乳腺癌

相关媒体:乳房切除术

Definition

乳腺癌 is cancer cells that start in the breast. The breast is made up of lobules and ducts. The lobules are surrounded by fat blood vessels, and lymph and connective tissue. 乳腺癌 can start and grow in all these areas. 一些类型的乳腺癌有:

• Ductal carcinoma in situ—found in the ducts
• Invasive ductal carcinoma—starts in the ducts and spreads to surrounding tissues
• Invasive lobular carcinoma—starts in the lobules and spreads to surrounding tissues
• 炎症-侵入淋巴管 通常会扩散到身体的其他部位
• Paget disease of the breast—found in the areola and nipple

乳腺癌

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Causes

Cancer happens when cells divide without control or order. 这些细胞一起生长形成肿瘤. They can then invade and damage nearby tissues. Cancer can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

风险因素

乳腺癌 is most common in women over 40. 其他可能增加风险的因素有:

• 家庭和遗传风险，例如:
  • 患有乳腺癌的家庭成员
  • 某些基因，比如BRCA1和BRCA2
  • Rare genetic conditions such as Li-Fraumeni syndrome
• 雌激素暴露增加，由于:
  • 月经提前
  • 绝经后期
  • 不生育或晚育
  • 激素替代疗法
• Excess body weight or obesity—especially after menopause
• 吸烟或酗酒
• A history of breast atypical hyperplasia or 小叶原位癌
• 致密的乳房
• 以前患过乳腺癌
• 辐射暴露

Symptoms

有些乳腺癌没有症状. 其他可能最终导致:

• 乳房肿块乳房中的一个或多个肿块
• One or more lumps near the breast—or under the arm or collarbone
• A change in the way the breast or nipple looks or feels, such as:
  • 乳房内或乳房周围变厚的
  • A change in the size or shape of the breast
  • 乳头向内凹陷
  • 乳房皮肤的隆起或凹陷
  • 乳房皮肤发红、疼痛或剥落
• 乳头溢液或疼痛
• 乳房疼痛

Diagnosis

乳腺癌 may be found during a mammogram screening.

Breast changes may also be found during a regular health visit. The doctor will ask about symptoms and past health. 体检，乳房检查，还有 会做血液检查.

Images may show abnormal growth or changes in the breasts. 测试可能包括:

• Mammogram
• Ultrasound
• CT scan
• PET / CT扫描

A biopsy of the abnormal area will be done. 组织样本 and nearby lymph nodes will be taken and tested for cancer cells. 这是可以做到的 with:

• 细针抽吸 -使用细针 to remove fluid and/or cells from a breast lump
• Core needle—uses a larger, hollow needle to remove a wider area of tissue
• Surgical -或者乳房肿块的一部分 removed

诊断是通过检查确定的. Blood and other tissue tests may be done to look for more information about the type of cancer. The tests can show what type of receptors the cancer has. 这被称为生物标志物. The cancer is also given a grade to show how likely it is to grow and spread.

The test results, biomarkers, and grade will be used to determine the stage. The stage will help determine the treatment plan.

Treatment

The goal is to remove the cancer and stop it from coming back or spreading. Treatment is based on the person's health and the stage and type of cancer. 可以使用一种或多种治疗方法.

选项可能是:

• Surgery to remove as much cancer as possible, such as:
  • Lumpectomy-切除乳房 cancer, some area tissue, and sometimes lymph nodes
  • Mastectomy-切除乳房, and sometimes lymph nodes and other tissues
• External or internal radiation therapy—may be used before surgery to help shrink tumors or after to make sure all cancer was removed. 也可用于治疗 造成问题的大肿瘤.
• 化疗 口服、注射或口服药物 杀死癌细胞.
• 药物，如:
  • Targeted therapy—special antibodies are made to help attack cancer cells. They may keep cancer cells from growing and spreading or kill cancer cells.
  • Hormone-blocking therapy—to slow or stop growth in certain types of breast cancer. Medicine is taken over several years to help prevent recurrence.
  • Biological therapy—trains or boosts the immune system to fight cancer.

预防

Avoiding risk factors may help to decrease risk of cancer. The risk of breast cancer may be lowered by:

• 达到并保持健康的体重
• 有规律的体育活动
• 避免或限制饮酒

Women with a very high risk may benefit from hormone therapies or other treatments.

References

• 乳腺癌. 美国癌症协会网站. Available 在:http://www.cancer.org/cancer/types/breast-cancer.html.
• 乳腺癌. 疾病控制中心网站. 可在:http://www.cdc.gov /癌症/乳房/索引.htm.
• 乳腺癌治疗. 国家癌症研究所网站. 可在:http://www.cancer.gov/types/breast/patient/breast-treatment-pdq.
• 女性乳腺癌. EBSCO DynaMed网站. 可以在: http://www.dynamed.com/condition/breast-cancer-in-women.
• Brewer HR, Jones ME等. 家族史和风险 breast cancer: an analysis accounting for family structure. 乳腺癌治疗. 2017;165(1):193-200.
• 冷冻疗法. 乳癌网站. 可以在: http://www.breastcancer.org/treatment/surgery/cryotherapy.
• 辐射是如何工作的. 乳癌网站. 可以在: http://www.breastcancer.org/treatment/radiation-therapy.
• 计划治疗. 乳癌网站. Available 在:http://www.breastcancer.org/treatment/planning.
• 乳腺癌的危险因素. EBSCO DynaMed网站. 可在:http://www.dynamed.com/condition/risk-factors-for-breast-cancer.
• 5/3/2023 DynaMed Systematic Literature Surveillance http://www.dynamed.com/condition/risk-factors-for-breast-cancer: de Blok CJM, Wiepjes CM, Nota NM等人. 乳腺癌 risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. BMJ. 2019;365:l1652.