What is mammography and how can it help us?

What is mammography

From the age of 40, it is important to have an annual mammogram to prevent the development of tumors. It is recommended for all women, especially for those with a family history.

Mammography is one of the safest and most effective tests to detect breast cancer before it develops; Therefore, mammograms are among the tests that all women susceptible to breast cancer should be done every year.

Mammography is a very simple test, in which only each of the breasts will be placed in a device to make a type of x-ray. The test is completely painless although it can be somewhat annoying for certain people when the breast is flattened.

With this test, medical specialists can detect certain lumps that may arise in our breasts. This test provides a clear and clear image of the inside of our breasts and detect small lumps from the moment they are forming. Therefore, mammography is the indicated test to try to prevent this type of cancer before it develops, because it is more effective than even to the palpations of doctors.

The results of the mammography can be obtained at the same time that the test is done or it is possible that we have to wait a few days to have them, depending on the center in which we take the test.

The results may indicate that there is nothing strange about what we have to worry about; That there is a potentially malignant lump that must be removed, that the lump is potentially benign or that it is not just clear and the test should be repeated.

In cases where the test indicates that there is a lump that should not be in the breast, the specialist doctor will probably ask us for a biopsy of the lump itself so we can diagnose whether it is cancer or not. In any case, the great majority of physicians and regardless of the result of the biopsy, will indicate the extraction of this by security of the woman.

When should we have a mammogram?

Women who are at higher risk for breast cancer and who must therefore do this test every year are those over 40 years of age, women who have had a history of breast cancer in the family and all those who, for Personal circumstances, may develop this disease. In any case, the test is simple and usually covered by social security centers, so it should not be a matter of laziness to do this test, even when we are not within these groups. Health is first.

How to detect breast cancer in time?

How to detect breast cancer

Although their odds are much lower than in women, men can also develop breast cancer because they have mammary glands.

Breast cancer is a very common disease for women. Although it is impossible to know who you will touch, as many of the risk factors can not be modified, there are things you can do to have control over your body. Find out. Get to know the details for an early detection, this little action can save your life!

Here we will let you know some questions about breast cancer so that you are more informed on the subject. To be able to do a good early detection, it is necessary to know what this disease is, what the risk factors are, what it is necessary for an early detection and what practices it includes. If you want to know more, we invite you to continue reading.

First things first: What is breast cancer?

Breast cancer is caused by the development of a malignant tumor that begins in the cells of the mammary gland. We mean by malignant tumor those tumor cells that are generated in the glandular tissue of the breast and invade the rest of the healthy tissue that surrounds it.

Why is it important to detect it as soon as possible?

According to the WHO (World Health Organization), 16% of female cancer cases are diagnosed as breast cancer. It is considered that this is the most frequent type of cancer in the women. Therefore, it is necessary to take special care in the detection of this pathology in time. It is obvious that the sooner it is detected, the greater the chances of initiating the necessary treatments and of achieving healing. To be clear, detecting this disease early can make the difference between life and death.

Breast cancer is a disease that initially has no visible symptoms. It is in turn this ideal moment to attack it. According to the American Cancer Association – and reinforcing the above – almost all cases detected and treated early can be cured. It is proven that the early detection campaigns are highly effective and have reduced the number of deaths from this disease.

As we see, then, early detection is essential from our place. The first step is to inform us and know what we can do to be aware. Here are some utility keys.

How to detect breast cancer

Know the risk factors

A risk factor is that element that increases the chances of suffering a certain disease. It is necessary to clarify that having one or several risk factors does not imply that one has or will develop this disease. These are simply indicators that allow us to place ourselves within some of the groups that measure risk. Having a record of these allows us to inform our doctor so that he can take actions accordingly. It is important to know if we are part of the population at risk and what care must be taken from this.

Within risk factors, there are modifiable and non-modifiable factors. Although there is no proven direct relationship between the alterable factors and the disease, there are studies indicating that there is some correlation between them. By knowing them, we can make the necessary changes in our lives.

Non-modifiable factors:

  • Being female: The main risk factor for this disease is to belong to the female gender. Men may develop breast cancer because they have mammary glands, but their odds are much lower than in women.
  • Being over 55 years old: Another unchangeable risk factor is age. With age, the risk of developing breast cancer increases. Two out of three patients with invasive breast cancer are older than 55 years.
  • Possess a genetic predisposition: Genetics is the third risk factor. Having a family history of breast cancer immediately implies a more rigorous control for early detection. It is estimated that between 5% and 10% of breast cancers are hereditary. According to the American Cancer Association, having or having had a direct blood relative who has had this disease doubles the chances of having this disease at some point in life.
  • Having a personal history of breast cancer: This is another unalterable risk factor. A woman who has already had this disease is more likely than the average woman to develop breast cancer again.
  • Not having children: Women who have not developed and given birth to children up to the age of 30 are more likely to have breast cancer.
  • Not having suckled: In turn, having gone through a lactation process decreases the chances of suffering this type of cancer.

Modifiable Factors:

Among the modifiable risk factors we find obesity (especially post menopause), smoking, absence of exercise and estrogen therapy for menopause.

Perform self exams

From the age of 20, you should have breast self-exams. Performing this kind of breast exams regularly allows you to know the shape and how your healthy breast is composed. So, if you find any kind of change, it will be easy to detect. The self-examination does not serve as a screening method if used alone. You should always consult with your primary care doctor what you have found or that causes you doubt.

Knowing your own body and your breasts can allow you to detect abnormalities, such as lumps, inflammations, secretions, temperature increases, changes in size or shape, pain, peeling of the skin, change in coloration of the nipple and its surrounding.
If you are unsure about how to perform these tests, ask your doctor to teach you the correct way to perform these self-exams.

How to detect breast cancer

Perform clinical exams

Between the ages of 20 and 40, it is necessary to perform clinical breast exams with your doctor. Between these ages, it is advisable to take the exams every three years.

Get a mammogram

From the age of forty, it is necessary to have a clinical breast exam and a mammogram every year. A mammogram is an x-ray imaging study that explores the consistency and formation of the mammary gland. It is done by medical indication and you must take it when you have it so that the professional can evaluate the results.

Where and how to get a clinical examination and mammogram?

Make an appointment with your gynecologist. In addition to answering all the doubts you have regarding the subject and the risk factors that concern you, can teach you how to perform self exams and do the relevant clinical tests.

Find a doctor with whom you feel comfortable and take advantage of the space that gives you in the consultation to formulate all the questions that you think pertinent. He will keep track of how often you have done the various tests and will give you a mammogram when needed.

Well, as you have seen, the detection of breast cancer requires simple actions that we must all take into account to preserve our health. And you, how do you control yourself? Do you know how to do the self-examination? Visits your gynecologist as often as indicated?

Cardiovascular physical examination

To get a good approximation of the cardiovascular examination, it is convenient to remember the function of the heart. This body, the motor of the body, in the physiological state fulfills the function of supplying the needs of oxygen (variables in time) of the cells of the organism.

When this is altered, they manifest in a series of recognized symptoms and signs that can guide the precise cause.

Within the faults it could happen that the myocardium had a decrease in the blood that expels, due to problems of contractibility, alteration of filling, limitation to the exit, etc.

Any of these will result in a patient showing signs of low flow; Cold extremities, fill in the capillary, alteration of the skin (color, turgor, gynaeum, hydration), collapse of the large examining vessels, alteration of the nails, pallor of mucous membranes, among many others that vary according to the chronicity of the picture.

On the other hand it could happen that the amount of blood that reaches the heart pump is smaller, for example when the blood is accumulated in the interstitium, in the extravasular space of the rest of the organs. In that case signs of systemic congestion will be appreciated; Edema, ascites, hepatomegaly, effusions, hepatoabdominal reflux, jugular engorgement, paradoxical pulse, etc., in the case of compromised right cavities, or pulmonary level, with pleural and pericardial effusion, in the left faulty constipation. These alterations of low flow, or backward congestion can be expressed in any of the chambers. Also, both mechanisms and bilateral alteration (right and left cavities) could coexist. This is common in long-standing cardiovascular disorders.

Taking into account the above, it is easy to agree that the clinical evaluation of the cardiovascular system is much broader than simple auscultation of the thorax. It requires an integral view of the patient as a whole.

Basically, it involves evaluating, with some examples:

  • Attitude and position: Orthopnea (Heart Failure), Genupectoral position (pericarditis), dyspnea, respiratory difficulty
  • Constitution: Obesity (CV Risk Factor), cachexia (terminal heart failure)
  • Skin and mucous membranes: Anemia, gravid edema (heart failure), sweating, cyanosis, palides
  • Nails: Fill capillary, splinter hemorrhages
  • Fever: In infective endocarditis, including AMI, PE.
  • Head: Pupillary beat, Musset’s sign (the “nodding” with head to beat of heart, in Aortic Insufficiency), peripheral cyanosis
  • Neck: Estimated central venous pressure measuring jugular, jugular engorgement (cardiac insufficiency, cardiac tamponade), carotid dance (aortic insufficiency), auscultation of murmurs (irradiated from the heart or by local atheromatosis)
  • Abdomen: Hepato-jugular reflux (heart failure), hepatosplenomegaly, ascites, abdominal cramps (Aortic stenosis or renal arteries)

Cardiovascular Thoracic Examination

Inspection: Tip collision (left ventricle) in 5th Intercostal Space (EIC), Clavicular midline (CML). Difficult to see, not necessarily pathological.

Palpation: Confirms clash of the tip (in the same place), its outward and downward movement indicates VI hypertrophy. “Sustained” beats, pressure surges (AHT, aortic stenosis), versus “live” beats differ in volume overloads (aortic insufficiency). Pericardial thrusts or rhythms may also be felt.

Percussion: In disuse, before it was looked for projection of the heart (“Cardiac mastness”)

Auscultation:

  • For a systematic evaluation, it is suggested to follow the foci of auscultation:
    Aortic: 2nd right parasternal EIC (focus on aortic valve)
    Pulmonary: 2nd left parasternal EIC (focus on pulmonary valve)
    Aortic Attachment: 3rd left parasternal EIC
    Mesocardial: 3rd and 4th left parasternal EIC (interventricular septal noises)
    Mitral: apex area (LMC 5th EIC Iº). (Focus on mitral valve)
    Tricuspid: Infrared. (Focus on tricuspid valve)

Cardiovascular physical examination

  • The behavior of noises versus inspiration-exhalation and changes of position
  • Noise
    First noise, by closure of the Auriculoventricular (AV, mitral and tricuspid) valves. It can be separated, for example. In branch blocks.
    Second noise, by closing the sigmoid valves (pulmonary and aortic), being shorter and sharper. It unfolds physiologically in inspiration.
    Third noise, for fast (passive) filling of the ventricle. Physiological in young people, tends to disappear with age. It may appear in hyperdynamic states or pathologically if there is diminished compliance.
  • Fourth noise, due to active filling of the ventricle (atrial systole), indicating abrupt distension of a rigid ventricle, eg. In heart failure.
    Blows, which correspond to turbulent blood flow due to sudden changes in velocity. They are classified according to temporality in:
    Systolic, during ventricular systole (between 1st and 2nd noises). They can be pansystolic (all systole), mesosystolic (half) or end-systolic (at the end)
    Diastolic, between 2nd and 1st noises, being able to be protodiastolic (at the beginning of diastole), mesodiastolic or presystolic (at the end of diastole)
    Continuous

Maximum intensity site (measuring I-VI), irradiation and character should be evaluated.

Cardiovascular physical examination

In addition, there are innocent murmurs, in young people or hyperdynamic states. They are not very intense, they maintain the 2nd noise, never pansystolic or diastolic.

Rub pericardial, like “sandpaper scraping”, at any point in the cycle. It is heard in inflammations of the pericardium, recent cardiac surgery or renal failure.

Bibliography

  1. Suárez, L. (2009) “Physical examination of the cardiovascular system” In Argente, H. and Álvarez, M., Medical semiology. (Pp. 341 – 390) Medical Editorial Panamericana, Argentina.
  2. Chamorro, G. (2009) “Cardiovascular examination” in Goic, A., Chamorro, G. and Reyes, H. Medical semiology (pp. 393-405) Editorial Mediterráneo, Chile.