Justificación - Ministerio de Salud y Protección Social y Publicaciones... · 37 Departament de Salut de Cataluña 1 Oncoguía de mama Actualización 2008 Guías de práctica clínica

Instituto Nacional de Cancerología - E.S.EBogotá – Colombia Marzo de 2011Instituto Nacional de Cancerología - E.S.EBogotá – Colombia Marzo de 2011

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

con diagnóstico de cáncer de mama.


Justificación

• Epidemiología

15/04/2011

Incidencia de cáncer de mamaMujeres (Todas las edades) - TAE por 100.000

15/04/2011

Globocan 2008

0 10 20 30 40

Melanoma

Leucemia

Linfomas no Hodgkin

Ovario y otros anexos

Tráquea, bronquios y pulmón

Colon, recto y ano

Estómago

Tiroides

Cuello del útero

Mama

IncidenciaMortalidad

15/04/2011

Incidencia y mortalidad por cáncer en Colombia

Mujeres (Todas las edades) – TAE por 100.000

Nuevos casos por añoMama: 7007

Fuente: Pardo C et al. Incidencia y mortalidad por cáncer en Colombia 2002-2006. INC; 2010

Mortalidad por cáncer de mama en Colombia

Murillo R et al. INC-IGAC; 200415/04/2011

Razones mortalidad/incidencia para países seleccionados de América

15/04/2011

0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45

Canadá

Estados Unidos

Argentina

Chile

Costa Rica

Brasil

Bolivia

Perú

Colombia

Ecuador

México

Cuba

Razón Mortalidad/incidencia

Fuente: Globocan 2008

15/04/2011

Tendencias de mortalidad por cáncer en Colombia

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

Mujeres

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Year

AS

R p

er10

0.00

0

Stomach

Lung

Cervix uteri

Breast

Women

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

Mujeres

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Year

AS

R p

er10

0.00

0

Stomach

Lung

Cervix uteri

Breast

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Year

AS

R p

er10

0.00

0

Stomach

Lung

Cervix uteri

Breast

Women

Murillo R et al. Serie Doc Tec INC 2006; No. 1

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

Mujeres

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Year

AS

R p

er10

0.00

0

Stomach

Lung

Cervix uteri

Breast

Women

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

Mujeres

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Año

TAE

por

100

.000 Estómago

Pulmón

Cuello uterin

Mama

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Year

AS

R p

er10

0.00

0

Stomach

Lung

Cervix uteri

Breast

0

2

4

6

8

10

12

14

16

18

1980 1984 1988 1992 19962000

Year

AS

R p

er10

0.00

0

Stomach

Lung

Cervix uteri

Breast

Women


Justificación

• Impacto

• Evidencia

15/04/2011


Antecedentes

• Convocatoria

• Alianzas

• Marco metodológico

15/04/2011


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.

15/04/2011


Aspectos sanitarios

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

15/04/2011


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.

15/04/2011


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.

15/04/2011


Preguntas

• Construcción de matriz

• Envío al GDG.

15/04/2011


Priorización

• Tamización: 6

• Neoplasia in situ: 7

• Estadíos tempranos: 16

• Estadíos localmente avanzados: 10

15/04/2011


Priorización

• Enfermedad metastásica: 7

• Económicas: 7

• Otras: 10

15/04/2011


15/04/2011

# Elaboradores n Título1 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


15/04/2011

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 # 1‐14

26 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 Cáncer31 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


15/04/2011

41 European Society for Medical Oncology (ESMO) Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007

42 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 2009

43 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 200646 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 VI2010

48 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 2009

58 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


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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 2006

67 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 cáncer71 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)


Gracias.

15/04/2011

Documents

Justificación - Ministerio de Salud y Protección Social y Publicaciones... · 37 Departament de Salut de Cataluña 1 Oncoguía de mama Actualización 2008 Guías de práctica clínica