Lviv Womens Wellness Center:

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Lviv Womens Wellness Center Breast Health
Promotion Services L.S. Gutsal Director
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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
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Educational program
Sexually transmitted diseases
Family planning
Breast self-examination
Psychological preparation to birth giving
Partnership in birth giving
Pathological climax
Breast feeding
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Director
Ultra-sound 2
Technician 1
Cosme-tologist-derma-tologist 1
Radiologist 2
Obstetrician-gynecologist 6
Oncologist-mammologist 1
Psychotherapist 1
Perinatologist 1
Sexopatho-logist 1
Nurses 10
Subordinate medical personnel 6
Information coordinator 1
Medical registrar 1
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Services Provided by the WWC

• 1. Specialist consultations
• obstetrician-gynecologist
• oncogynecologist
• oncologist-mammologist
• sexopathologist
• dermatologist
• psychotherapist-psychologist
• 2. Breast screening and diagnostics

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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

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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

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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

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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

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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

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Laboratory

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

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Laboratory

• hemoglobin
• cholesterol
• HDL-cholesterol (high-density alpha-lipoproteins)
• ?
• 4. Gynecological smear cytological examination
• 5. Gynecological smear cultures

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Laboratory

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

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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
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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
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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
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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

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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

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Diagnoses

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

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Diagnoses

• X Breast cancer, 146
• Stage I, 56 (preclinical form, 27)
• Stage II, 53
• Stage III, 31
• Stage IV, 6

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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

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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

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Diagnoses

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

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Diagnoses

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

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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

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Early breast cancer diagnosis allowed us to

• 4. Alleviate psychosocial traumas caused by
  cancer to family members
• 5. Decrease treatment costs (government and
  private)

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Breast Screening Program Report for 2000

• Mammography- 4278
• Diagnostics- 3663
• Screening- 615

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

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• 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)