saline solution - A saltwater solution.
scan - A study using either x-rays or radioactive isotopes to produce images of internal body organs.
scant cellularity - An unsatisfactory Pap smear with inadequate cellularity.
scirrhous cancer - A breast cancer with a hard, firm, fibrous texture; usually an infiltrating ductal carcinoma.
screening - The search for disease, such as cancer, in people without symptoms. Screening may refer to coordinated programs in large populations. The principal screening measure for breast cancer is mammography.
screening guidelines - Recommendations for the application of screening procedures, which are formulated by professional and governmental agencies.
screening mammogram - American College of Radiology defines a screening mammogram as “an x-ray breast examination of asymptomatic women in an attempt to detect breast cancer, when it is small, nonpalpable and confined to the breast."
screening provider(s) - Health departments, primary care facilities, and/or any other entities under contract with Missouri’s SMHW program to provide breast and cervical cancer screening services.
screening services - Refers to clinical breast examination, Pap smear, pelvic examination, mammography, instruction in breast self-examination, and informational and educational services relating to breast and cervical cancer by providers of SMHW services.
secondary tumor - A tumor that forms as a result of spread (metastasis) of cancer from its site of origin.
shall/must/should - Reference to the words "shall" and "must" indicate mandatory program policy. "Should" indicates recommended program policy relating to program management and patient care that the provider is urged to follow.
Show Me Healthy Women (SMHW) - The functional entity created within the Missouri Department of Health and Senior Services, Division of Community and Public Health, Section for Community Health Services & Initiatives, Bureau of Cancer and Chronic Disease Control, to implement and manage all components of the grant.
silicone gel - Synthetic gel compound used in breast implants because of its flexibility, strength, and texture, which is similar to the texture of the natural breast. Silicone gel breast implants are available for women who have had breast cancer surgery. (See breast augmentation.)
sonogram - An image produced by using high-frequency sound waves. This technique is used to examine and measure internal body structures and detect bodily abnormalities but does not utilize radiation or x-rays.
speculum - A metal or plastic instrument that permits visual inspection of the cervix and performance of a Pap smear.
staging - A method of determining and describing the extent of cancer, based on the size of the tumor, whether regional axillary lymph nodes are involved, and whether distant spread (metastasis) has occurred. Knowing the stage at diagnosis determines the best treatment and the prognosis.
stages of breast cancer:
Stage 0: The earliest stage of breast cancer; the disease is in situ.
Stage I: The tumor is 2 cm or less in size and contained within the breast tissue; not spread beyond the breast.
Stage II: The tumor is more than 2 cm and spreads to regional lymph nodes, such as the lymph nodes under the arm, or the tumor is more than 5 cm in diameter and no regional nodes are involved.
Stage III: The tumor, any size, has spread to several regional lymph nodes and/or other tissues near the breast.
Stage IV: The cancer has spread to other organs and/or tissues by way of direct extension, lymph system and/or bloodstream.
stages of cervical cancer:
Stage 0: The earliest stage of cervical cancer; the disease is in situ.
Stage I: Cancer has not spread beyond the cervix and uterus.
Stage II: Cancer has spread beyond the uterus, but not to the pelvic wall or to the lower third of the vagina.
Stage III: Cancer has spread to the pelvic wall and/or involves the lower third of the vagina and/or regional lymph nodes.
Stage IV: The cancer has spread to other organs and/or tissues by way of direct extension, lymph system and/or bloodstream.
stereotactic biopsy - A diagnostic procedure that combines the technology of radiological imaging with surgical biopsy. Images taken at different angles of the area surrounding a lesion and a computer precisely calculates the lesion’s location. An automatic biopsy needle obtains samples of the tissue at the exact spot calculated by the computer.
subcutaneous mastectomy - A surgery to remove internal breast tissue, yet the nipple and skin are left intact.
supraclavicular nodes - Lymph nodes that are above the collarbone (clavicle).
surgery - An operation, a procedure performed by a surgeon to repair or remove a part of the body or to find out if disease is present.
surgical or specialist consultation - A referral of a woman to a surgical specialist for additional diagnostic evaluation, following detection of a breast or cervical abnormality.
survival rate - A way of expressing how long, on average, people may live after diagnosis of disease or after treatment of the disease and expressed as the percentage of people who live a certain period, as opposed to the percentage of those who die. For example, the five-year survival rate for women with localized breast cancer (including all women living five years after diagnosis, whether the patient was in remission, disease-free, or under treatment) was 78 percent in the 1940’s, but in the 1990’s it was 93 percent.
suspicious abnormality - A finding on a test that indicates cancer might be present.
synchronous - At once or at the same time.
systemic disease - In breast cancer, a tumor that originated in the breast has spread to distant sites, such as the liver, chest, brain, bones, or lungs.
tamoxifen (brand name: Nolvadex) - A drug that blocks estrogen; an antiestrogen drug. Blocking estrogen is desirable in some cases of breast cancer because estrogen feeds the growth of certain types of tumors.
target population - The desired or intended audience, in this case for SMHW interventions.
therapy - Any of the measures taken to treat a disease. Alternative therapy is any unapproved therapy and sometimes called questionable methods or unproven methods. Sometimes alternative and standard therapies are used together. Some are harmless, some may be helpful, and others can be dangerous, especially if they divert a person with cancer from receiving standard therapy. Some people use alternative therapies along with standard therapy; in this approach, the healthcare team should be informed of the alternative method used. Experimental therapy is any new, as-yet- unproven method that is undergoing testing for specific purposes in a scientific clinical trial. Standard therapy is any method that has been scientifically tested and proven useful for specific purposes and is the standard treatment.
tissue - A collection of similar cells, united to perform a particular function. There are four basic types of tissue in the body: epithelial, connective, muscle, and nerve.
tomosynthesis - An optional method of performing high-resolution mammogram with three-dimensional images of the breast.
transformation - A multistep process by which normal cells change into neoplastic cells.
tumor - Tissue growth in which the cells multiply uncontrollably, also called neoplasm. It can be either benign or malignant. Benign tumor is a noncancerous tumor (i.e., does not invade and destroy adjacent normal tissue). Malignant tumor is a tumor that is cancerous and likely to cause death unless adequately treated.
ultrasonography (ultrasound) - An imaging method in which high-frequency sound waves, transmitted through the area of the body being studied, are used to outline a part of the body; the echoes are read, displayed and transmitted to a television screen. The painless procedure mainly determines if a structure is solid or liquid. It is useful in detecting breast cysts in young women with firm, fibrous breasts. No radiation exposure occurs.
underinsured - A patient is considered underinsured if she has medical insurance that does not cover SMHW screening services, or if she has an unmet deductible or required copayment for services covered by SMHW.
underserved - Groups of individuals who chronically lack access to health care for a variety of reasons.
unilateral - Affecting one side of the body. For example, unilateral breast cancer occurs in one breast only. (Also see bilateral.)
unproven methods of cancer management - Any therapy that has not been subjected to traditional scientific study and proved effective in clinical trials. Such methods range from harmless to life- threatening, especially if used in place of medically sound methods of treatment. The American Cancer Society maintains a reference file on proven methods of cancer management. Information is available by request from the society's toll-free cancer information hotline, 1-800-ACS-2345. (Also see therapy.)
x-rays - One form of radiation that can, at low levels, produce an image of cancer on film, and at high levels can destroy cancer cells.
