2009年1月20日 星期二

黃柏榮醫師代表協會全體致詞

身為台灣乳腺健康協會的一分子,希望每個珍貴的會員都能對協會有所建議,務期使協會對乳腺健康之推廣有所助益。

『關懷』是本協會的力量,能連結起全球的華人婦女,引起愛惜乳房的自我意識。希望在新的一年開始,我們能一方面檢討過去的缺陷,一方面也認識自己的力量,既不自傲,也不自餒,以工作表現團體的精神,以團體發展工作。同時,也希望各位會員能齊力協助,宣揚『I Pledge 我保乳 保生命 保尊嚴』以及定期乳房健康管理的理念。

在這次的第一屆第四次理監事大會中,我們以推動本協會登記為社團法人為主要目標,以便推廣和各相關協會---如中華民國乳癌病友協會--等等之聯繫與合作關係。

本次第一屆第二次會員大會,我們很榮幸的與一位乳癌病友的會員---姚老師,一同分享了她的心路歷程,在坐的諸多醫師都相當感同身受,深深佩服姚老師的堅強與活力,也非常感謝姚老師為大會添增如同大家庭的溫馨氣氛。

衷心感谢各位會員對本次會議的積極支持和密切配合,感谢理堅事會為會議等準備工作所做的大量周密的工作;衷心感谢各位會員對協會的信任和支持,也感谢大家對我本人的信任和支持。我和協會的工作夥伴一定團結一致,努力工作,繼續推動協會登記為法人之工作、推動協會與各相關協會之聯繫與合作,不辜負大家的期望。


感謝各位會員的支持 祝福各位新年快樂



2009年1月4日 星期日

恭賀彭汪嘉康院士成為本協會榮譽顧問、北醫吳志雄院長成為本協為榮譽理事長!

有鑑於北醫吳志雄院長與本協會理念相當契合,第二屆理監事大會舉行前夕,協會理事長黃柏榮醫師特邀北醫院長擔任本協會榮譽理事長,並經由台北醫學院邱文達校長推薦,邀請北醫癌症腫瘤癌究中心兼北醫講師,彭汪嘉康院士擔任本協會榮譽顧問,為促進乳腺疾病診斷及治療研究計畫齊盡心力。

日前本協會理事長黃柏榮醫師協同協會理事何淑圭女士,前往交通大學醫學院附屬上海瑞金醫院進行交流及演講。瑞金醫院向協會理事長表示,未來三年內將應用多學科合作的綜合醫療技術優勢,針對中國百萬婦女進行緻密性乳房資料庫的建置計畫,並希望能由位在台北醫學大學附設醫院的乳房健康管理中心,結合美國 AURORA乳房專用螺旋磁振造影掃描儀的最新技術,提供屬於台灣婦女的乳房資料,以整合並完整百萬婦女資料庫計畫。


何淑圭女士將此訊息帶回台灣後,北醫附醫 吳志雄院長對成立此國際型交流平台表示全力支持,並認為台灣所擁有乳房相關醫療資源相當豐富,足以做為中國未來建置乳腺病中心的最佳參考。

為結合台北醫學大學及其附設醫院的研究資源,本協會特邀北醫附醫 吳志雄院長及具有國際醫療背景的彭汪嘉康 院士分別擔任協會榮譽理事長及榮譽顧問,共同提升台灣乳腺健康之水平。

2009年1月3日 星期六

乳癌的高危險因子

Risk Factors for Breast Cancer 乳癌的高危險因子



Sex 性別
The overwhelming majority of breast cancers occur in women. It does also occur in men.The ratio from woman to man is 135:1.
絕大多數的乳癌都發生在女性的身上,也有少數男性乳癌案例。
以人類性別而言,罹患乳癌的男女比為1:135。

Age年齡
As a woman gets older her risk of breast cancer increases. For example, at age 30, 1 in 2200 women develop breast cancer but at age 80 approximately 1 in 10 develop breast cancer.
以女性而言,年紀越大罹患乳癌的機率越高,就30歲的女性來說,每2200人會有1人可能得到乳癌;但以80歲的婦女而言,每10人就有1人會得到乳癌。

Race種族
Caucasian women have the highest incidence of breast cancer.
白人女性是乳癌發病率最高的人種。

Personal History of Breast or Ovarian Cancer 個人乳癌或卵巢癌病史
Women who have had a breast cancer in one breast have a higher risk of developing another breast cancer; either within the same breast or in the other. Women who have had ovarian cancer are also at a higher risk of developing breast cancer.
曾得過乳癌的婦女,有很高的機率會同側或另一側乳房再度復發。
曾得過卵巢癌的婦女也有很高的機率會罹患乳癌。

Breast Hyperplasia 乳腺增生
Women who have had a breast biopsy with atypical hyperplasia (ductal or lobular), lobular carcinoma in situ, or cellular atypia also have an elevated risk for the development of breast cancer.
曾因為乳管或乳小葉的非典型增生(ADH)、乳小葉原位癌(LCIS)、細胞性不典型而接受導引穿刺切片手術的婦女,都會有很高的機率會發展成乳癌。

Family History 家族病史
Having a strong family history of breast cancer (either maternal or paternal) increases a woman's risk status.
擁有乳癌家族史(無論是母族或父族的親屬),都會增加女性罹患乳癌的機率。

Breast Density 乳房緻密度
Breast density tends to decrease as a woman ages. As she gets older the dense ducts and lobules (glandular tissue) get replaced by fatty tissue. High breast density, especially post-menopausally, is a risk factor for breast cancer.
乳房的緻密度會隨著年歲的增加而減少,當年齡增長時,乳房中的乳腺管和乳小葉組織(腺體組織)會逐漸被脂肪替代。尤其是停經後乳房仍然屬於緻密者,都是乳癌的高危險因子。

Hormones 赫爾蒙
The longer the breasts have been exposed to hormones, the higher the risk for developing breast cancer. Therefore, women who started menstruating before the age of 12 and stopped menstruating after 55 are at greater risk.
乳腺組織受赫爾蒙的影響時間越長,得到乳癌的機率就會越高。因此,初經早於12歲、停經晚於55歲的女性都算是乳癌的高危險群。

Child-Birth 生育史
Not having children or having a first child over 30 also increases a woman's risk. Breast-feeding has been shown to reduce breast cancer risk.
未曾生育或三十歲以後生育第一胎者都會增加罹患乳癌的機率。
也有研究顯示,哺餵母乳可降低罹患乳癌的機率。

Radiation Exposure 輻射線影響
Prior radiation to the chest area, especially during the period between puberty and 30 years of age, increases the risk of breast cancer.
在30歲前尤其是青春期時,胸部曾接受大量的放射線照射,都會增加罹患乳癌的風險。

Alcohol Use 酗酒
Studies suggest that greater than 2 drinks a day increases breast cancer risk.
研究顯示,每天喝酒超過兩杯會增加罹患乳癌的機率。

Hereditary Breast Cancer遺傳性乳癌
5-10% of all the breast cancers we see are likely due to an inherited mutation. BRCA 1 and BRCA 2 are two genes everyone has. Certain people are born with a mutation of one of these genes and this mutation significantly increases their likelihood of developing breast and ovarian cancer. Some red flags in a person's personal or family history that would make us concerned about a genetic mutation are:
約有5-10%的乳癌和遺傳的基因突變有關,每個人的體內都有BRCA 1和BRCA 2這兩種基因,但有些人卻遺傳到BRCA 1和BRCA 2的突變基因,增加了罹患乳癌和卵巢癌的機率。在個人病史及家族史中值得注意的基因突變警訊如下:
*Breast cancer before the age of 50 曾在50歲之前罹患乳癌
*Ovarian cancer at any age 在任何年齡罹患卵巢癌
*Male breast cancer 男性乳癌
*Bilateral breast cancer 對側性乳癌
*Both breast and ovarian cancer 雙邊乳房和卵巢曾罹患過癌症
*Relative with a BRCA 1 and BRCA 2 Mutation 遺傳BRCA 1和BRCA 2的突變基因

降低罹患乳癌風險

Breast cancer risk reduction can be managed in four different categories:
降低罹患乳癌風險的方式有以下4種類型:

*Increased Surveillance
密集追蹤

*Lifestyle Modifications
改善生活習慣

*Chemoprevention
藥物控制

*Preventative Surgery.
預防性手術


Some women who are found to be high risk may choose to have closer surveillance. Traditionally for average risk women guidelines for surveillance are:
乳癌高危險群婦女可選擇適度增加乳房篩檢次數,一般風險婦女的乳房篩檢指導原則如下:

*Monthly Self Breast Exam starting at age 18.
自18歲起每個月應定期自我檢查。

*Clinical Breast Exam semiannually starting at age 25.
自25歲起每半年應安排一次乳房特別門診檢查。

*Annual mammograms at age 40 or 5-10 years younger than any 1st degree relative.
自40歲起每年應安排定期乳房X光攝影檢查,或是比任何直系親屬再提早5~10年,即可安排檢查。

* American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography
美國癌症協會建議可使用乳房磁振造影增加乳房X光攝影的篩檢準確度。



New guidelines for very high risk women or women with a known genetic mutation are :
乳癌高危險群的最新篩檢指導原則如下:

*Monthly Breast Self Exam starting at age 18
  自18歲起每個月應定期自我檢查。

*Clinical Breast Exam semiannually starting at age 25.
  自25歲起每半年應安排一次乳房特別門診檢查。

*Annual mammograms alternating with breast MRI starting at the age of 25.
  自25歲起每年可交替使用乳房X光攝影及乳房磁振造影進行篩檢。



Breast Health High Risk Breast Clinic can help develop a personalized surveillance program for you based on your risk factors for breast cancer.
乳癌高危險群特別門診能根據不同的乳癌高危險因子制訂個人篩檢計畫。

For extremely high risk women and women with known genetic mutations there are guidelines for increased ovarian survelillance. They are:
對於攜帶突變基因的特別高危險群婦女,以下是增加卵巢篩檢的指導原則:

*Concurrent transvaginal ultrasound and CA-125 (blood test) every 6 months starting at age 35 or 5-10 years earlier than the earliest age of first diagnosis of ovarian cancer in the family.
自35歲起,甚至可比家族中罹患卵巢癌之親屬的年齡更提早5~10年,每六個月應同時採行陰道超音波檢查及驗血報告。

Lifestyle Modifications 改善生活習慣

Diet: Some research suggests that diets low in fats may decrease your risk of breast cancer. We recommend avoiding diets high in saturated or hydrogenated fats such as peanut and vegetable oil and instead using fats such as canola or olive oil. We also recommend a diet rich in fresh fruits and vegetables which add cancer fighting anti-oxidants.
飲食控制:
部分研究顯示,減少飲食中脂肪的攝取量能幫助減低罹患乳癌的風險。我們建議避免食用過多的飽和脂肪酸及氫化油脂,例如花生、植物油等;菜籽油或橄欖油是較為合適的脂肪攝取來源。

Weight: Some research suggests that postmenopausal obesity is a risk factor for breast cancer. Maintaing a healthy weight and exercising regularly may reduce your risk of breast cancer and improve your general health.
體重控制:
部分研究認為,停經後的肥胖現象是導致乳癌的風險之一,維持健康的體重和規律的運動不僅能降低乳癌風險,還能維持你的整體健康。

Alcohol: Consuming more than 2 drinks of alcohol a day does increase the risk of breast cancer. Recent data suggests that dietary folate can counteract the effect of alcohol.
每酒精用量控制:
天的飲酒量若超過兩杯,會增加罹患乳癌的風險。最近的資料顯示膳食葉酸可以抵消酒精的影響。


Chemoprevention 化學治療

Tamoxifen: Tamoxifen is a drug that is approved for breast cancer reduction in high risk women. It is a selective estrogen receptor modulator, this means it works by blocking the effects of estrogen in breast tissue, which can be a stimulant for breast cancer cell growth. It has been shown to reduce breast cancer risk by 50%.
抗雌激素:抗雌激素是一種已被核准用於降低乳癌風險的藥物。她是種選擇性的雌激素受體調節器,可調節乳癌高危險因子之一的雌激素對乳腺的影響。抗雌激素倍正時可降低50%的罹癌機率。

Oral Contraceptives: Oral contraceptives may reduce the risk of ovarian cancer in women with BRCA1 or BRCA2 mutations by as much as 54%.
口服避孕藥:口服避孕藥可以降低卵巢癌患者高達54%的BRCA1、BRCA2基因之突變機率。


Preventative Surgery 預防性手術

Preventative Mastectomy: Preventative Mastectomy is the removal of both breasts. Preventative Mastectomy significantly reduces the risk of breast cancer to the high 90% range.
預防性乳房切除手術:預防性乳房切除手術就是一種將雙邊乳房全數切除的手術,可降低90%的罹癌機率。

Preventative Oophorectomy: Preventatice Oopherectomy is the removal of the ovaries for risk reduction. This procedure significantly reduces the risk of ovarian cancer by as much as 96% and the risk of breast cancer by as much as 53%.
預防性卵巢切除手術:為了減低罹癌風險,可施行卵巢切除手術。此種措施可有效減少96%的卵巢癌機率和53%的乳癌機率。

For more information about ways you can reduce your risk call the High Risk Breast Clinic。
你可以聯繫乳癌高危險群篩檢門診得到更多減低癌機率的方法。