Breast cancer in Slovenia

Izhodišča. Rak dojk je v Sloveniji najpogostejši rak pri ženskah. Leta 2000 je za njim zbolelo 932 žensk (92,2/100.000), pričakujemo pa, da se bo v prihodnjih desetih letih incidenca še večala. V primarni preventivi zaenkrat ni posebnih priporočil, so le splošna: vzdrževanje normalne telesne teže, pravilna prehrana, telesna dejavnost in zmernost pri pitju alkoholnih pijač. V randomiziranih študijah, narejenih v ZDA, Kanadi, na Škotskem in Švedskem se je izkazalo, da redna mamografija, bodisi sama ali skupaj s kliničnim pregledom dojk, zmanjša umrljivost za rakom dojk po 50. letu starosti za približno 25%, manj pa med mlajšimi. Preventivna mamografija ima tudi številne slabe strani, med katerimi so najpomembnejši napačno pozitivni in negativni izvidi. Številne raziskave so pokazale, da se prednosti presejanja lahko pokažejo le, če je pri vseh postopkih zagotovljena primerna kakovost, od usposobljenosti radiologov do tehnične kakovosti naprav. Seveda pa mora vsem pozitivnim izvidom slediti kakovostna diagnostika in zdravljenje. Zaključki. V Sloveniji imamo jasna navodila in standarde za delo ambulant za dojke. V prihodnje bo treba poskrbeti, da bodo natančno opredeljeni normativi zaživeli tudi v praksi. Zmanjšanje bremena raka pa lahko pričakujemo le s skupnimi napori, usmerjenimi v primarno preventivo in zgodnje odkrivanje, pa tudi kakovostno diagnostiko in zdravljenje te bolezni.Background. Breast is the most frequent cancer site in Slovenian female population. In the year 2000 there were 932 new breast cancer cases registered (91.2/100,000), the incidence is expected to increase in the next ten years. Primary prevention includes general recommendations for healthly life style, e.g. avoidance od obesity, diet, physical activity and moderate alcohol consumption. Randomised controled trials conducted in the USA, Canada, Scotland and Sweden have shown that regular mammography, alone or in combination with clinical examination, is effective in reducing mortality for about 25% in women over the age of 50, and much less in younger population. However, mammography screening has several drawbacks, the major being its tendency towards false positive and false negative results with all their potential psychosocial consequences. High quality assurance and control, as well as effective and readily available diagnostics and treatment, all of which demand high investments, are indispensable for good results. Conclusions. In Slovenia there are standards for breast cancer screening units, but their implementation in every day\u27s work is still a problem. In any case, breast cancer control could be achieved only by combined efforts directed into primary prevention and early detection, as well as by improving availability of effective treatment