医学英语疾病介绍――Breast Cancer(乳腺癌)

BreastCancer乳腺癌“粉红丝带”作为全球乳腺癌防治活动的公认标识，用于宣传“及早预防，及早发现，及早治疗”这一信息，足迹遍布全球数十个国家。各国政府亦将每年的10月定为“乳腺癌防治月”。粉红丝带是一场关爱乳房的运动，更是人们对健康和美丽的一种追求，她已经成为了一种爱心和时尚，她正在世界各地迅速升温，越来越多的媒体、政要、名人、明星正在参与进来，我们已经进入了一个全新的“粉红时代”。BreastCancerToday概述CausesAndRiskFactors病因学BreastAnatomy解剖学结构PathologicalChanges病理改变Metastasis转移Symptoms症状SignsAndTests诊断Staging分期Treatment治疗Expectations预后Prevention预防Summary综述BreastCancerToday—InAmerica•Breastcancertodayisnotwhatitwas20yearsago.Survivalratesareclimbing,thankstogreaterawareness,moreearlydetection,andadvancesintreatment.(归功于更多的关注，更早的监测和更先进的治疗技术)•Forroughly200,000Americanswhoarediagnosedwithbreastcancereachyear(每年约有二十万美国人被诊断为乳腺癌),thereareplentyofreasonstobehopeful.•InAmerica,About1outof8womenarediagnosedwithbreastcancereveryyear.(在美国，一年统计数据表明，大约每八个女性中有一个会罹患乳腺癌)BreastCancerToday—InChina•Chinaisoneofthecountrieswithlowerincidenceofbreastcancer(中国是乳腺癌低发病率的国家之一),Butinrecentyears,theincidenceincreasedsignificantly(但近年来发病率出现了引人注目的增长),Anannual(每年的)increaseof3%to4%,Morethan1to2%oftheworldlevel,Theincidencerateisoneofthewomenmostsusceptibletotumor(发病率为女性易患肿瘤第一位).•Theincidenceofbreastcancerfromage40to60yearsgenerally,Butchinesepatientswithearlyageofonset,The45-year-oldisthemaximumageofsickness.(乳腺癌的好发年龄为40~60岁，但我国患者发病年龄提前，45岁为发病最高峰)•Hormonalinfluence(激素影响):–Longdurationofreproductive([ˌriprəˈdʌktɪv])life(育龄的长时间持续)–Nulliparity([,nʌli‘pærəti]未产妇)–Lateageatfirstchild(老龄生育)–Functioningovarian([əʊˈveəri:ən])tumor(卵巢肿瘤影响)•Fibrocystic([,faɪbro‘sɪstɪk])disease(乳腺纤维囊性病)•Radiationexposure(射线照射)•Obesity(肥胖)•Geneticpredisposition([priːdɪspə‘zɪʃn])(遗传倾向)•Virus(病毒)CausesAndRiskFactors—Outline•Themostobviousriskfactorforbreastcancerisbeingawoman.Mengetthedisease,too,butitisabout100timesmorecommoninwomen.Othertopriskfactorsincludebeingoverage55orhavingacloserelative(有亲缘关系)whohashadthedisease.Butkeepinmindthatupto80%ofwomenwithbreastcancerhavenofamilyhistoryoftheillness(80%的乳腺癌患者并无家族病史).CausesAndRiskFactors—BreastCancer:WhyMe?•ThegenesmostcommonlyinvolvedinbreastcancerareknownasBRCA1andBRCA2.Womenwithmutations(突变)inthesegeneshaveuptoan80percentchanceofgettingbreastcanceratsomepointinlife(有大于80%的几率在其一生的某个年龄段罹患乳腺癌).CausesAndRiskFactors—BreastCancerGenes•Beingoverweight(过度肥胖),gettingtoolittleexercise(极少锻炼),anddrinkingmorethanonealcoholicbeverageperday(每天喝超过一定量的含酒精饮料)canraisetheriskofdevelopingbreastcancer.•Birthcontrolpills(避孕药)andsomeformsofpostmenopausal([pəʊst,menəʊ‘pɔːzəl])hormonetherapy(某些形式的绝经后激素疗法)canalsoboostyourrisk(提高发病几率).•Recentstudiessuggestthatphysicalactivity(体育活动)mayhelplowertheriskofarecurrence(降低复发率)andit‘saprovenmood-booster(被公认为“愉悦情绪激发器”).CausesAndRiskFactors—RiskFactorsinYourControlBreastAnatomyouterupperquadrant(外上四分之一区域)50%Centralzone(中心区域)20%10%outerlowerquadrant(外下四分之一区域)10%innerlowerquadrant(内下四分之一区域)innerupperquadrant(内上四分之一区域)10%BreastAnatomy—Site(发病部位):Breastcancerisacancerthatstartsinthetissuesofthebreast.Therearetwomaintypesofbreastcancer(乳腺癌有两种主要类型):•Ductalcarcinoma(导管癌)startsinthetubes(ducts)thatmovemilkfromthebreasttothenipple(从乳房向乳头运输乳汁的导管).Mostbreastcancersareofthistype(大多数乳腺癌隶属此种类型).•Lobular(['lɑbjʊlɚ])carcinoma(小叶癌)startsinthepartsofthebreast,calledlobules(['lɒbjuːl]),thatproducemilk(产生乳汁的小叶).PathologicalChangesBreastcancermaybeinvasive([ɪn‘vesɪv],侵袭性的)(临床常见约占70%)ornoninvasive.Invasivemeansithasspreadfromthemilkductorlobuletoothertissuesinthebreast(已经从乳腺管向其他组织扩散).Noninvasivemeansithasnotyetinvadedotherbreasttissue(尚未累及其他乳腺组织).Noninvasivebreastcanceriscalled“insitu([sitju:]).”(非侵袭性乳腺癌又称为原位癌)•Ductalcarcinomainsitu(DCIS)orintraductalcarcinoma(导管内原位癌),isbreastcancerintheliningofthemilkducts(穿过乳腺导管壁)thathasnotyetinvadednearbytissues(累及邻近组织).Itmayprogresstoinvasivecancerifuntreated(如未及时治疗会发展为侵袭性癌).•Lobularcarcinomainsitu(LCIS)(小叶原位癌),isamarkerforanincreasedriskofinvasivecancerinthesameorbothbreasts(它是一个向一侧或双侧乳房呈侵袭性癌发展的危险标志).PathologicalChangesComedocarcinoma(粉刺癌)(隶属非浸润性癌中的导管内原位癌(DCIS))highgrademalignant([mə'lɪgnənt])cells,centralnecrosis([ne'krəʊsɪs]),microcalcifications([,kælsɪfɪ'keɪʃən])(高度恶性细胞，中央区域坏死，微钙化)Grossly(肉眼观):infiltrating([ɪn'fɪltret])thesurroundingbreasttissues,(乳腺组织周围浸润)stony([ˈstəʊni])hardonpalpation([pæl'pet])(触诊坚硬如石),retracted([rɪ'trækt]),dimpling(['dɪmpl])ofskin(皮肤收缩凹陷).Massorropy(['rəʊpɪ])cords(团块状或丝状束),nocapsule(无被囊包被),infiltratingperipheral([pə'rɪf(ə)r(ə)l])tissues(浸润累及周围组织).Invasiveductalcarcinoma(浸润性导管癌)(隶属浸润性癌)(临床常见约占70%)Morebilateral([baɪ‘læt(ə)r(ə)l])(多累及双侧乳腺),multicentricdiffusely([di’fju:zli])invasive(弥漫性多灶性分布)singlefilesofsmallcellsinconcentricring(同心的环状)aboutducts(癌细胞呈列兵样排列,部分围绕乳腺小导管环形排列).Grossly(肉眼观):rubbery(['rʌbərɪ])(切面呈橡皮样)andpoorlycircumscribed(['sɜːkəmskraɪb])(与周围组织无明确界限)Invasivelobularcarcinoma(浸润性小叶癌)(隶属浸润性癌)Directspread(直接扩散)Lymphatic([lɪm'fætɪk])(淋巴道转移):•Axillary([æk'sɪlərɪ])node(腋窝淋巴结),Subclavian([sʌb'kleɪvɪən])node(锁骨下淋巴结).Bloodstream(血道转移):•Lung,Bone,Liver,andBrain.(肺、骨、肝和脑)1,锁骨上淋巴结2,锁骨下淋巴结3,腋窝淋巴结4,胸肌内淋巴结5,乳内淋巴结MetastasisThereareoftennosymptomsofbreastcancer,butsometimeswomenmaydiscoverabreastproblemontheirown.Signsandsymptomstobeawareofma