Moskvyak-Lesnyak D. The medical and social justification of risk-oriented model of medical prevention of breast cancer [С.50] among female persons at the primary level of medical service.

The dissertation is devoted to the actual scientific problem ? minimizing of breast cancer morbidity among women in Ukraine. This pathology in the general structure of cancer morbidity takes the first place in rating among women and forms certain problems because of mortality among female persons of working and reproductive age, which has great medical and social importance and significant impact on the indicators of the health of the nation. As a result of thorough and in-depth study the author establishes the basic regularities of dynamics of morbidity and mortality of women in Ukraine due to breast cancer with determination of their prognostic tendencies up to 2025, studied social and hygienic characteristic of women with breast cancer and carried out the analysis of applied preventive and diagnostic technologies in breast cancer oncopathology for providing medical aid. Thus is defined that the major preventive and diagnostic technologies in practical health care in the possible suspection / early detection of breast cancer oncopathology were and are: women self-exam of mammary gland; bimanual palpation examination of mammary glands in women by doctor of family doctor and doctor obstetrician-gynecologist of welfare center; ultrasound examination, mammography examination of mammary glands in women that is appropriate to regard as secondary prevention measures, whereas measures of primary prevention concerning minimization of occurrence of breast cancer among women in the current system of medical aid in the context of early detection of risk factors in Ukraine are absent. All this became the basis for the establishment of risk factors and the degree of their influence on the occurrence / development of breast cancer among women that allowed to determine by using correlation and regression analysis the epidemiological characteristics of impact of medical and social risk factors of cumulative and provocative actions on health of woman concerning the possible occurrence / further development of breast cancer. The obtained results of the complex social and hygienic research formed the basis for justification of model of medical prevention of breast cancer among female persons at the primary level of medical service, based on detection mechanisms, minimization of controlled existing risk factors with personification in practical activity of family doctor. In this innovation the attention should be paid on the scientific methodology of hand forming of RR and AR limit value at the individual level in women regarding the possible occurrence / development of breast cancer presented by the author. The feasibility of implementation the practical health care of the proposed model as the basic preventive technology of minimizing the breast cancer morbidity in activity of doctor of general practice / family doctor is confirmed by the positive results of expert evaluation and data of the local organizational experiment. According to the obtained materials of dissertation research the author makes the general conclusions that nowadays the problem of minimizing the morbidity and mortality due to breast cancer among women of Ukraine is still quite relevant that actually confirm in this issue the disappointing data of prognosis for the period up to 2025 and other significant evidences, therefore proposed prevention technology in the form of justification the risk-oriented model of medical prevention of breast cancer among female persons at the primary level of medical service is still the prerogative in activity of doctor of general practice / family doctor in this issue. Actually, all this demonstrate the realization of aim and tasks of research and allow to suggest the recommendations to implement them in practical health care as ways of minimization of described problem that outlines the content of published branch methodological recommendations (1) and informational letters (2).