醫(yī)學(xué)英語疾病介紹-Breast Cancer(乳腺癌)培訓(xùn)

1、醫(yī)學(xué)英語疾病介紹Breast Cancer(乳腺癌)“粉紅絲帶”作為全球乳腺癌防治活動(dòng)的公認(rèn)標(biāo)識(shí)，用于宣傳“及早預(yù)防，及早發(fā)現(xiàn)，及早治療”這一信息，足跡遍布全球數(shù)十個(gè)國(guó)家。各國(guó)政府亦將每年的10月定為“乳腺癌防治月”。粉紅絲帶是一場(chǎng)關(guān)愛乳房的運(yùn)動(dòng)，更是人們對(duì)健康和美麗的一種追求，她已經(jīng)成為了一種愛心和時(shí)尚，她正在世界各地迅速升溫，越來越多的媒體、政要、名人、明星正在參與進(jìn)來，我們已經(jīng)進(jìn)入了一個(gè)全新的“粉紅時(shí)代”。The Pink Ribbon Breast Cancer Today 概述Causes And Risk Factors 病因?qū)WBreast Anatomy 解剖學(xué)結(jié)構(gòu)Patholo

2、gical Changes 病理改變Metastasis 轉(zhuǎn)移Symptoms 癥狀Signs And Tests 診斷Staging 分期Treatment 治療Expectations 預(yù)后Prevention 預(yù)防Summary 綜述Breast Cancer Today In ChinaChina is one of the countries with lower incidence of breast cancer(中國(guó)是乳腺癌低發(fā)病率的國(guó)家之一), But in recent years, the incidence increased significantly(但近年來發(fā)病率

3、出現(xiàn)了引人注目的增長(zhǎng)), An annual(每年的) increase of 3% to 4%, More than 1 to 2% of the world level, The incidence rate is one of the women most susceptible to tumor(發(fā)病率為女性易患腫瘤第一位).The incidence of breast cancer from age 40 to 60 years generally, But chinese patients with early age of onset, The 45-year-old is t

4、he maximum age of sickness.(乳腺癌的好發(fā)年齡為4060歲，但我國(guó)患者發(fā)病年齡提前，45歲為發(fā)病最高峰)The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but it is about 100 times more common in women. Other top risk factors include being over age 55 or having a close relative(有親緣關(guān)系) who has had t

5、he disease. But keep in mind that up to 80% of women with breast cancer have no family history of the illness (80%的乳腺癌患者 并無家族病史). Causes And Risk Factors Breast Cancer: Why Me?The genes most commonly involved in breast cancer are known as BRCA1 and BRCA2. Women with mutations(突變) in these genes have

6、 up to an 80 percent chance of getting breast cancer at some point in life(有大于80%的幾率在其一生的某個(gè)年齡段罹患乳腺癌). Causes And Risk Factors Breast Cancer GenesBreast Anatomy outer upper quadrant (外上四分之一區(qū)域) 50%Central zone(中心區(qū)域) 20% 10% outer lower quadrant (外下四分之一區(qū)域) 10% inner lower quadrant (內(nèi)下四分之一區(qū)域) inner uppe

7、r quadrant (內(nèi)上四分之一區(qū)域) 10%Breast Anatomy Site(發(fā)病部位):Breast cancer may be invasive(nvesv,侵襲性的)(臨床常見約占70%) or noninvasive. Invasive means it has spread from the milk duct or lobule to other tissues in the breast(已經(jīng)從乳腺管向其他組織擴(kuò)散). Noninvasive means it has not yet invaded other breast tissue(尚未累及其他乳腺組織). N

8、oninvasive breast cancer is called “in situ(sitju:).”(非侵襲性乳腺癌又稱為原位癌)Ductal carcinoma in situ (DCIS) or intraductal carcinoma(導(dǎo)管內(nèi)原位癌), is breast cancer in the lining of the milk ducts(穿過乳腺導(dǎo)管壁) that has not yet invaded nearby tissues(累及鄰近組織). It may progress to invasive cancer if untreated(如未及時(shí)治療會(huì)發(fā)展為侵

9、襲性癌).Lobular carcinoma in situ (LCIS)(小葉原位癌), is a marker for an increased risk of invasive cancer in the same or both breasts(它是一個(gè)向一側(cè)或雙側(cè)乳房呈侵襲性癌發(fā)展的危險(xiǎn)標(biāo)志). Pathological Changes Comedocarcinoma(粉刺癌)(隸屬非浸潤(rùn)性癌中的導(dǎo)管內(nèi)原位癌(DCIS) high grade malignant(mlgnnt) cells, central necrosis(nekrss), micro calcifications

10、(,klsfken)(高度惡性細(xì)胞，中央?yún)^(qū)域壞死，微鈣化) Grossly(肉眼觀): infiltrating(nfltret) the surrounding breast tissues,(乳腺組織周圍浸潤(rùn)) stony(stni) hard on palpation(plpet)(觸診堅(jiān)硬如石), retracted(rtrkt), dimpling(dmpl) of skin(皮膚收縮凹陷). Mass or ropy(rp) cords(團(tuán)塊狀或絲狀束), no capsule(無被囊包被), infiltrating peripheral(prf()r()l) tissues(浸

11、潤(rùn)累及周圍組織).Invasive ductal carcinoma (浸潤(rùn)性導(dǎo)管癌)(隸屬浸潤(rùn)性癌)(臨床常見約占70%) More bilateral(balt()r()l)(多累及雙側(cè)乳腺), multicentric diffusely(difju:zli) invasive (彌漫性多灶性分布) single files of small cells in concentric ring(同心的環(huán)狀) about ducts(癌細(xì)胞呈列兵樣排列,部分圍繞乳腺小導(dǎo)管環(huán)形排列). Grossly(肉眼觀): rubbery(rbr)(切面呈橡皮樣) and poorly circumsc

12、ribed(skmskrab)(與周圍組織無明確界限)Invasive lobular carcinoma (浸潤(rùn)性小葉癌)(隸屬浸潤(rùn)性癌)There are often no symptoms of breast cancer, but sometimes women may discover a breast problem on their own. Signs and symptoms to be aware of may include:A painless lump(lmp)(無痛的腫物) in the breast.Changes in breast size or shape(

13、乳房大小和形狀改變).Swelling in the armpit(mpt). (腋窩處隆起)Nipple changes or discharge. (乳頭變化 或出現(xiàn)非生理性泌乳)Symptoms Signs and testsTests used to diagnose and monitor patients with breast cancer(用于診斷和監(jiān)控乳腺癌患者的試驗(yàn)) may include:Mammography(mmgrf)(乳房X線攝影術(shù)) to screen for breast cancer(顯示乳腺癌病灶) or help identify the breast

14、 lump.(幫助辨別乳房腫物)The earlier breast cancer is found, the easier it is to treat. And mammograms, X-rays of the breast, can detect tumors(能夠探測(cè)腫瘤) before they are large enough to feel(在它們生長(zhǎng)到足夠大以至于可以被感覺到之前).Signs and testsBreast MRI(乳房核磁共振成像) to help better identify the breast lump(幫助更好地辨別乳房腫物的性質(zhì)) or eva

15、luate(vljet) an abnormal change on a mammogram(評(píng)估乳房造影攝片上可見的異常改變)Breast ultrasound(ltrsand)(乳房超聲檢測(cè)) to show whether the lump is solid(固態(tài)的) or fluid-filled(充滿液體的), An ultrasound can help determine the presence of cysts, fluid-filled sacs that are not cancer(超聲檢測(cè)可以幫助判定病灶區(qū)包囊的出現(xiàn)和充滿液體的囊并非都是癌癥改變).MRI: Magn

16、etic(mgnetk) Resonance(rez()nns) Imaging 核磁共振成像Signs and testsThe only sure way to determine whether a lump is cancer is to do a biopsy(baps)(活體組織切片檢查). This involves taking a tissue sample for further examination in the lab, sometimes through a small needle(通過細(xì)小針頭抽取). Sometimes surgery is done to t

17、ake part of or the entire lump for testing(手術(shù)切除部分腫物送檢). The results will show whether the lump is cancer, and if so, what type.(活檢結(jié)果會(huì)顯示腫 物是否為癌癥，如果是還 可以判定它的型別) It was once widely recommended that women check their own breasts once a month(一月一檢). But studies suggest these breast self-exams play a very

18、 small role in finding cancer(實(shí)際成效并不顯著). The current thinking is that(現(xiàn)在的想法是) its more important to know your breasts(更重要的是要了解你的乳房) and be aware of any changes(并且及時(shí)注意你的乳房出現(xiàn)的任何改變), rather than checking them on a regular schedule(比定時(shí)規(guī)律地檢查它們更加有效). Signs and tests Breast Self-ExamsOnce breast cancer has

19、 been diagnosed(一旦被確診為乳腺癌), the next step is to determine how big the tumor is and how far the cancer has spread. This process is called staging(這個(gè)過程稱為分期). Staging Doctors use Stages 0-4 to describe whether cancer is localized(是否局限于) to the breast, has invaded(nved) nearby lymph nodes(已經(jīng)侵入臨近淋巴結(jié)), or

20、 has spread to other organs(或是已經(jīng)擴(kuò)散到其他器官), such as the lungs(常擴(kuò)散到肺).There are many types of breast cancer surgery, from taking out the area around the lump (lumpectomy(lmpktmi)(乳房腫瘤切除術(shù)) or breast-conservation(knsve()n)(保留) surgery(乳腺癌保乳治療) to removing the entire breast (mastectomy(mstektm)(外科全乳房切除術(shù)).

21、) Its best to discuss the pros and cons(各自的優(yōu)缺點(diǎn)) of each of these procedures(prsi:d)(流程) with your doctor before deciding whats right for you.Treatment Surgery Radiation Therapy(erp)(放射療法) for Breast CancerRadiation therapy uses high-energy rays to kill cancer cells(用高能量的射線殺傷癌細(xì)胞). It may be used afte

22、r breast cancer surgery to wipe out any cancer cells that remain(通常在乳腺癌手術(shù)之后采用放射療法來清除任何殘存的癌細(xì)胞). It can also be used along with chemotherapy(,kim()erp; ,kem-)(與化療一同使用) for treatment of cancer that has spread to other parts of the body(針對(duì)已經(jīng)擴(kuò)散到身體其他 部位的乳腺癌). Side effects can include(副作用包括) fatigue(ftig)(

23、疲勞) and swelling(水腫) or a sunburn-like feeling in the treated area(治療局部有烈日 灼燒感).Treatment Additional Treatments Treatment Additional TreatmentsChemotherapy for Breast CancerChemotherapy uses drugs to kill cancer cells anywhere in the body(化療使用藥物來殺傷體內(nèi)任何部位的癌細(xì)胞). The drugs are often given by IV(intrave

24、nous injection通常采用靜脈注射), but are sometimes taken by mouth(有時(shí)也經(jīng)口服). Chemotherapy may be done after surgery to lower the odds(優(yōu)勢(shì)，幾率) of the cancer coming back(術(shù)后進(jìn)行化療可以降低癌癥的復(fù)發(fā)率). In women with advanced breast cancer(處于 進(jìn)展期乳腺癌的婦女), chemotherapy can help control the cancers growth(化療可以 幫助控制腫瘤的生長(zhǎng)). Side e

25、ffects(副作用) may include hair loss(脫發(fā)), nausea (ns; -z-)(惡心), fatigue (疲勞), and a higher risk of infection(更易受細(xì)菌感染).Hormone-Sensitive Breast Cancer(激素敏感型乳腺癌)Some types of breast cancer are fueled by the hormones estrogen(estrdn)(雌激素) or progesterone(prdestrn)(孕酮)(某些類型的乳腺癌可由雌激素和孕酮刺激引起). A biopsy can r

26、eveal whether a tumor has receptors for estrogen (ER-positive) and/or progesterone (PR-positive)(活檢可以顯示腫瘤是否有雌激素受體(ER陽(yáng)性)和孕酮受體(PR陽(yáng)性). About two out of three breast cancers are hormone sensitive(已證實(shí)約2/3的乳腺癌是激素敏感性的). There are several medications that keep the hormones from promoting further cancer grow

27、th(已知 有多種藥物能夠阻止這些 激素進(jìn)一步促進(jìn)癌癥的發(fā)展).The image shows a molecular(mlekjl) model(分子模型) of an estrogen receptor(雌激素受體).Treatment First You Should Know Hormone Therapy for Breast Cancer(乳腺癌的激素療法)Hormone therapy is an effective treatment for women with ER-positive or PR-positive breast cancer(激素療法對(duì)ER陽(yáng)性或PR陽(yáng)性乳腺

28、癌十分有效). These are cancers that grow more rapidly in response to the hormones estrogen or progesterone(即指對(duì)雌激素和孕酮的反應(yīng)具有生長(zhǎng)加速作用的乳腺腫瘤). Hormone therapy can block this effect(激素療法可以阻斷這個(gè)效應(yīng)). It is most often used after breast cancer surgery to help keep the cancer from coming back. It may also be used to re

29、duce the chance of breast cancer developing in women who are at high risk (激素療法同樣也能減少乳腺癌 易感婦女的患病幾率).Treatment Additional TreatmentsHER2-Positive Breast Cancer(高雌激素應(yīng)答者-2陽(yáng)性乳腺癌)In about 20% of patients(約有20%的病人), breast cancer cells have too many receptors for a protein called HER2(乳腺癌細(xì)胞內(nèi)有過多針對(duì)HER2蛋白的受體

30、). This type of cancer is known as HER2-positive(HER2-陽(yáng)性), and it tends to spread faster than other forms of breast cancer(這類乳腺癌的發(fā)生發(fā)展要遠(yuǎn)遠(yuǎn)快于其他形式的乳腺癌). Its important to determine whether a tumor is HER2-positive(判定是否為HER-2陽(yáng)性乳腺癌顯得尤為重要), because there are special treatments for this form of cancer(因?yàn)檫@類乳腺

31、 癌有著特殊的治療方法).A HER2-positive breast cancer cell is illustrated (lstret) here(圖解為一個(gè) HER2-陽(yáng)性的乳腺癌細(xì)胞), with abnormal growth signals shown in green(圖中綠色標(biāo) 識(shí)為異常生長(zhǎng)信號(hào)).Treatment First You Should KnowTargeted Drugs(靶向藥物治療) for Breast CancerTargeted therapies(靶向藥物療法) are newer drugs(新藥) that target specific pr

32、operties within cancer cells(具有攻擊癌細(xì)胞的特性). For example, women with HER2-positive breast cancer have too much of a protein called HER2(舉例來說，一個(gè)HER2-陽(yáng)性乳腺癌婦女體內(nèi)有過多的HER2蛋白). Targeted therapies can stop this protein from promoting the growth of cancer cells(靶向藥物可以阻斷這些蛋白促進(jìn)癌細(xì)胞生長(zhǎng)的作用). These drugs are often use

33、d in combination(kmbne()n) with chemotherapy(這些藥物 經(jīng)常與化療結(jié)合使用). They tend to have milder(mald) side effects compared to chemotherapy.(相對(duì)化療來說 副作用較小)Treatment Additional TreatmentsTheres no doubt that cancer is a life-changing experience. The treatments can wear you out(使你精疲力盡). You may have trouble man

34、aging daily chores(t)(日常家庭雜務(wù)), work(工作), or social outings(社交). This can lead to feelings of isolation(這可能會(huì)導(dǎo)致讓你覺得自己被孤立了). Its crucial to reach out to friends and family for support(因而多接觸朋友、獲得家人的支持是至關(guān)重要的). They may be able to go with you to treatments, help out with chores, or just remind you that yo

35、u are not alone. Many people choose to join a support group (許多患者會(huì)選擇參加一個(gè)互助 小組) - either locally or online (無論是本地的還是網(wǎng)上的).Expectations Life After DiagnosisMany women who have a breast removed choose to undergo reconstructive surgery(經(jīng)受重建外科手術(shù)). This replaces the skin, nipple, and breast tissue that are

36、 lost during a mastectomy(全乳房切除術(shù)). Reconstruction(乳房再造術(shù)) can be done with a breast implant(mplnt)(乳房假體) or with tissue from somewhere else in your body(或是來源于你身體上其他部位的組織), such as the tummy(tm胃，肚子). Some women opt to begin reconstruction at the same time as their mastectomy(一些婦女選擇在 做全乳房切除術(shù)的同時(shí)就進(jìn)行 乳房再造

37、術(shù)). But its also possible to have reconstructive surgery months or years later (當(dāng)然切除乳房后數(shù)月甚至數(shù)年 再進(jìn)行乳房再造術(shù)亦可).Expectations Breast Reconstruction(乳房再造術(shù))An alternative to breast reconstruction(一種不做乳房再造術(shù)的替代方式) is to be fitted for(適合于) a breast form. This is a breast-shaped prosthesis(prsiss; prs,ss)(這是一種類似

38、乳房形狀的假體) that fits inside your bra(能夠適合于你的胸罩). Wearing a breast form allows you to have a balanced look(和諧的外觀) when you are dressed - without undergoing additional surgery(不用遭受額外的手術(shù)). Like reconstructive surgery, breast forms are often covered by insurance(nr()ns)(通常由 保險(xiǎn)公司支付).Expectations Breast Forms Many risk factors, such as your genes and family history, cannot be controlled. However, eating a healthy diet and making a few lifestyle changes may reduce your overall chan