圖片來源(←內含連結)
可能很多人都不知道10月是國際乳癌防治月…
而圖片中的粉紅絲帶則是全球關懷乳癌的標誌…
Few ppl know October is also called International Breast Cancer Awareness Month…
N the pink ribbon is the symbol…
圖片來源(←內含連結)
說到乳癌最近比較有名的新聞大概就是安潔莉娜裘莉的消息了…
大家應該多少看到新聞都聽到她為了戰勝乳癌勇敢的把雙乳都切掉了…
相關新聞(←點我可看‧來自奇摩新聞)
Speaking of breast cancer, you might hear the news of Angelina Jolie underwent a double mastectomy to prevent breast cancer.
And here are some news that you can check if you haven’t heard about it.
news from CNN
1.Angelina Jolie’s cancer decision
2.Angelina Jolie reveals double mastectomy
但到底大家知道什麼是乳癌嗎???
乳癌又該怎麼預防跟治療呢???
以下來跟大家淺談乳癌的一些小觀念…
So do you know what breast cancer is?
And what’s the prevention and treatment?
Here are some basic views of breast cancer…
Q：乳癌有那些症狀啊???
Q：The symptoms of breast cancer.
圖片來源(←內含連結)
乳癌最常見的臨床表現是乳房可觸摸到硬塊或結節…
如果是發展到後期的則會看到胸部皮膚潰爛或有分泌物…
Usually you could touch the lump around your breast, even worse there would be some discharge and ulcer.
Q：到底甚麼是乳癌???
Q：What is breast cancer?
圖片來源(←內含連結)
乳癌是乳房細胞不正常分化增生產生的惡性腫瘤…幾乎都發生在女性同胞…但別懷疑…男生也是會得乳癌的…
Breast cancer is a malignant tumor that starts in the cells of the breast.
A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body.
The disease occurs almost entirely in women, but men can get it, too.
Q：那麼要做哪些檢查才能得知並診斷自己得到乳癌呢???
Q：The diagnosis of breast cancer.
圖片來源(←內含連結)
通常是藉由自己觸診或診視自己的乳房…
發現到乳房跟之前比起來有不正常的變化…
進而求助於醫師…
才會做進一步的檢查以確立診斷…
Usually you could find something abnormal with your breast by BSE. Then you go to see the doctor to do further exams.
為了確認乳房硬塊是否真為乳癌…
細胞學或組織病理學的檢查是不可或缺的…
細針抽吸細胞學檢查(fine needle aspiration cytology examination)
通常只要一支10c.c的空針套上22號針頭進行採樣…
不需局部麻醉即可進行…
一般來說如果臨床觸診懷疑是乳癌…
加上乳房X光攝影呈現典型乳癌的變化…
再由細針抽吸細胞學檢查證實為”陽性”結果…
則可確立診斷…精確率幾乎達100%...
另外有時也會採局部麻醉行活體切片(biopsy)送組織病理學檢查…
等病理報告出爐後再視情況進行乳房切除或乳房保留術式的外科治療…
To ensure whether the breast lump you found is cancer or not, the cytology and pathology examinations are necessary.
Under a fine needle aspiration cytology examination, you don’t have to take a local anesthesia to get the example.
If you doubt the lump as a cancer while doing the palpation,
after the mammography and the positive finding of the needle aspiration cytology examination,
then you could diagnose it as a breast cancer, and the accuracy is almost 100%.
In addition, the biopsy would be done under a local anesthesia for the cytology, and after the pathologic data,
the doctor will do the surgery either mastectomy or MRM(depends on the stage of cancer.)for you.
哈不過感覺像我這種小奶奶根本沒大到可以放在檯面上的…
好像沒辦法做乳房X光攝影吼…囧…
(非專業內文恕不翻譯: P)
(No translation for this sentence which is not related to this article. :P)
Q：為什麼我會得到乳癌呢???
Q:Why I get breast cancer?
圖片來源(←內含連結)
由於飲食習慣西化…
再加上初經年齡提早、婦女懷孕次數減少、停經年齡延後等…
使國內乳癌的發生率逐年增加…
且罹病年齡層有逐漸下降趨勢…
Because the change of people’s habit about food (westernized) today,
many women start their menstruation in their early age(under 12).
Here are some risk factors of breast cancer:
危險群：
高危險群-
1.年齡超過50歲
2.一側乳房曾有侵犯性乳癌或原位癌
3.乳房切片有不正常細胞増生現象
4.特殊家庭史(如停經前罹患過2側乳癌)
次危險群-
1.母親或姊妹罹患過乳癌
2.30歲以後才生第1胎
3.未曾生育者
4.停經後肥胖
5.子宮內膜癌及卵巢癌
6.胸部曾暴露於大量放射線
略高危險群-
1.中量飲酒(1oz/day)
2.初經較早(小於12歲)
3.停經較晚(大於55歲)
4.接受荷爾蒙治療
high risk group-
1.over 50years old
2.one side of the breast has been undergoing an invasive breast cancer or DCIS(Ductal carcinoma In Situ)
3.abnormal growing cell which is found in the biopsy of the breast
4.family history:
medium risk group
1.your mother or sister had the breast cancer
2.give the first birth to your baby over 30years old
3.no experience of giving a birth to a baby
4.get fat after the menopause
5.history of cervical cancer and ovary cancer
6.exposure to a high radiation
slightly high- risk group
1.take alcohol 1oz/day
2. women who start their menstruation in their early age(under 12)
3.women whose menopause over 55years old
4.undergo a hormone therapy
Q：那得到乳癌該怎麼處理治療呢???
Q: The treatments of breast cancer.
根據不同期別的乳癌有不同的治療策略…
The treatment are different from every stage.
第I期與第II期乳癌
Stage I &II
主要以外科手術切除為主…
然後再視預後因子給予術後輔助性治療(adjuvant treatment)…
20世紀初最常被使用的手術方式為…
乳房根治性切除術(radical mastectomy)…
因當時觀念為乳癌主要是經由局部淋巴腺推擴散及轉移展開來…
所以切除部位應包含整個罹病乳房、胸大肌、胸小肌和鄰近部位整體的淋巴腺…
當時認為這樣比較不會再復發…
Surgery of cutting the breast is the main treatment during the stage I and II,
and the prognostic factors would be considered in to decide the post-treatment(adjuvant treatment).
In 20century, the common treatment is radical mastectomy.
The doctors believed that the more range of the breast you cut the less recurrence.
The cutting part includes the whole breast, pectoralis major muscle, pectoralis minor muscle, and the lymph node around.
之後則提倡改良型根治性乳房切除術(modified radical mastectomy)…
可保有同樣治療效果…
也保留胸大肌避免術後外觀與功能缺陷…。
因早期治療傾向廣泛性淋巴擴清術…
容易導致肩關節僵硬、疼痛、患側淋巴水腫等後遺症…
嚴重影響生活品質…
After, coming up the surgery called modified radical mastectomy; MRM which advocated most.
Because it has the same effect compared to the radical mastectomy, and you still could keep your appearance and function of your breast,
plus less side effect of the lymph node dissection.(pain, lymphedema of the affected side, and stiff shoulder etc)
所以藉由檢查前哨淋巴結(sentinel lymph node)
先得知淋巴結是否被癌症侵襲…
再決定是否做淋巴擴清術以避免上述後遺症發生…
Therefore by doing the examination of sentinel lymph node to see if the lymph node is attacked.
And then decide to take the lymph node dissection or not for avoiding the side effects after the surgery.
(注)偵測前哨淋巴結的方法是於術前在癌症腫塊附近注射藍色染劑或含有放射性同位素的物質，當染劑回流至前哨淋巴結，則可將淋巴切片送病理檢驗。
p.s.the way to detect the lymph node: by injecting a blue dye or radio-isotope around the lump, after the dye returning back to the lymph node and then get the biopsy for pathology.
第III期與第IV期乳癌
Stage III&IV
針對第III期乳癌的治療…
原則上如果可以進行外科手術切除的話…
可以先行改良型根治乳房切除術…
再以輔助性的化學治療及放射線治療…
如果不適合開刀…
則可以先行3~4個療程的引導性化療…
待腫瘤縮小之後再以手術切除或給予放射線治療…
最後還要給予手術後的化學治療…
The treatment of Stage III breast cancer, in principle, we could take the MRM surgery then adjuvant chemotherapy and radiotherapy.
If it’s not proper to do the surgery(usually because of the size of tumor is too big),
you could take 3~4 courses of chemotherapy first, and then take the surgery after the size of tumor becomes smaller,
至於已經有遠處轉移的第IV期…
則主要以全身系統性的化學治療、分子標靶治療及荷爾蒙治療為主…
再搭配支持性照護(supportive care)…
來延長病患有限生命存活期…並維持其生活品質。
As for stage IV, the main treatment is the whole systematic chemotherapy, target therapy,
and hormone therapy, combined with supportive care to prolong the patients’ life and maintain the quality of life.
有關乳癌臨床上的預後因子包含以下的有無：
腋下淋巴腺的轉移…
動情素受體(estrogen receptor)…
黃體素受體(progesterone receptor)……
HER-2基因的過度表現…
腫瘤實質塊的大小…
乳癌細胞分化的程度…
月經周期的有無等。
The prognosis factors of breast cancer which are emphasized in clinic are: metastasis of axillary lymph node, ER, PR, HER-2, tumor size etc.
不同於其他固態腫瘤(如肺癌、肝癌)…
病患即使能活超過5年…
也不代表乳癌已獲得根治…
因此定期接受乳房放射線攝影…
做乳房自我檢查(Breast self-examination; BSE)…
及定期追蹤是有必要的…
Compared to other cancer, even a patient survives from the breast cancer over 5years, that doesn’t mean the breast cancer is cured completely.
Therefore take mammogram, BSE, and follow-up regularly are necessary.
Q：如何預防乳癌發生???
Q: The preventions of breast cancer.
前面既然提到過乳癌主要是跟荷爾蒙的變化有關…
(有可能是因為飲食西化導致攝取過多荷爾蒙…或是接受荷爾蒙治療的關係…)
所以就飲食方面調整是最簡單的預防方法…
雖然我也很喜歡吃G排啊炸G那些的…
(因為現在很多雞隻在飼養時都有注射荷爾蒙…)
可是為了健康著想…這類食物還是少碰為妙…
正所謂”放下G排…保住妳奶” XD
這句是開玩笑的…
重點是要告訴大家盡量避免這類的食物…
We mentioned earlier that one of the high risks of breast cancer is hormone.
(due to the food or hormone therapy etc)
So the easiest prevention is to avoid taking food that contains lots of hormone such as fried chicken.
(many chicken were injected hormone to grow better)
Though I also like to eat this kind of junk food, but I will quit it ASAP for my own good, and so do you!!!
另外早期發現早期治療一直是治療癌症的黃金法則…
雖然無法預防…但之後的預後會比較樂觀…治療也會較順利…
所以平常的乳房自我檢查…
定期追蹤乳房超音波、乳房攝影都是相當重要的…
這裡附上影片教大家如何做乳房自我檢查…以及何時該做…
To find the cancer in an early stage and start the treatment as soon as possible is the principle of treating cancer.
Though it’s nothing to do with the prevention, but the prognosis and treatment will be more optimistic if you find it earlier.
So it’s really important to follow up the breast ultrasound, mammography, and do the breast self-examination regularly.
Here is a film teaching you how and when to do the BSE.
乳房自我檢查示範影片
Breast Self-Exam How-to
希望這些有關乳癌的小資訊對大家有幫助喔…
Hope all the basic info is useful for you: )
更多乳癌相關知識可參考：
從「安潔莉娜裘莉」事件談乳癌BRCA1及BRCA2基因(←點我點我)
(資料來自:財團法人台灣癌症基金會)
http://www.canceraway.org.tw/page.asp?IDno=1734
more info about breast cancer:
http://www.cancer.org/cancer/breastcancer/
參考資料
Reference
1.How is breast cancer diagnosed?
http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-diagnosis
2.陳敏鋑、黃采薇(2012)癌症護理學(3版，66-71頁‧台北市：華杏。
留言列表
