 1990,1995,2000 and 2002. Methods The disability-adjusted life year indicator, taken as the sum of potential years of life lost from mortality and the potential years of life lost from morbidity. The former was calculated on the basis of life expectancy estimates and the latter on the basis of severity, incidence and average duration of disease. Results The breast cancer consistently exhibited the highest burden caused by mortality and morbidity in the four studied years for the whole country. The potential years of life lost (PYLL) from premature death by location were on the rise in the four years for the four gynecological locations. Uterine cancer was responsible for deaths at younger ages. Except for endometrium, the rest of locations increased morbidity burden from 1990 to 2002. The comprehensive burden increased from 3.58 to 4.54; 1.62 to 2.42; 1.72 to 2.03 and 0.86 to 0.88 per 1 000 for breast, uterine neck, endometrium and ovary respectively. There were some differences among the provinces; it is worth to underline the highest comprehensive burden found in Ciudad de la Habana due to breast cancer (6.72 per 1000) and in Camagüey province and the rest of Eastern provinces due to uterine neck cancer. Conclusions Mortality and morbidity were both involved in the unfavorable development of the gynecological cancer burden in the studied years in Cuba.

Infection of human papillomaviruses in cancers of different human organ sites.

Clinico-epidemiological and molecular studies have established the casual link between Human Papillomavirus (HPV) infection and cervical cancer as also association of HPV infection with several other cancers. In India, cervical cancer is a leading cancer among women and almost all cases of cervical cancer show prevalence of High Risk (HR)-HPV infection. HPV has been also detected in a significant proportion of oral, esophageal, anal, vaginal, vulvar, and penile cancer and in a small percentage of lung, laryngeal, and stomach cancer in India. Due to lack of organized HPV screening program, insufficient infrastructure and trained manpower and inadequacy in cancer registries, there are not much data available on the countrywide HPV prevalence and its type distribution in different cancers in India. Forthcoming introduction of recently developed HPV vaccines in India given a new urgency to know the prevalence and distribution of various HPV types in different organ sites for the management and monitoring of vaccination program and its impact on prevalence of other cancers. This review, summarizes studies on the prevalence of HPV infection in cancers of different organ sites in India.

Infecções causadas pelos papilomavírus humanos: atualização sobre aspectos virológicos, epidemiológicos e diagnóstico / Human papillomavirus infection: update on virological and epidemiological aspects and diagnosis

Papilomavírus humanos são pequenos vírus de DNA capazes de infectar epitélio da pele e mucosas. Mais de 100 tipos já foram descritos, sendo que cerca de 40 causam doenças sexualmente transmissíveis. É também no trato genital que alguns tipos exercem poder oncogênico, sendo 13 considerados agentes etiológicos do câncer cervical, responsável pela morte de 200.000 mulheres em todo o mundo, anualmente. O diagnóstico disponível para o controle das DST e câncer causados pelos HPV baseia-se no tripé colposcopia, citologia e histopatologia, podendo ser confirmado laboratorialmente por técnicas de biologia molecular. Dentre elas: PCR e captura do híbrido. Recentemente, duas vacinas profiláticas contra os tipos 6, 11, 16 e 18 (Merck) e 16 e 18 (Glaxo) foram desenvolvidas. São compostas de VLPs (Vírus-like particles) expressas em leveduras. Resultados promissores vêm sendo publicados, embora alguns mecanismos imunológicos de defesa contra o HPV não estejam ainda esclarecidos.

Human papillomavirus are small DNA viruses capable of infecting the epithelium of skin and mucosa. More than a hundred types have already been described, and nearly 40 promote sexually transmitted diseases. It is in the genital tract that 13 HPV types exert their oncogenic potential, being responsible by the death of 200,000 women worldwide, annualy. The available diagnosis to STD and cancer control is based upon the colposcopy, cytology and histopathology tools, and can be laboriatorially confirmed by molecular biology techniques: PCR and hybrid capture. Recently, two prophylactic vaccines against HPV types 6, 11, 16 e 18 (Merck) and 16 e 18 (Glaxo) were developed. They are composed by VLP (Virus-like particles) expressed in yeasts. Promissing results have been published. Nevertheless, immunological mechanisms for human defense are not well elucidated.

Ovarian carcinoma local experience at Shaikh Zayed Hospital for Women [CMCH] and LINAR Larkana

To study the frequency of Ovarian Carcinoma for early detection and appropriate management. DESIGN: Retrospective observational study. [One years study]. ShaiKhzayed Women Hospital [CMCH] Larkana. A tertiary care Hospital] and Larkana Institute of Nuclear Medicine and Radiotherapy. [LINAR]. The total number of carcinoma patients reported from January 2000 to December 2000, were analyzed. In our study total numbers of ovarian carcinoma presented was 29. Chronologically this was 2nd common gynaecological cancer in the women. Advanced cases [stage III and IV] were 58.5 percent. Surgery was performed in all cases. A complete course of postoperative chemotherapy as received by 7 patients only, remaining cases received incomplete chemotherapy course. Ovarian carcinoma is common health problem. Late presentation leads to poor prognosis

Incidência em biópsias de infecçäo por papilomavírus humano (HPV) no aparelho genital inferior feminino / Biopsy incidence of infecction by human papillomavirus (HPV) in inferior female genital apparatus

A infecção pelo HPV representa hoje um dos fatores mais importantes no desenvolvimento dos carcinomas espinocelulares do trato genital inferior feminino. Com a finalidade de comparar os casos diagnosticados como infecção por HPV, neoplasias intra-epiteliais (lesões pré-cancerosas) e carcinomas espinocelulares, biopsiados nessa Instituição, com a literatura e verificar as faixas etárias atingidas com maior freqüência pelos diferentes diagnósticos, foram estudados exames anatomopatológicos realizados em 1997 e 1998, num total de 1011 biópsias. Os resultados, de um modo geral, são semelhantes aos da literatura, ressaltando-se a grande freqüência de diagnósticos de infecção por HPV (62,43 por cento de todos os casos) e o número de casos com diagnóstico de infecção por HPV, neoplasias intra-epiteliais e carcinomas espinocelulares abaixo dos 30 anos de idade (44,46 por cento das biópsias de colo uterino) e mesmo abaixo de 20 anos (9,8 por cento das biópsias de colo uterino). Concluindo, os autores dão ênfase à necessidade de utilização mais efetiva de métodos de diagnóstico de conhecida eficiência para as lesões analisadas, bem como da preocupação com a realização desses exames desde o início da atividade sexual.

A study of 70 cases of cutaneous metastases from internal carcinoma.

A retrospective analysis of 70 patients with metastatic cutaneous nodules, was conducted in the department of pathology, Kasturba Medical College, Mangalore. The available clinical records and histologic material of these cases were reviewed. In last few years fine needle aspiration cytology (FNAC) was being used as the main diagnostic tool. The commonest primary site of cutaneous metastasis in this study was gastro-intestinal tract (46.7%) in males and breast (32%) in females. Abdomen (including umbilical nodules) was found to be the most frequent site for metastatic cutaneous nodule.

Cáncer de mama: evaluación clínica de casos tratados desde 1986 a 1996 en el Hospital Escuela de Corrientes / Breast cancer: clinical valuation of treated cases between 1986 to 1996 in the Hospital Escuela of Corrientes

El cáncer de mama es la principal causa de muerte en Argentina y el mundo, afortunadamente las posibilidades de diagnóstico temprano son mayores que otros cánceres. Planteamos como objetivos: Conocer su frecuencia, posibilidades de diagnóstico temprano y conciencia de las mujeres sobre el autocontrol. Se evaluaron 71 Historias Clínicas de pacientes internados en los Servicios de Ginecología y/o Cirugía del Hospital "José de San Martín"; paralelamente se encuestaron a 216 mujeres. El cáncer de mama se encontró en 2º lugar en frecuencia (36 por ciento) después del cáncer de cuello uterino (43 por ciento). El motivo de consulta mas frecuente fue por nódulo (78 por ciento) seguido en frecuencia el dolor (12 por ciento). La mayoría de las enfermas no consultan tempranamente, sólo el 12 por ciento lo hizo antes de los 2 meses. El nódulo era detectable con la palpación en un 83 por ciento y el dolor en un 50 por ciento. Los nódulos oscilaban entre 2 y 5 cm. de diámetro, generalmente eran duro elásticos (80 por ciento), la mitad no tenían adherencias. El diagnóstico de certeza lo dió siempre el estudio anatomopatológico. La estadificación demostró desgraciadamente que el 60 por ciento consulta en un estadio avanzado con pocas chances de cura. Con la encuesta se demostró falta total de control mamográfico, así como del autoexamen. En mujeres mayores de 40 años, solo un 16,5 por ciento se hace una mamografía al menos cada 2 años, un 63,1 por ciento no lo hace y el 21,4 por ciento desconoce la práctica de este estudio. Adecuada semiología, mamografía oportuna y correcta enseñanza del autoexamen en las mujeres, permitirían aumentar la sobrevida de las pacientes

Cáncer de ovario / Ovarian cancer

En Costa Rica, el cáncer ovárico ocupa el séptimo lugar en la frecuencia entre los tumores malignos que afectan a la población femenina, con una incidencia que se ha mantenido estable a lo largo de los últimos años, siendo el tercer cáncer gincecológico más frecuente, precedido por el cáncer de mama y el cáncer de cérvix. Probablemente la extirpación profiláctica de anexos durante procedimientos de histerectomía abdominal realizadas por causas no oncológicas, así como el uso creciente de marcadores tumorales, y el progreso en el diagnóstico por imágenes (ultrasonografía vaginal y técnicas de Doppler-Color), harán que la captación en estadíos tempranos...