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Lviv Women’s Wellness Center: Breast Health Promotion Services L.S. Gutsal Director

Lviv Women’s Wellness Center: Breast Health Promotion Services L.S. Gutsal Director. Gynecological diseases. Diagnosis. Prenatal diagnosis. Cervical pathology. All obstetric, gynecological, and breast conditions. Operation. Treatment. Self-education.

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Lviv Women’s Wellness Center: Breast Health Promotion Services L.S. Gutsal Director

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  1. Lviv Women’s Wellness Center: Breast Health Promotion Services L.S. Gutsal Director

  2. Gynecological diseases Diagnosis Prenatal diagnosis Cervical pathology All obstetric, gynecological, and breast conditions Operation Treatment Self-education KBLZhD medical personnel education program Education Patient education program

  3. Educational program Sexually transmitted diseases Family planning Breast self-examination Psychological preparation to birth giving Partnership in birth giving Pathological climax Breast feeding

  4. Director Obstetrician-gynecologist 6 Oncologist-mammologist 1 Radiologist 2 Ultra-sound 2 Technician 1 Cosme-tologist-derma-tologist 1 Psychotherapist 1 Perinatologist 1 Sexopatho-logist 1 Nurses 10 Subordinate medical personnel 6 Information coordinator 1 Medical registrar 1

  5. Services Provided by the WWC 1. Specialist consultations: • obstetrician-gynecologist • oncogynecologist • oncologist-mammologist • sexopathologist • dermatologist • psychotherapist-psychologist 2. Breast screening and diagnostics

  6. Services Provided by the WWC 3. Ductography 4. Pneumocystography 5. Needle location of nonpalpable tumors using mammograph 6. Breast ultrasound examination 7. Breast aspiration biopsy with ultrasound monitoring followed by cytological examination 8. Breast aspiration cysts with ultrasound monitoring

  7. Services Provided by the WWC 9. Wide-bore needle biopsy with ultrasound monitoring followed by cytological examination 10. Needle location of nonpalpable tumors with ultrasound monitoring 11. Excision (surgical) biopsy of nonpalpable tumors preceded by needle location with ultrasound or mammograph monitoring 12. Cytological examination of nipple discharge and aspirated fluid; histological examination of wide-bore needle and aspiration biopsies

  8. Services Provided by the WWC 13. Out patient services for pregnant women: • complete set of laboratory tests • Ultrasound examination • alpha-fetoprotein • perinatologist-geneticist consultation 14. Colposcopy, biopsy of cervical erosions, electrical coagulation of cervix, insertion and extraction of intrauterine devices, diagnostic abrasion of the cervical channel and uterine cavity, polypectomy, removal of condylomas, ambulatory treatment of gynecological diseases, hysterosalpingography, cytological examination of cervical channel discharge, and smear culturing

  9. Services Provided by the WWC 15. Ultrasound examination: • pregnant women • gynecological patients • abdominal organs and kidneys • thyroid gland • transvaginal examination of gynecological patients • examination of children

  10. Services Provided by the WWC 16. Sanitary education in all programs: • breast self-examination • partnership in birth giving • prevention of sexually transmitted diseases • prevention of osteoporosis • family planning

  11. Laboratory 1. Blood test 2. Urine test (qualitative) 3. Blood biochemistry in a Reflotron analyzer: • bilirubin • AST (aspartate aminotransferase) • ALT (alanine aminotransferase) • urea • glucose

  12. Laboratory • hemoglobin • cholesterol • HDL-cholesterol (high-density alpha-lipoproteins) • К+ 4. Gynecological smear cytological examination 5. Gynecological smear cultures

  13. Laboratory 6. Puncture biopsy of breast tumors 7. Puncture biopsy of breast cysts (centrifuge preparation) 8. Nipple discharge 9. Spermogram

  14. Railway Ministry healthcare facilities in Lvov Self-sustained Local out-patient clinic Regional cancer clinic Health care facilities Medical registry Obstetrician-gynecologist Psychotherapist Surgeon (oncologist-mammologist) Ultrasound diagnostic techniques Laboratory tests Mammography

  15. Laboratory tests Vaginal smears Cytological examination of nipple discharge Cytological examination of cervical smears Cytology of breast cyst punctate Blood chemistry Intraoperational rapid cytological examination Urine tests in pregnant women

  16. Ultrasound diagnostic suite Breast ultrasound examination prior mammography Prenatal diagnosis Gynecological diseases Separate diagnosis of uterine and ectopic pregnancy Transvaginal examination Cyst Neoplasm Solid neoplasm Intracystal neoplasm Cyst Biopsy Mammography Preparation of patients for IVF Puncture Biopsy

  17. Breast Screening Program Report for 1998, 1999, and 2000 (through August) I Total number of female patients examined, 2893 • screening, 1388 • diagnosis, 4505 II Mammography • total number of procedures, 4863 • needle location of nonpalpable tumors, 59 • ductography, 11

  18. Breast Screening Program Report for 1998, 1999, and 2000 (through August) III Breast ultrasound examination, 1510 • cyst aspiration with ultrasound monitoring, 206 IV Biopsy • aspiration of solid formations, 227 • wide-bore needle biopsy for cytological examination, 49 • excision, 59 V Cytological examinations, 519 VI Histological examinations, 132

  19. Diagnoses VII Healthy, 1605 VIII Gynecomastia- 12 IX Mastopathy- 4130 • diffuse, 2848 • nodal, 1282: cystic, 368 fibrous, 384 cystic-fibrous, 530

  20. Diagnoses X Breast cancer, 146: Stage I, 56 (preclinical form, 27) Stage II, 53 Stage III, 31 Stage IV, 6

  21. Breast Screening Program Report for 2000 I Total female patients examined, 27704 • railway employees, 21642 • screening, 615 • diagnosis, 3663 II Mammography • total number of procedures, • needle location of nonpalpable tumors, 14 • ductography, 6

  22. Breast Screening Program Report for 2000 III Breast ultrasound examination, 729 • cyst aspiration with ultrasound monitoring- 81 IV Biopsy • aspiration of solid formations, 108 • with wide-bore needle for histological examination, 14 • excision, 22 V Cytological examinations, 388 VI Histological examinations, 36

  23. Diagnoses VII Healthy, 731 VIII Gynecomastia, 2 IX Mastopathy- 4216 • diffuse, 2775 • nodal: cystic, 322 fibrous, 331 cystic-fibrous, 803

  24. Diagnoses X Breast cancer, 72 Stage I, 44 (including 12 nonpalpable) Stage II, 41 Stage III, 24 Stage IV, 4

  25. Early breast cancer diagnosis allowed us to: 1. Cure cancer in situ 2. Increase life span of cancer patients in stages I and II 3. Improve the patients’ quality of life over the longer life span by using the most effective approach: organ-preserving surgery combined with chemotherapy and radiotherapy

  26. Early breast cancer diagnosis allowed us to: 4. Alleviate psychosocial traumas caused by cancer to family members 5. Decrease treatment costs (government and private)

  27. Breast Screening Program Report for 2000 Mammography- 4278 • Diagnostics- 3663 • Screening- 615

  28. 1. Mastopathy • Diffuse- 2775 (65,8%) • Nodal- 1463 (34,7%) • cystic- 322 (22%) • fibrous- 331 (23%) • cystic-fibrous- 803 (53,4%)

  29. 2. Breast Cancer- 72 (1,68%) stage I- 44 (61,1%) stage II- 41 (56,6%) stage III- 24 (33,3%) stage IV- 4 (5,5%)

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