Volume 03 Issue 03-2023
16
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
A
BSTRACT
During the implementation of this interesting research method, activities were organized under the motto
"Let's all fight against breast cancer" with the help of patronage nurses trained on the basis of the pilot
program of breast early detection, and special questionnaires were conducted and analyzed among women
living in Andijan region and Andijan city. Based on the results of the analysis, women were divided into
risk groups, and preventive measures were selected that should be implemented in the future.
Journal
Website:
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Original
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4.0 licence.
Research Article
ANALYSIS OF METHODS OF IMPROVING PRIMARY
PREVENTION MEASURES CARRIED OUT IN THE EARLY
STAGES OF BREAST CANCER AND PRE-CANCER DISEASES BY
STUDYING THE RISK FACTORS
Submission Date:
March 14, 2023,
Accepted Date:
March 19, 2023,
Published Date:
March 24, 2023
Crossref doi:
https://doi.org/10.37547/ijasr-03-03-03
Dilfuzahon Zakirjanovna Mamarasulova
Ph.D., Docent, Head Of The Department Of Oncology And Medical Radiology, Andijan State Medical Institute,
Andijan, Uzbekistan
Dilbarkhon Abdulkosimovna Urmanbaeva
Senior Teacher At The Department Of Oncology And Medical Radiology, Andijan State Medical Institute,
Andijan, Uzbekistan
Albina Faalievna Validova
Republican Specialized Scientific And Practical Center Of Oncology And Radiology Of Andijan Regional
Branch, Andijan, Uzbekistan
Vycheslav Hrehorovich Garumov
Republican Specialized Scientific And Practical Center Of Oncology And Radiology Of Andijan Regional
Branch, Andijan, Uzbekistan
Volume 03 Issue 03-2023
17
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
K
EYWORDS
Breast cancer, prevention, early diagnostics, risk factors, objective examination of the mammary gland,
precancerous breast diseases, genetic factors.
I
NTRODUCTION
The main way to reduce disability and death rates
from breast cancer (BC) is to increase the quality
of educational programs among the population
and to inform about the goals of the planned
intervention. Government, non-governmental
organizations,
representatives
of
health
organizations, as well as oncologists in many
countries with experience of long-term screening
programs for this disease are in constant focus
[5,6,8].
In Western European countries, the main method
of attracting the population to targeted screening
is through personal mailing of addressed
invitations to women to be screened. The
invitation contains information about the
screening procedure (its exact time, date and
coordinates of the institution where the
examination will be conducted). In the conditions
of Andijan region, the use of this method remains
impossible for a number of reasons [4,12].
The analysis of the data presented above shows
the need to conduct such research among the
women of the Andijan region, which has the
highest population density in the Republic of
Uzbekistan. Conducting such researches in this
region indicates that the region has its own
geographical,
climatic,
demographic
and
ecological indicators [6]. It is undoubtedly
important to study the epidemiological situation
of oncological diseases in the region with high
natural development of the population and to
compare these indicators with the indices of the
Republic. In addition, the provided oncological
data, as well as medical examination and
questionnaire materials conducted with citizens,
require careful clarification [3].
Compatibility of the topic of our article with the
priority directions of scientific research works of
the Republic of Uzbekistan [15].
PF-5590 of the President of the Republic of
Uzbekistan dated December 7, 2018 "On
comprehensive measures to fundamentally
improve the healthcare system of the Republic of
Uzbekistan" and PF-6110 dated November 12,
2020
"Introduction
of
completely
new
mechanisms to the current activities of primary
medical and sanitary care institutions" and on
measures to further increase the effectiveness of
reforms in the health care system", Resolution No.
PQ-4891 of November 12, 2020 "On additional
measures to ensure public health by further
increasing the effectiveness of medical preventive
work" and this This study serves to a certain
extent in the implementation of the tasks defined
in other regulatory and legal documents adopted
in the direction [1,5].
Volume 03 Issue 03-2023
18
International Journal of Advance Scientific Research
(ISSN
–
2750-1396)
VOLUME
03
I
SSUE
03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
M
ATERIALS AND METHODS
We and leading mammologists based the
modification of the Gale model, taking into
account the factors that cause it in the climate
where we live, population density and the climate
of the Fergana Valley, and the questionnaire was
created and widely used. In order to fulfill the
tasks, set before the research, under the motto
"Let's all fight against breast cancer",
questionnaire data was collected and studied
from 2181 women (1116 Andijan city, 1065
Andijan region) women, based on the
questionnaire data, breast cancer and cancer
pathology was involved in the investigation in
order to determine.
R
ESULTS AND DISCUSSION
Women from 17 to 75 years of age who answered
the questions of the questionnaire were included
in the clinical research object, who were involved
in the preventive examination conducted by the
specialists of the branch and the department
(Table 1).
Table 1
Women aged 17 to 75 years who answered questionnaires and underwent preventive
examinations
Patients of the examined group
Quantity
abs.
%
The first subgroup is breast cancer
21
1,91%
The second subgroup is mammary gland disease
886
38,2
The third subgroup is healthy women
1374
59,89%
Total :
2181
100,0
The average age of the examined patients is
46.5±1.0 years, the average age of healthy women
is 45.2+0.8 years, the age of women with breast
disease is 42.1±1.4 years, the average age of
breast cancer patients is age was -51.7±0.9 years.
In Andijan city and Andijan region, the cause-and-
effect relationship between breast cancer and
death from medical-demographic, ecological-
hygienic factors and disease indicators was
studied. The risk factors of the origin of breast
cancer were evaluated and a group of women
with a high risk of developing this pathology was
identified. In Andijan region and Andijan city, the
priority directions of diagnosis of BC in
connection with the spread of the disease and
Volume 03 Issue 03-2023
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International Journal of Advance Scientific Research
(ISSN
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2750-1396)
VOLUME
03
I
SSUE
03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
carcinogenic factors were shown. A program for
the prevention of mammary gland disease was
formed.
Information on breast cancer was obtained from
the following documents:
1) Questionnaire on checking the risk factors of
the origin and development of breast cancer
(2181 questionnaires);
2) 7 mobile examination materials for the
purpose of research and preventive examination
of risk factors for the development of breast
cancer in women of Andijan region and Andijan
city in 2017-2019;
Examination of individual oncological risk factors
for the development of BC was performed
according to the principle of BC 101 patients
"case-control", "case", 448 women "control".
Consent was obtained from all women before
filling out the questionnaire.The results of the
study were obtained by the author from the
examination and questioning of the patient, from
the
processing
of
the
questionnaire
(questionnaire), filling out the patient's inpatient
and outpatient medical card, from the dispensary
monitoring control card, from the patient's
notification of the first diagnosis, from the
hospitalization and examination logs, from the
paraclinical research reports.
Methodological support is intended to improve
the activities of oncology dispensary specialists to
trainers focused on the primary link of health
care:
• Screening rooms –
implementation of a practical
activity for Q&A on the note "BC Disease Alert",
• Elimination of defects of mammographic
research,
• Improving the professional skills of doctors and
medical staff on physical examination of BC,
• formation of risk groups for BC,
• Effectiveness of
the work of the panel of doctors
on the analysis and study of the report of the late
diagnosis of BC in order to minimize defects in
preventive, dispensary, sanitary-educational
work.
Table 2
General description of patients participating in the study (based on questionnaire analysis)
Volume 03 Issue 03-2023
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International Journal of Advance Scientific Research
(ISSN
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2750-1396)
VOLUME
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Pages:
16-24
SJIF
I
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FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
Age
•
median age
57
35/77
• minimum/maximum age
Menstrual function
335 (99,7%)
1 (0,3%)
• postmenopause
• premenopause/perimenopause
8/17
Menarche
• minimum/maximum age
16/40
Maternal age
• minimum / maximum age
94 (27,9%)
24 (7,1%)
Family anamnesis
74 (22,0%)
• relatives of the
first degree of consanguinity
20 (5,9%)
• relatives of the second degree of consanguinity
9 (2,7%)
9 (2,7%)
2 (0,6%)
Volume 03 Issue 03-2023
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International Journal of Advance Scientific Research
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VOLUME
03
I
SSUE
03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
The average age of the patients participating in
the study was 57 (35-77) years. 2 patients 2
(0.6%) age unknown (patient did not return after
obtaining written consent, no follow-up was
recorded, age was not determined).
Table 3
Characteristics of patients participating in the study in accordance with the Gale model and
specific risk factors
Menarche
• 7
-11 years old
39 (11,6%)
• 12
-13 years old
148 (44,0%)
• Age 14 and older
134 (39,9%)
• unknown age
15 (4,5%) а
First birth and age
•
under 20
18 (5,4%)
• 20
-24 years old
138 (41,1%)
• 25
-29 years old
81 (24,1%)
• Age 30 and older
44 (13,1%)
• did not give birth
41 (12,2%)
• no data
14 (4,1%)
First-degree relatives with BC
• not sick
235 (69,9%)
• 1 relative
84 (25,0%)
• More than 1 relative
10 (3,0%)
• no data
7 (2,1%)
Volume 03 Issue 03-2023
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International Journal of Advance Scientific Research
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2750-1396)
VOLUME
03
I
SSUE
03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
Fine needle aspiration /Biopsy related to suspected BC
• not observed
258 (76,8%)
• 1
needle aspiration/biopsy
50 (14,9%)
• More than 1
needle aspiration /biopsy
24 (7,1%)
• no data
4 (1,2%)
Morphological summary (biopsy)
Total 74
• no data
54 (73,0%)
• other morphology
18 (24,3%)
• atypical hyperplasia
2 (2,7%)
Significant risk factors were observed in the
patients involved in the study. Many of them had
an early onset of menarche: 44.0% of patients had
their first menstruation at the age of 12-13, 11.6%
of patients had it earlier than the age of 12. Very
few (5.4%) patients had their first birth before
the age of 20 years. Therefore, 41.1% of patients
at the age of 20-24 had their first birth, 24.1% at
the age of 25-29, 13.1% at the age of 30 and older,
and 12.2% of patients did not give birth. In 28%
of patients with BC, first-degree consanguinity
was detected, and in 3% of patients, second- and
third-degree consanguinity was detected. 22% of
patients had mammary nodules requiring
diagnostic puncture/biopsy to rule out BC. Mainly
mammary tumors are in the form of
fibroadenoma (FA) and intraocular papilloma
(IP). Atypical hyperplasia was diagnosed in 2.7%
of cases.
The risk of developing BC over 5 years according
to the Gale model is presented in Table 4. Risk was
calculated for 179 of 180 patients without a
personal history of BC.
Table 4
For 5 years according to Gale's model the risk of developing breast cancer
Volume 03 Issue 03-2023
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International Journal of Advance Scientific Research
(ISSN
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2750-1396)
VOLUME
03
I
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03
Pages:
16-24
SJIF
I
MPACT
FACTOR
(2021:
5.478
)
(2022:
5.636
)
(2023:
6.741
)
OCLC
–
1368736135
Risk Factors
Low, less than 1.67%
70 (39,1%)
High, 1.67% and more
109 (60,9%)
Total
179 (100%)
According to Gale's model, a high risk of
developing BC was found in 109 (60.9%) patients.
Referred for an in-depth medical examination for
women classified as high-risk according to the
Gale model.
C
ONCLUSION
According to the data of the questionnaire and
palpation of the mammary gland, more than half
of the women who underwent the ultrasound
examination were diagnosed with precancerous
diseases and breast cancer. Patronage led to
nurses working on a program for early detection
of breast pathology, public understanding of the
purpose of planned preventive examinations, and
a dramatic improvement in women's coverage of
preventive examinations.
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