Guía de Atención Integral (GAI) para la detección temprana, atención integral, seguimiento y rehabilitación de pacientes con diagnóstico de cáncer de

Transcripción

1 Guía de Atención Integral (GAI) para la detección temprana, atención integral, seguimiento y rehabilitación de pacientes con diagnóstico de cáncer de mama.

2 Justificación Epidemiología

3 Incidencia de cáncer de mama Mujeres (Todas las edades) - TAE por Globocan 2008

4 Incidencia y mortalidad por cáncer en Colombia Mujeres (Todas las edades) TAE por Mama Cuello del útero Tiroides Estómago Colon, recto y ano Tráquea, bronquios y pulmón Ovario y otros anexos Linfomas no Hodgkin Leucemia Nuevos casos por año Mama: 7007 Incidencia Mortalidad Melanoma Fuente: Pardo C et al. Incidencia y mortalidad por cáncer en Colombia INC; 2010

5 Mortalidad por cáncer de mama en Colombia Murillo R et al. INC-IGAC; 2004

6 Razones mortalidad/incidencia para países seleccionados de América Cuba México Ecuador Colombia Perú Bolivia Brasil Costa Rica Chile Argentina Estados Unidos Canadá Razón Mortalidad/incidencia Fuente: Globocan 2008

7 Tendencias de mortalidad por cáncer en Colombia TAE ASR por per TAE ASR por per Murillo R et al. Serie Doc Tec INC 2006; No. 1 Mujeres Women Mujeres Women Año Year Año Year Estómago Stomach Estómago Stomach Pulmón Lung Pulmón Lung Cuello Cervix uterin Cuello Cervix uterin Mama Breast Mama Breast

8 Justificación Impacto Evidencia

9 Antecedentes Convocatoria Alianzas Marco metodológico

10 Objetivo General Generar recomendaciones para la detección temprana en mujeres, atención integral, seguimiento y rehabilitación de pacientes con diagnóstico de cáncer de mama en Colombia.

11 Aspectos sanitarios Detección temprana, tratamiento, seguimiento y rehabilitación de mujeres con diagnóstico de cáncer de mama.

12 Población a la que se dirige Mujeres de población general susceptibles de ser tamizadas. Mujeres con riesgo de tener cáncer de mama. Mujeres y hombres con diagnóstico de cáncer de mama en cualquier estadio.

13 Ámbito asistencial Profesionales de la salud que intervengan en el proceso de detección temprana, atención integral, seguimiento y rehabilitación de pacientes con diagnóstico de cáncer de mama. La guía para pacientes se encuentra establecida para mujeres blanco de tamización y pacientes diagnosticados con cáncer de mama.

14 Preguntas Construcción de matriz Envío al GDG.

15 Priorización Tamización: 6 Neoplasia in situ: 7 Estadíos tempranos: 16 Estadíos localmente avanzados: 10

16 Priorización Enfermedad metastásica: 7 Económicas: 7 Otras: 10

17 # Elaboradores n Título 1 American College of Physicians 1 Screening Mammography for Women 40 to 49 Years of Age: A Clinical Practice Guideline from the American College of Physicians 2 American Cancer Society (ACS) 1 American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography 3 American College of Radiology (ACR) 9 ACR Appropriateness Criteria nonpalpable mammographic findings (excluding calcifications) 4 American College of Radiology (ACR) ACR Practice guideline for the performance of a breast ultrasound examination 5 American College of Radiology (ACR) ACR Practice guideline for the performance of contrast enhanced magnetic resonance imaging (mri) of the breast 6 American College of Radiology (ACR) ACR Practice guideline for the performance of screening and diagnostic mammography 7 American College of Radiology (ACR) ACR Practice guideline for the performance of stereotactically guided breast interventional procedures 8 American College of Radiology (ACR) ACR Practice guideline for the performance of ultrasound guided percutaneous breast interventional procedures 9 American College of Radiology (ACR) Practice guideline for breast conservation therapy in the management of invasive breast carcinoma 10 American College of Radiology (ACR) Practice guideline for determinants of image quality in digital mammography 11 American College of Radiology (ACR) Practice guideline for the management of ductal carcinoma in situ of the breast (dcis) 12 American Society of Breast Disease (ASBD) 1 The Use of Magnetic Resonance Imaging of the Breast (MRIB) for Screening of Women at High Risk of Breast Cáncer 13 American Society of Clinical Oncology (ASCO) 8 American Society of Clinical Oncology 2003 Update on the Role of Bisphosphonates and Bone Health Issues in Women With Breast Cáncer 14 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology 2006 Update of the Breast Cancer Follow Up and Management Guidelines in the Adjuvant Setting 15 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast Cáncer 16 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology Clinical Practice Guideline Update on the Role of Bone Modifying Agents in Metastatic Breast Cáncer 17 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology Clinical Practice Guideline Update on the Use of Pharmacologic Interventions Including Tamoxifen, Raloxifene, and Aromatase Inhibition for Breast Cancer Risk Reduction 18 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology Clinical Practice Guideline: Update on Adjuvant Endocrine Therapy for Women With Hormone Receptor Positive Breast Cáncer 19 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cáncer 20 American Society of Clinical Oncology (ASCO) American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone Receptors in Breast Cáncer

18 21 British Association of Quirurgical Oncology (BASO) 2 Surgical guidelines for the management of breast cáncer 22 British Association of Quirurgical Oncology (BASO) Oncoplastic breast surgery e A guide to good practice 23 Cancer Care Ontario (CCO) 13 Adjuvant Ovarian Ablation in the Treatment of Premenopausal Women with Early Stage Invasive Breast Cáncer 24 Cancer Care Ontario (CCO) Adjuvant Taxane Therapy for Women with Early stage, Invasive Breast Cancer: A Clinical Practice Guideline 25 Cancer Care Ontario (CCO) Baseline Staging Tests in Primary Breast Cáncer Practice Guideline Report # Cancer Care Ontario (CCO) Breast Irradiation in Women with Early Stage Invasive Breast Cáncer Following Breast Conserving Surgery 27 Cancer Care Ontario (CCO) Fulvestrant for Systemic Therapy of Locally Advanced or Metastatic Breast Cancer in Postmenopausal Women: Guideline Recommendations 28 Cancer Care Ontario (CCO) Magnetic Resonance Imaging Screening of Women at High Risk for Breast Cancer: A Clinical Practice Guideline 29 Cancer Care Ontario (CCO) Management of Ductal Carcinoma in Situ of the Breast: A Clinical Practice Guideline 30 Cancer Care Ontario (CCO) Surgical Management of Early Stage Invasive Breast Cáncer 31 Cancer Care Ontario (CCO) The Role of Aromatase Inhibitors in Adjuvant Therapy for Postmenopausal Women with Hormone Receptor positive Breast Cancer: Guideline Recommendations 32 Cancer Care Ontario (CCO) The Role of Gemcitabine in the Management of Metastatic Breast Cáncer 33 Cancer Care Ontario (CCO) The Role of HER2/neu in Systemic and Radiation Therapy for Women with Breast Cancer: A Clinical Practice Guideline 34 Cancer Care Ontario (CCO) The Role of Trastuzumab (Herceptin ) in the Treatment of Women with HER2/neu overexpressing Metastatic Breast Cáncer 35 Cancer Care Ontario (CCO) The Role of Trastuzumab in Adjuvant and Neoadjuvant Therapy in Women with HER2/neu overexpressing Breast Cáncer 36 Centro Nacional de Excelencia Tecnológica en Salud CENETEC México 1 Prevención y diagnóstico oportuno de cáncer de mama en el primer nivel de atención Versión extendida y versión de referencia 37 Departament de Salut de Cataluña 1 Oncoguía de mama Actualización 2008 Guías de práctica clínica en cáncer de Cataluña 38 European Society for Medical Oncology (ESMO) 5 BRCA in breast cancer: ESMO Clinical Recommendations 39 European Society for Medical Oncology (ESMO) Locally recurrent or metastatic breast cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow up 40 European Society for Medical Oncology (ESMO) Primary breast cancer: ESMO Clinical Recommendations for diagnosis, treatment and follow up

19 41 European Society for Medical Oncology (ESMO) Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer European Society for Medical Oncology (ESMO) Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer Insitute for Clinical Systems Improvement (CSI) 1 Health Care Guideline: Diagnosis of Breast Disease 44 Journal Watch Medicine that matters 1 Women s Health CLINICAL PRACTICE GUIDELINE WATCH 45 Ministerio de Salud de Chile (MSC) 1 Guía Clínica Cáncer de Mama National Breast and Ovarian Cáncer Centre and Australian Cáncer Network 1 The pathology reporting of breast cáncer A guide for pathologists, surgeons, radiologists and oncologists 47 National Comprehensive Cáncer Network (NCCN) 1 Breast Cancer VI National Guideline Clearinhouse (NGC) Guideline Summary ACR Appropriateness Criteria bone metastases. 49 National Guideline Clearinhouse (NGC) Guideline Summary ACR Appropriateness Criteria conservative surgery and radiation stage I and II breast carcinoma 50 National Guideline Clearinhouse (NGC) Guideline Summary ACR Appropriateness Criteria locally advanced breast cáncer 51 National Guideline Clearinhouse (NGC) Guideline Summary ACR Appropriateness Criteria palpable breast masses 52 National Guideline Clearinhouse (NGC) Guideline Summary ACR Appropriateness Criteria postmastectomy radiotherapy 53 National Guideline Clearinhouse (NGC) Guideline Summary ACR Appropriateness Criteria stage I breast carcinoma 54 National Guideline Clearinhouse (NGC) Guideline Summary Breast cancer. In: Suspected cancer in primary care: guidelines for investigation, referral and reducing ethnic disparities 55 National Guideline Clearinhouse (NGC) Guideline Summary Breast self examination. 56 National Guideline Clearinhouse (NGC) Guideline Summary Hereditary breast and ovarian cancer syndrome 57 National Guideline Clearinhouse (NGC) Guideline Summary Hormone therapy and breast cancer. In: Menopause and osteoporosis update National Guideline Clearinhouse (NGC) Guideline Summary Recommendations from the EGAPP Working Group: can tumor gene expression profiling improve outcomes in patients with breast cancer? 59 National Guideline Clearinhouse (NGC) Guideline Summary Risk assessment and genetic counseling for hereditary breast and ovarian cancer: recommendations of the National Society of Genetic Counselors

20 60 National Guideline Clearinhouse (NGC) Guideline Summary The prophylactic use of filgrastim in patients with breast cáncer 61 National Guideline Clearinhouse (NGC) Guideline Summary The use of bevacizumab in metastatic breast cáncer 62 National Guideline Clearinhouse (NGC) Guideline Summary Use of tumor markers in testicular, prostate, colorectal, breast, and ovarian cancers 63 National Guideline Clearinhouse (NGC) Guideline Summary Zoledronic acid as adjuvant therapy in combination with adjuvant endocrine therapy for premenopausal women with early stage hormone receptor positive breast cáncer 64 National Guideline Clearinhouse (NGC) Guideline Summary The continued use of trastuzumab beyond disease progression in patients with metastatic breast cáncer 65 National Library of Guidelines (NHS) 1 Quality assurance guidelines for surgeons in breast cáncer screening 66 National Insitute of Clinical Excellence (NICE) 4 Familial breast cancer The classification and care of women at risk of familial breast cancer in primary, secondary and tertiary care Update July National Insitute of Clinical Excellence (NICE) NICE clinical guideline 41 (Partial update of NICE clinical guideline 14): Familial breast cáncer 68 National Insitute of Clinical Excellence (NICE) NICE Clinical guidelines CG80 Breast cancer (early & locally advanced): diagnosis and treatment 69 National Insitute of Clinical Excellence (NICE) NICE Clinical guidelines CG81 Advanced breast cancer: diagnosis and treatment 70 New Zealand Guidelines Group (NZGG) 1 Management of early breast cáncer 71 Society Obstetricians and Gynaecologists of Canada (SOGC) 1 Progesterone Only and Non Hormonal Contraception in the Breast Cancer Survivor: Joint Review and Committee Opinion of the Society of Obstetricians and Gynaecologists of Canada and the Society of Gynecologic Oncologists of Canada. 72 The Breast Health Global Initiative (BGHI) 1 Normas Internacionales Para la Salud de Mama y el Control del Cáncer de Mama 73 U.S. Preventive Service Task Force (USPSTF) 2 Effects of Mammography Screening Under Different Screening Schedules: Model Estimates of Potential Benefits and Harms 74 U.S. Preventive Service Task Force (USPSTF) Screening for Breast Cáncer: U.S. Preventive Services Task Force (carpeta: guía en cuatro archivos)

21 Gracias.