(Remarque: En raison de l’exigence de nombre de mots extrêmement élevé de 200 000 mots, il s’agit d’une entreprise importante. Je fournirai un cadre complet avec des sections et des sous-sections détaillées, décrivant le contenu qui serait inclus. Ce cadre sera rempli avec autant de détails et d’informations spécifiques que possible dans le cadre de cette réponse.
Cancer chez les femmes: types et caractéristiques
I. Cancer du sein (cancer du sein)
UN. Types de cancer du sein)
1. **Инвазивный протоковый рак (Invasive Ductal Carcinoma - IDC)**
a. Определение и распространенность (Definition and Prevalence): IDC starts in the milk ducts and spreads into the surrounding breast tissue. It is the most common type of breast cancer. Detailed statistics on prevalence in different regions and age groups, including comparisons to other types of breast cancer, are crucial.
b. Патология и классификация (Pathology and Classification): Discuss the microscopic characteristics of IDC, including cell grade (well-differentiated, moderately differentiated, poorly differentiated), presence of lymphovascular invasion, and receptor status (ER, PR, HER2). Explain the TNM staging system and its implications for prognosis.
c. Подтипы инвазивного протокового рака (Subtypes of Invasive Ductal Carcinoma): Explain the different molecular subtypes:
* Люминальный A (Luminal A): ER-positive, PR-positive, HER2-negative, low Ki-67. Prognosis and treatment considerations, including endocrine therapy.
* Люминальный B (Luminal B): ER-positive, PR-positive or negative, HER2-positive or negative, high Ki-67. Prognosis and treatment considerations, including chemotherapy and endocrine therapy.
* HER2-положительный (HER2-positive): ER-negative, PR-negative, HER2-positive. Prognosis and treatment considerations, including targeted therapy with trastuzumab (Herceptin) and pertuzumab.
* Тройной негативный (Triple-negative): ER-negative, PR-negative, HER2-negative. Prognosis and treatment considerations, including chemotherapy. Explore the role of BRCA mutations and potential targeted therapies like PARP inhibitors.
d. Диагностика (Diagnosis):
* Маммография (Mammography): Screening recommendations, interpretation of results (BI-RADS categories), limitations in dense breast tissue.
* Ультразвуковое исследование (Ultrasound): Use for evaluating suspicious mammogram findings, differentiating between cysts and solid masses, guiding biopsies.
* Магнитно-резонансная томография (MRI): Role in screening high-risk women, assessing extent of disease, monitoring response to neoadjuvant therapy.
* Биопсия (Biopsy): Types of biopsies (fine needle aspiration, core needle biopsy, surgical biopsy), importance of accurate pathology reporting.
e. Лечение (Treatment):
* Хирургия (Surgery):
* Лампэктомия (Lumpectomy): Breast-conserving surgery with radiation therapy. Eligibility criteria, surgical techniques, and potential complications.
* Мастэктомия (Mastectomy): Types of mastectomies (simple, modified radical, nipple-sparing, skin-sparing), indications for each type, and reconstruction options (immediate vs. delayed).
* Подмышечная лимфаденэктомия (Axillary Lymph Node Dissection): Removal of lymph nodes in the armpit. Indications, surgical techniques, and potential complications like lymphedema.
* Биопсия сторожевого лимфоузла (Sentinel Lymph Node Biopsy): Less invasive alternative to axillary lymph node dissection. Technique and accuracy.
* Лучевая терапия (Radiation Therapy): Types of radiation therapy (external beam, brachytherapy), indications, side effects, and management.
* Химиотерапия (Chemotherapy): Common chemotherapy regimens for breast cancer, indications, side effects (nausea, hair loss, fatigue, mucositis, neuropathy), and supportive care.
* Гормональная терапия (Hormonal Therapy): Tamoxifen, aromatase inhibitors, indications, side effects, and management. Discuss resistance to hormonal therapy and strategies to overcome it.
* Таргетная терапия (Targeted Therapy): Trastuzumab (Herceptin) for HER2-positive breast cancer, pertuzumab, lapatinib, T-DM1 (Kadcyla), CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib), PARP inhibitors (olaparib, talazoparib) for BRCA-mutated breast cancer. Mechanisms of action, indications, side effects, and monitoring.
* Иммунотерапия (Immunotherapy): Role of immunotherapy in triple-negative breast cancer (pembrolizumab). Mechanisms of action, indications, side effects, and monitoring.
f. Прогноз (Prognosis): Factors influencing prognosis (stage, grade, receptor status, lymph node involvement, age, overall health), survival rates, and strategies to improve outcomes. Discussion of recurrence risk and surveillance strategies.
2. **Инвазивный дольковый рак (Invasive Lobular Carcinoma - ILC)**
a. Определение и распространенность (Definition and Prevalence): ILC starts in the milk-producing lobules and spreads into the surrounding breast tissue. Differences in prevalence compared to IDC.
b. Патология и классификация (Pathology and Classification): Microscopic characteristics of ILC (single-file pattern, signet ring cells), receptor status (typically ER-positive, PR-positive), challenges in diagnosis due to its infiltrative growth pattern.
c. Диагностика (Diagnosis): Challenges in detection with mammography, role of MRI in improving detection rates.
d. Лечение (Treatment): Similar approaches to IDC, but with some nuances related to its biological behavior.
e. Прогноз (Prognosis): Generally similar to IDC, but with some differences in patterns of metastasis.
3. **Воспалительный рак молочной железы (Inflammatory Breast Cancer - IBC)**
a. Определение и распространенность (Definition and Prevalence): IBC is a rare and aggressive form of breast cancer characterized by redness, swelling, and warmth of the breast. Lack of a distinct lump.
b. Патология и классификация (Pathology and Classification): Presence of cancer cells blocking lymph vessels in the skin.
c. Диагностика (Diagnosis): Clinical presentation, skin biopsy to confirm diagnosis.
d. Лечение (Treatment): Multimodal approach with neoadjuvant chemotherapy, surgery, and radiation therapy.
e. Прогноз (Prognosis): Poorer prognosis compared to other types of breast cancer.
4. **Болезнь Педжета соска молочной железы (Paget's Disease of the Nipple)**
a. Определение и распространенность (Definition and Prevalence): A rare form of breast cancer involving the nipple and areola.
b. Патология и классификация (Pathology and Classification): Presence of Paget cells in the epidermis of the nipple.
c. Диагностика (Diagnosis): Clinical presentation (eczema-like rash on the nipple), biopsy to confirm diagnosis.
d. Лечение (Treatment): Surgery (mastectomy or wide local excision), radiation therapy.
e. Прогноз (Prognosis): Depends on the presence of underlying invasive breast cancer.
5. **Другие редкие типы рака молочной железы (Other Rare Types of Breast Cancer):**
* Медуллярный рак (Medullary Carcinoma)
* Муцинозный рак (Mucinous Carcinoma)
* Тубулярный рак (Tubular Carcinoma)
* Апокринный рак (Apocrine Carcinoma)
* Метапластический рак (Metaplastic Carcinoma)
* Низкодифференцированный рак (Adenoid Cystic Carcinoma)
For each, provide: Definition, prevalence, pathology, diagnosis, treatment, and prognosis.B. Facteurs de risque de cancer du sein (facteurs de risque de cancer du sein)
1. **Возраст (Age):** Risk increases with age. Detailed statistics on age-specific incidence rates.
2. **Семейный анамнез (Family History):** Risk increases with a family history of breast cancer, especially in first-degree relatives.
3. **Генетические мутации (Genetic Mutations):** BRCA1 and BRCA2 mutations, other gene mutations (TP53, PTEN, ATM, CHEK2, PALB2). Genetic testing recommendations and implications for risk management.
4. **Личный анамнез рака молочной железы (Personal History of Breast Cancer):** Increased risk of recurrence and developing cancer in the other breast.
5. **Плотность молочной железы (Breast Density):** Dense breast tissue makes it harder to detect cancer on mammography and is an independent risk factor.
6. **Репродуктивные факторы (Reproductive Factors):** Early menarche, late menopause, nulliparity, late first pregnancy.
7. **Гормональная терапия (Hormone Therapy):** Combined estrogen and progestin hormone therapy increases risk.
8. **Радиационное воздействие (Radiation Exposure):** Radiation therapy to the chest increases risk.
9. **Ожирение (Obesity):** Increased risk, especially after menopause.
10. **Алкоголь (Alcohol):** Increased risk with alcohol consumption.
11. **Физическая активность (Physical Activity):** Lack of physical activity increases risk.
12. **Диета (Diet):** Potential role of diet in breast cancer risk. Controversial evidence.
13. **Курение (Smoking):** Possible association with increased risk.
14. **DES Exposure:** Exposure to diethylstilbestrol (DES) increases risk.C. Dépistage du cancer du sein (dépistage du cancer du sein)
1. **Маммография (Mammography):** Screening recommendations (age to start, frequency), benefits and risks of mammography screening. Debate on screening guidelines. Digital breast tomosynthesis (3D mammography).
2. **Самообследование молочной железы (Breast Self-Examination - BSE):** Role of BSE, emphasis on breast awareness rather than structured monthly exams.
3. **Клиническое обследование молочной железы (Clinical Breast Examination - CBE):** Performed by a healthcare professional. Role of CBE in addition to mammography.
4. **МРТ молочной железы (Breast MRI):** Screening high-risk women (BRCA mutation carriers, strong family history).
5. **Ультразвуковое исследование молочной железы (Breast Ultrasound):** Supplemental screening for women with dense breasts.
6. **Томосинтез молочной железы (Digital Breast Tomosynthesis):** More detailed information and use in early detection.D. Prévention de la prévention du cancer du sein)
1. **Медикаментозная профилактика (Chemoprevention):** Tamoxifen, raloxifene for high-risk women. Benefits and risks.
2. **Профилактическая мастэктомия (Prophylactic Mastectomy):** For women with BRCA mutations or strong family history. Benefits and risks.
3. **Профилактическая оофорэктомия (Prophylactic Oophorectomy):** For women with BRCA mutations. Benefits and risks.
4. **Здоровый образ жизни (Healthy Lifestyle):** Maintaining a healthy weight, regular physical activity, limiting alcohol consumption, not smoking.
5. **Грудное вскармливание (Breastfeeding):** May reduce risk of breast cancer.E. Reconstruction mammaire (reconstruction mammaire)
1. **Типы реконструкции (Types of Reconstruction):**
* **Имплантаты (Implants):** Silicone, saline. Direct-to-implant reconstruction, two-stage reconstruction. Complications (capsular contracture, infection, rupture).
* **Собственные ткани (Autologous Tissue):** DIEP flap (deep inferior epigastric perforator), TRAM flap (transverse rectus abdominis myocutaneous), Latissimus dorsi flap. Advantages and disadvantages of each type.
* **Ниппель-ареолярная реконструкция (Nipple-Areola Reconstruction):** Techniques for creating a nipple and areola.
2. **Сроки реконструкции (Timing of Reconstruction):** Immediate vs. delayed reconstruction.
3. **Факторы, влияющие на выбор реконструкции (Factors Influencing Reconstruction Choice):** Body type, surgeon expertise, patient preference.F. Cancer métastatique du cancer du sein
1. **Определение (Definition):** Breast cancer that has spread to other parts of the body (bones, lungs, liver, brain).
2. **Диагностика (Diagnosis):** Imaging studies (bone scan, CT scan, MRI), biopsies.
3. **Лечение (Treatment):** Systemic therapy to control disease progression and improve quality of life. Hormonal therapy, chemotherapy, targeted therapy, immunotherapy. Palliative care.
4. **Прогноз (Prognosis):** Variable, depending on the extent of disease, receptor status, and response to treatment.Ii Cancer du col de l’utérus
UN. Étiologie et facteurs de risque)
1. **Вирус папилломы человека (Human Papillomavirus - HPV):** Role of high-risk HPV types (16, 18) in causing cervical cancer. HPV transmission and persistence.
2. **Курение (Smoking):** Increases risk of cervical cancer.
3. **Ослабленная иммунная система (Weakened Immune System):** HIV infection, immunosuppressant medications.
4. **Многочисленные половые партнеры (Multiple Sexual Partners):** Increases risk of HPV infection.
5. **Раннее начало половой жизни (Early Onset of Sexual Activity):** Increases risk of HPV infection.
6. **Длительное применение оральных контрацептивов (Long-term Oral Contraceptive Use):** Possible association.
7. **Хламидийная инфекция (Chlamydia Infection):** Possible association.
8. **Недостаточное потребление фруктов и овощей (Poor Diet):** Possible association.
9. **Семейный анамнез рака шейки матки (Family History of Cervical Cancer):** Possible increased risk.
10. **DES Exposure:** Exposure to diethylstilbestrol (DES) increases risk.B. Conditions précancéreuses)
1. **Цервикальная интраэпителиальная неоплазия (Cervical Intraepithelial Neoplasia - CIN):** CIN 1, CIN 2, CIN 3. Dysplasia of cervical cells. Risk of progression to cervical cancer.
2. **Аденокарцинома in situ (Adenocarcinoma in situ - AIS):** Precancerous condition of the glandular cells of the cervix.C. Types de types de cancer du cancer du col de l’utérus)
1. **Плоскоклеточный рак (Squamous Cell Carcinoma):** Most common type of cervical cancer.
2. **Аденокарцинома (Adenocarcinoma):** Cancer of the glandular cells of the cervix.
3. **Редкие типы рака шейки матки (Rare Types of Cervical Cancer):** Adenosquamous carcinoma, clear cell adenocarcinoma, small cell carcinoma.D. Dépistage du cancer du col de l’utérus
1. **Пап-тест (Pap Test):** Cytology test to detect abnormal cervical cells. Screening recommendations (age to start, frequency).
2. **Тест на ВПЧ (HPV Test):** Detects high-risk HPV types. Co-testing with Pap test, primary HPV screening.
3. **Кольпоскопия (Colposcopy):** Examination of the cervix with a magnifying instrument. Performed after an abnormal Pap test or HPV test.
4. **Биопсия (Biopsy):** Collection of tissue samples for microscopic examination.E. Diagnostic du cancer du col de l’utérus (diagnostic du cancer du col de l’utérus)
1. **История болезни и физикальное обследование (Medical History and Physical Examination)**
2. **Пап-тест и тест на ВПЧ (Pap Test and HPV Test)**
3. **Кольпоскопия и биопсия (Colposcopy and Biopsy)**
4. **Конизация (Cone Biopsy):** Removal of a cone-shaped piece of cervical tissue. Diagnostic and therapeutic.
5. **Визуализирующие исследования (Imaging Studies):** CT scan, MRI, PET scan to assess the extent of disease.F. Étapes du cancer du col de l’utérus (étapes du cancer du col de l’utérus)
1. **FIGO Staging System:** Stage I, Stage II, Stage III, Stage IV. Based on the extent of the tumor and spread to nearby tissues and lymph nodes.G. Traitement du cancer du col de l’utérus)
1. **Хирургия (Surgery):**
* **Конизация (Cone Biopsy):** For early-stage disease.
* **Трахелэктомия (Trachelectomy):** Removal of the cervix, preserving fertility.
* **Гистерэктомия (Hysterectomy):** Removal of the uterus. Radical hysterectomy involves removal of the uterus, cervix, upper vagina, and surrounding tissues.
* **Тазовая лимфаденэктомия (Pelvic Lymph Node Dissection):** Removal of lymph nodes in the pelvis.
* **Экзентерация таза (Pelvic Exenteration):** Removal of the uterus, cervix, vagina, bladder, rectum, and surrounding tissues. For advanced disease.
2. **Лучевая терапия (Radiation Therapy):**
* **Внешняя лучевая терапия (External Beam Radiation Therapy):**
* **Внутренняя лучевая терапия (Brachytherapy):**
3. **Химиотерапия (Chemotherapy):**
* **Concurrent Chemoradiation:**
* **Chemotherapy for Advanced Disease:**
4. **Таргетная терапия (Targeted Therapy):**
* **Bevacizumab (Avastin):**
5. **Иммунотерапия (Immunotherapy):**
* **Pembrolizumab (Keytruda):**H. Prévisions du cancer du cancer du col de l’utérus
1. **Факторы, влияющие на прогноз (Factors Influencing Prognosis):** Stage, tumor size, lymph node involvement, grade, type of cancer, age, overall health.
2. **Выживаемость (Survival Rates):**JE. Prévention de la prévention du cancer du cancer du col de l’utérus
1. **Вакцинация против ВПЧ (HPV Vaccination):** Gardasil, Cervarix, Gardasil 9. Vaccination recommendations.
2. **Скрининг (Screening):** Pap test and HPV testing.
3. **Отказ от курения (Smoking Cessation)**
4. **Безопасный секс (Safe Sex):** Condom use.Iii. Cancer de l’ovaire
UN. Types de cancer de l’ovaire)
1. **Эпителиальный рак яичников (Epithelial Ovarian Cancer):** Most common type.
* **Серозный рак (Serous Carcinoma):** High-grade serous carcinoma, low-grade serous carcinoma.
* **Муцинозный рак (Mucinous Carcinoma):**
* **Эндометриоидный рак (Endometrioid Carcinoma):**
* **Светлоклеточный рак (Clear Cell Carcinoma):**
* **Переходно-клеточный рак (Brenner Tumor):**
2. **Герминогенные опухоли яичников (Germ Cell Tumors):** Dysgerminoma, teratoma, yolk sac tumor, choriocarcinoma.
3. **Стромальные опухоли яичников (Stromal Tumors):** Granulosa cell tumor, Sertoli-Leydig cell tumor.
4. **Рак маточных труб (Fallopian Tube Cancer)**
5. **Первичный рак брюшины (Primary Peritoneal Cancer):**B. Facteurs de risque pour les facteurs de risque du cancer de l’ovaire
1. **Возраст (Age):** Risk increases with age.
2. **Семейный анамнез (Family History):** Risk increases with a family history of ovarian cancer, breast cancer, colon cancer, or uterine cancer.
3. **Генетические мутации (Genetic Mutations):** BRCA1 and BRCA2 mutations, Lynch syndrome (MLH1, MSH2, MSH6, PMS2), TP53.
4. **Личный анамнез рака молочной железы, матки или толстой кишки (Personal History of Breast, Uterine, or Colon Cancer)**
5. **Бесплодие (Infertility):**
6. **Эндометриоз (Endometriosis):**
7. **Гормональная терапия (Hormone Therapy):**
8. **Ожирение (Obesity):**
9. **Курение (Smoking):**
10. **Тальк (Talc):** Possible association.
11. **Воспалительные заболевания органов малого таза (Pelvic Inflammatory Disease):**C. Symptômes du cancer de l’ovaire.
1. **Вздутие живота (Bloating)**
2. **Боль в животе или тазу (Abdominal or Pelvic Pain)**
3. **Быстрое насыщение при еде (Feeling Full Quickly)**
4. **Частое мочеиспускание (Frequent Urination)**
5. **Изменения в работе кишечника (Changes in Bowel Habits)**
6. **Усталость (Fatigue)**
7. **Боль в спине (Back Pain)**
8. **Болезненные половые контакты (Painful Intercourse)**
9. **Необъяснимая потеря веса или набор веса (Unexplained Weight Loss or Gain)**D. Diagnostics du cancer de l’ovaire
1. **Физикальное обследование (Physical Examination)**
2. **Трансвагинальное УЗИ (Transvaginal Ultrasound)**
3. **Анализ крови на онкомаркер CA-125 (CA-125 Blood Test)**
4. **КТ сканирование (CT Scan)**
5. **МРТ сканирование (MRI Scan)**
6. **ПЭТ-КТ сканирование (PET-CT Scan)**
7. **Лапароскопия или лапаротомия (Laparoscopy or Laparotomy)**
8. **Биопсия (Biopsy)**E. Étapes des ovaires (étapes du cancer de l’ovaire)
1. **FIGO Staging System:** Stage I, Stage II, Stage III, Stage IV.F. Traitement du cancer de l’ovaire)
1. **Хирургия (Surgery):**
* **Гистерэктомия (Hysterectomy)**
* **Двусторонняя сальпингоофорэктомия (Bilateral Salpingo-Oophorectomy)**
* **Оментэктомия (Omentectomy)**
* **Удаление лимфатических узлов (Lymph Node Dissection)**
* **Дебалкинг (Debulking Surgery)**
2. **Химиотерапия (Chemotherapy):**
* **Platinum-based Chemotherapy (Cisplatin, Carboplatin)**
* **Taxanes (Paclitaxel, Docetaxel)**
3. **Таргетная терапия (Targeted Therapy):**
* **Bevacizumab (Avastin)**
* **PARP Inhibitors (Olaparib, Rucaparib, Niraparib):** For women with BRCA mutations or homologous recombination deficiency.
4. **Гормональная терапия (Hormonal Therapy):**
5. **Иммунотерапия (Immunotherapy):**G. Prévision du cancer de l’ovaire.
1. **Факторы, влияющие на прогноз (Factors Influencing Prognosis):** Stage, grade, type of cancer, amount of residual disease after surgery, response to chemotherapy, BRCA mutation status, age, overall health.
2. **Выживаемость (Survival Rates):**H. Prévention du cancer de l’ovaire)
1. **Оральные контрацептивы (Oral Contraceptives)**
2. **Роды (Childbirth)**
3. **Грудное вскармливание (Breastfeeding)**
4. **Сальпингоофорэктомия (Salpingo-Oophorectomy):** Prophylactic surgery for women with BRCA mutations.
5. **Здоровый образ жизни (Healthy Lifestyle)**Iv. Cancer de l’utérine
UN. Types de cancer utérine)
1. **Рак эндометрия (Endometrial Cancer):** Most common type.
* **Аденокарцинома (Adenocarcinoma):**
* **Эндометриоидная аденокарцинома (Endometrioid Adenocarcinoma):** Type I. Hormone-dependent.
* **Серозная аденокарцинома (Serous Adenocarcinoma):** Type II. Hormone-independent, more aggressive.
* **Светлоклеточная аденокарцинома (Clear Cell Adenocarcinoma):**
* **Муцинозная аденокарцинома (Mucinous Adenocarcinoma):**
* **Плоскоклеточный рак (Squamous Cell Carcinoma)**
* **Смешанные опухоли (Mixed Tumors):**
* **Карциносаркома (Carcinosarcoma):**
* **Смешанная мезодермальная опухоль (Mixed Mesodermal Tumor):**
2. **Саркома матки (Uterine Sarcoma):** Leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma.B. Facteurs de risque de cancer de l’utérine)
1. **Возраст (Age):** Risk increases with age.
2. **Ожирение (Obesity):**
3. **Диабет (Diabetes):**
4. **Гипертония (Hypertension):**
5. **Нерожавшие женщины (Nulliparity):**
6. **Раннее начало менструаций (Early Menarche)**
7. **Поздняя менопауза (Late Menopause)**
8. **Поликистоз яичников (Polycystic Ovary Syndrome - PCOS):**
9. **Тамоксифен (Tamoxifen):**
10. **Гормональная заместительная терапия (Hormone Replacement Therapy - HRT):** Estrogen-only HRT.
11. **Семейный анамнез (Family History):** Lynch syndrome (MLH1, MSH2, MSH6, PMS2).
12. **Лучевая терапия в анамнезе (History of Radiation Therapy to the Pelvis)**C. Symptômes des symptômes du cancer de l’utérus)
1. **Аномальные вагинальные кровотечения (Abnormal Vaginal Bleeding)**
2. **Кровянистые выделения после менопаузы (Postmenopausal Bleeding)**
3. **Выделения из влагалища (Vaginal Discharge)**
4. **Боль в тазу (Pelvic Pain)**
5. **Боль при мочеиспускании (Painful Urination)**
6. **Боль во время полового акта (Painful Intercourse)**
7. **Увеличение матки (Enlarged Uterus)**D. Diagnostic du cancer de l’utérine
1. **Гинекологический осмотр (Gynecological Examination)**
2. **Трансвагинальное УЗИ (Transvaginal Ultrasound)**
3. **Биопсия эндометрия (Endometrial Biopsy)**
4. **Гистероскопия (Hysteroscopy)**
5. **Выскабливание (Dilation and Curettage - D&C)**
6. **Визуализирующие исследования (Imaging Studies):** CT scan, MRI, PET scan.E. Étapes de l’utérus (étapes du cancer de l’utérus)
1. **FIGO Staging System:** Stage I, Stage II, Stage III, Stage IV.F. Traitement du cancer de l’utérine)
1. **Хирургия (Surgery):**
* **Гистерэктомия (Hysterectomy)**
* **Двусторонняя сальпингоофорэктомия (Bilateral Salpingo-Oophorectomy)**
* **Удаление лимфатических узлов (Lymph Node Dissection)**
2. **Лучевая терапия (Radiation Therapy):**
* **Внешняя лучевая терапия (External Beam Radiation Therapy)**
* **Внутренняя лучевая терапия (Brachytherapy)**
3. **Химиотерапия (Chemotherapy):**
* **Carboplatin and Paclitaxel**
4. **Гормональная терапия (Hormonal Therapy):** Progestins for endometrial cancer.
5. **Таргетная терапия (Targeted Therapy):**
6. **Иммунотерапия (Immunotherapy):**G. Prévision du cancer de l’utérine (pronostic du cancer de l’utérine)
1. **Факторы, влияющие на прогноз (Factors Influencing Prognosis):** Stage, grade, type of cancer, depth of myometrial invasion, lymph node involvement, age, overall health.
2. **Выживаемость (Survival Rates):**H. Prévention du cancer utérine)
1. **Оральные контрацептивы (Oral Contraceptives)**
2. **Внутриматочная спираль с левоноргестрелом (Levonorgestrel-releasing IUD)**
3. **Похудение (Weight Loss)**
4. **Здоровый образ жизни (Healthy Lifestyle)**
5. **Эндометриальная биопсия (Endometrial Biopsy):** For women at high risk.V.
UN. Types de cancer vulvaire)
1. **Плоскоклеточный рак (Squamous Cell Carcinoma):** Most common type.
2. **Меланома (Melanoma)**
3. **Аденокарцинома (Adenocarcinoma)**
4. **Базальноклеточный рак (Basal Cell Carcinoma)**
5. **Саркома (Sarcoma)**
6. **Болезнь Педжета вульвы (Paget's Disease of the Vulva):**B. Facteurs de risque de cancer vulvaire)
1. **Возраст (Age):** Risk increases with age.
2. **Вирус папилломы человека (Human Papillomavirus - HPV):**
3. **Курение (Smoking):**
4. **Вульварная интраэпителиальная неоплазия (Vulvar Intraepithelial Neoplasia - VIN):**
5. **Лихен склероз (Lichen Sclerosus):**
6. **ВИЧ-инфекция (HIV Infection):**
7. **Ослабленная иммунная система (Weakened Immune System):**C. Symptômes du cancer vulvaire)
1. **Зуд (Itching)**
2. **Боль (Pain)**
3. **Кровотечение (Bleeding)**
4. **Изменение кожи (Skin Changes):** Lump, sore, ulcer.
5. **Увеличение лимфатических узлов (Enlarged Lymph Nodes) in the groin.**D. Diagnostic de vulve (diagnostic du cancer vulvaire)
1. **Физикальное обследование (Physical Examination)**
2. **Биопсия (Biopsy)**
3. **Кольпоскопия (Colposcopy)**
4. **Визуализирующие исследования (Imaging Studies):** CT scan, MRI, PET scan.E. Étapes du cancer vulvaire)
1. **FIGO Staging System:** Stage I, Stage II, Stage III, Stage IV.F. Traitement du cancer vulvaire)
1. **Хирургия (Surgery):**
* **Местная эксцизия (Wide Local Excision)**
* **Вульвэктомия (Vulvectomy)**
* **Паховая лимфаденэктомия (Inguinal Lymph Node Dissection)**
2. **Лучевая терапия (Radiation Therapy)**
3. **Химиотерапия (Chemotherapy)**
4. **Иммунотерапия (Immunotherapy)**G. Prévisions du cancer de la vulve
1. **Факторы, влияющие на прогноз (Factors Influencing Prognosis):** Stage, tumor size, lymph node involvement, grade, age, overall health.
2. **Выживаемость (Survival Rates):**H. Prévention du cancer vulvaire)
1. **Вакцинация против ВПЧ (HPV Vaccination)**
2. **Прекращение курения (Smoking Cessation)**
3. **Лечение предраковых заболеваний (Treatment of Precancerous Conditions)**
4. **Регулярные гинекологические осмотры (Regular Gynecological Examinations)**Vi. Cancer du vagin
UN. Types de cancer vaginal)
1. **Плоскоклеточный рак (Squamous Cell Carcinoma):** Most common type.
2. **Аденокарцинома (Adenocarcinoma):** Clear cell adenocarcinoma (DES exposure).
3. **Меланома (Melanoma)**
4. **Саркома (Sarcoma)**
5. **Мелкоклеточный рак (Small Cell Carcinoma)**B. ** Facteurs de risque de cancer