乳腺癌的今天

     乳腺癌不像在20年前。因为健康意识不断提高、更多的早期发现和治疗技术的进步，乳腺癌患者的存活率大大提高。每年大概有200000美国人被诊断出患乳腺癌，他们有了新的希望。
 

乳腺癌的症状

     乳腺癌通常没有什么症状，但女性有时会自己发现乳腺的问题，常见的症状和体征主要以下几点：

• 无痛性的肿块

• 大小或形状产生变化

• 腋窝肿胀

• 乳头改变或流出乳液

• 乳腺疼痛也是乳腺癌的一种症状，但这并不常见。

炎症性乳腺癌的症状

      炎症性乳腺癌是一种罕见的、快速增长的肿瘤，通常没有明显的肿块。然而乳腺皮肤变厚、红，像橘子皮。该区可通常会感到发热、起小疙瘩，像皮疹。
 

乳腺癌和乳腺x光片

     乳腺癌发现的越早，治疗越容易。乳腺X射线可以在肿块未长大之前就发现。美国癌症研究所建议女性从40岁开始每年都应该做一次乳腺X射线。美国预防服务工作组建议50—74岁的女性每两年检查一次，考虑到定期检查的利益关系，每个女人在50岁前都应该与自己医生交谈，哪一种筛查更利于她自己。

乳腺超声和核磁共振（MRI）

      除了X射线，医生还会建议我们做乳腺彩超，这可以帮助我们确定是囊肿、液体囊还是癌症，而MRI和X光一起常用于检查高风险妇女身上。

乳腺的自我检查

      一月一次乳腺的自我的检查是曾经很多人建议的，但研究表明，乳腺的自我检查在发现早期的乳腺癌里是一个很小的部分，这样做更多是可以了解乳房和观察它的变化。如果真的要想检查，一定要借用先进仪器和医生的经验。

如果你自己发现一个肿块怎么办？

      首先，别怕，乳腺肿块百分之八十不是癌症，往往是无害的囊肿或组织变化而成，这与月经周期有关。但是你应该立即让你的医生知道你发现的问题。如果是癌，发现的早就好，如果确诊后不是，就可以放弃顾虑了。

乳腺活检

      确定肿块是不是癌症的金标准就是活检，通常是用一个小针吸取或去整块标本。如果是癌症，那么是什么类型的也要分辨出来，因为不同类型的癌治疗方案不同。
 

激素敏感型乳腺癌Some types ofbreast cancer are fueled by the hormones estrogen or progesterone. A biopsy canreveal whether a tumor has receptors for estrogen (ER-positive) and/orprogesterone (PR-positive). About two out of three breast cancers are hormonesensitive. There are several medications that keep the hormones from promotingfurther cancer growth.

      一些类型乳腺癌是受雌激素或孕激素刺激引起的。活检可以揭示肿瘤是否有雌激素受体（ER）和/或孕酮（PR阳性）。大约2/3的乳腺癌是激素敏感型的。目前也有一些药物是阻碍促使肿瘤生长的激素的。

The image shows a molecularmodel of an estrogen recepto

HER2阳性乳腺癌

In about 20% of patients,breast cancer cells have too many receptors for a protein called HER2. Thistype of cancer is known as HER2-positive, and it tends to spread faster thanother forms of breast cancer. It's important to determine whether a tumor isHER2-positive, because there are special treatments for this form of cance

      在20%的患者中，乳腺癌细胞中有很多的HER2蛋白受体。这种类型的肿瘤被称为HER2阳性，它往往比其他形式的乳腺癌扩散的更快。要确定是否是肿瘤的HER2阳性是很重要的，因为有特殊治疗这种癌症方法。

乳腺癌的阶段

Once breast cancer has beendiagnosed, the next step is to determine how big the tumor is and how far thecancer has spread. This process is called staging. Doctors use Stages 0-4 todescribe whether cancer is localized to the breast, has invaded nearby lymphnodes, or has spread to other organs, such as the lungs. Knowing the stage andtype of breast cancer will help your health care team formulate a treatmentstrategy

      一旦乳腺癌确诊，下一步是确定肿瘤有多大，癌症已经扩散到了多远。这个过程被称为分期。医生使用阶段0-4的描述是否肿瘤局限于乳腺，还是侵入邻近的淋巴结，还是已扩散到其他器官，如肺。认识阶段和乳腺癌的类型将帮助你的卫生保健小组制定治疗策略。

乳腺癌患者的生存率

     乳腺癌生存率和发现早晚有很大的关系。据美国癌症学会研究Ⅰ型乳腺癌的患者五年生存率达到88%，级别越高，生存率越低，Ⅳ型乳腺癌的5年生存率只有15%。

乳腺癌手术

There are many types of breast cancer surgery, from taking outthe area around the lump (lumpectomy or breast-conservation surgery) toremoving the entire breast (mastectomy.) It's best to discuss the pros and consof each of these procedures with your doctor before deciding what's right foryou.

      乳腺癌手术的类型有很多种，如：取出周围肿块（肿块切除术或乳房保留手术）、整个乳腺（乳房切除术。）。最好是讨论这些程序的优点和缺点，和你的医生才能决定什么对你来说是正确的。

乳腺癌的放射治疗

Radiation therapy useshigh-energy rays to kill cancer cells. It may be used after breast cancersurgery to wipe out any cancer cells that remain near the tumor site. It canalso be used along with chemotherapy for treatment of cancer that has spread toother parts of the body. Side effects can include fatigue and swelling or asunburn-like feeling in the treated area

      放射治疗用高能射线杀死癌细胞。它可用于乳腺癌术后清除残留的癌细胞在肿瘤部位。它也可以用在治疗癌症已经扩散到身体的其他部位，副作用是在治疗部位有疲劳、肿胀或晒伤样的感觉。

乳腺癌化疗

Chemotherapy uses drugs to kill cancer cells anywhere in thebody. The drugs are often given by IV, but are sometimes taken by mouth orshot. Chemotherapy may be done after surgery to lower the odds of the cancercoming back. In women with advanced breast cancer, chemotherapy can helpcontrol the cancer's growth. Side effects may include hair loss, nausea,fatigue, and a higher risk of infection

      化疗用药物在身体的任何地方杀死癌细胞，这些药物通常是IV阶段采用。术后化疗可以降低癌症复发的可能性。晚期乳腺癌患者，化疗有助于控制肿瘤的生长。可能的副作用包括脱发，恶心，疲劳，和一个更高的感染风险。
 

激素治疗乳腺癌

Hormone therapy is aneffective treatment for women with ER-positive or PR-positive breast cancer.These are cancers that grow more rapidly in response to the hormones estrogenor progesterone. Hormone therapy can block this effect. It is most often usedafter breast cancer surgery to help keep the cancer from coming back. It mayalso be used to reduce the chance of breast cancer developing in women who areat high risk

      激素疗法对患ER或PR阳性的乳腺癌的妇女来讲是一种有效的治疗方法。这些肿瘤生长很迅速，因为它们可以与雌激素或孕酮发生反应。激素治疗则能阻断这种效应。这是最常用的乳腺癌手术后阻止癌症复发的方法。它也可以用来减少高风险妇女患癌的概率。

乳腺癌的靶向药物

Targeted therapies arenewer drugs that target specific properties within cancer cells. For example,women with HER2-positive breast cancer have too much of a protein called HER2.Targeted therapies can stop this protein from promoting the growth of cancercells. These drugs are often used in combination with chemotherapy. They tendto have milder side effects compared with chemotherapy.      靶向治疗是针对性的杀死肿瘤细胞。例如，HER2阳性乳腺癌的妇女有太多的HER2蛋白。针对性的治疗，可以阻止这种蛋白质从促进癌细胞的生长。这些药物常用于联合化疗。
 

治疗后的生活

There's no doubt thatcancer is a life-changing experience. The treatments can wear you out. You mayhave trouble managing daily chores, work, or social outings. This can lead tofeelings of isolation. It's crucial to reach out to friends and family forsupport. They may be able to go with you to treatments, help out with chores,or just remind you that you are not alone. Many people choose to join a supportgroup -- either locally or online

      毫无疑问，癌症会改变一个人的生活。治疗时穿的少了，在日常工作中、社交活动也会遇到较多的麻烦，这可能会导致孤立的感觉。朋友和家人会很好的支持你，他们帮你去帮忙做家务，和你聊天，你并不孤单。许多人也选择加入一个支持小组——无论是本地的还是网络的。

乳房重建

Many women who have abreast removed choose to undergo reconstructive surgery. This replaces theskin, nipple, and breast tissue that are lost during a mastectomy

      许多有转移乳腺癌患者的选择接受整形手术。重置皮肤，乳头和乳腺组织。做一个乳腺植入或从身体其他地方组织，如肚子。重建可以选择与切除手术同步或术后几个月。

乳腺癌：为什么是我？

The most obvious riskfactor for breast cancer is being a woman. Men get the disease, too, but it isabout 100 times more common in women. Other top risk factors include being overage 55 or having a close relative who has had the disease. But keep in mindthat up to 80% of women with breast cancer have no family history of the illness

     乳腺癌最明显的风险因素是性别。男人也会的，但概率约是女性的1/100。其他危险因素包括年龄在55岁以上、有家族史、晚婚。但请记住，多达80%的女性乳腺癌患者无家族史。

乳腺癌基因

Some women have a very highrisk of breast cancer because they inherited changes in certain genes. Thegenes most commonly involved in breast cancer are known as BRCA1 and BRCA2.Women with mutations in these genes have up to an 80% chance of getting breastcancer at some point in life. Other genes may be linked to breast cancer riskas well

      一些妇女有很高的患乳腺癌的风险，因为有相关遗传基因。最常见的乳腺癌基因被称为BRCA1和BRCA2。在这些基因突变的女性里，再其人生的某个阶段患乳腺癌的几率约是80%。还有其他的一些基因也与乳腺癌有关联。

最主要在于你自己对危险因素的控制

Being overweight, gettingtoo little exercise, and drinking more than one alcoholic beverage per day canraise the risk of developing breast cancer. Birth control pills and some formsof postmenopausal hormone therapy can also boost your risk. But the risk seemsto go back to normal after these medications are stopped. Among survivors, goodlifestyle choices may be helpful. Recent studies suggest that physical activitymay help lower the risk of a recurrence and it's a proven mood-boost

      超重、运动量太少、每天饮用一种以上的酒精饮料能增加患乳腺癌的风险。避孕药和绝经后激素治疗也可以增加你的风险。但这些药物停止后，风险也会消除。在幸存者中发现，健康的生活方式是很有益的。而最近的研究表明，体力活动可能有助于降低复发的风险，这个让我们更容易做到去预防乳腺癌。