Like every October 19, today the World Day Against Breast Cancer is commemorated and it is a date in which different activities are carried out. The goal is to raise awareness about this disease that every year it causes 685 thousand deaths on the planet. Although one of the main adversities is that most cases are detected in late stages. For this reason there are documents such as the Official Mexican Standard (NOM) 041 which specifies how correct medical care should be from the first contact consultations.
In this sense, to understand the dangerousness and progression of the disease, it must be taken into account that in 2005 the mortality rate from breast cancer in Mexico was 15.6 for every 100 thousand women 25 years of age or older. While for 2010 it increased to 16.9 and in 2017 it reached 19.04. With this, it is observed that the trend is upward.
What the law says about breast cancer care
Due to the complexity of the problem and the impact it has on society, the Ministry of Health (SSa) has the NOM 041. The objective is to establish the operating criteria for the prevention, diagnosis, treatment, control and epidemiological surveillance of cancer breast. It is also mandatory that any health service provider follow the indicated indications.
Prevention activities include educational communication to the population to assess risk factors and promote healthy lifestyles that contribute to reducing morbidity from breast cancer, as well as early detection activities for identification, diagnosis , treatment and timely control of breast cancer.
Identification and treatment of breast cancer
Breast cancer detection activities include three types of specific intervention that are directed at the female population according to their age group and vulnerability and include:
Once a lesion suspected of breast cancer has been detected, the woman must receive timely and adequate care for diagnosis and treatment, in accordance with established guidelines.
The minimum criteria and procedures for diagnosis and treatment that must be offered include those listed in the chapters on diagnosis, imaging, classification, counseling and treatment, dealt with in this standard.
The control activities, including those related to the monitoring of the prevention, diagnosis and treatment processes focused on the continuous improvement of the quality of care, must be carried out within the institutions in accordance with the corresponding infrastructure and internal regulations.
Classification and coding
Breast cancer should be coded, according to the International Classification of Diseases in its X revision, as follows:
- Malignant tumor of the breast (C50).
- Malignant tumor of the nipple and areola (C50.0).
- Malignant tumor of the central portion of the breast (C50.1).
- Malignant tumor of the upper-inner quadrant of the breast (C50.2).
- Malignant neoplasm of the lower inner quadrant of the breast (C50.3).
- Malignant tumor of the upper outer quadrant of the breast (C50.4).
- Malignant neoplasm of the lower outer quadrant of the breast (C50.5).
- Malignant neoplasm of the axillary extension of the breast (C50.6).
- Contiguous site lesion of the breast (C50.8).
- Malignant tumor of breast, part unspecified (C50.9).
Diagnosis
All women with suspected breast disease should undergo the following procedure:
- Complete clinical history focused on the search for risk factors for breast cancer.
- Complete clinical examination with emphasis on the mammary glands and lymphocarrier areas (axillary and supraclavicular nodes) in accordance with the provisions of normative Appendix A.
- Mammography and / or ultrasound, according to age, findings and detection of risk factors, according to paragraph 9.2.
- In case of suspicion of malignancy on clinical examination and / or imaging study (mammography), it is sent to the next level of care, when necessary.
- To establish the diagnosis, a correlation between clinical, mammographic and histopathological findings is necessary.
Histopathological diagnosis
The clinical diagnosis of breast cancer requires cytohistopathological confirmation by biopsy; This must be carried out exclusively by the specialist doctor.
The selection of the technique to use depends on the facilities and technological means available, as well as on the particular indications.
For all the above, NOM 041 is essential for any health professional throughout the year. To know the document, all you have to do is check this link.
