医学英语疾病介绍——Breast Cancer(乳腺癌)ppt课件.ppt

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 ThePinkRibbon 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 ripr d kt v life 育龄的长时间持续 Nulliparity n li p r ti 未产妇 Lateageatfirstchild 老龄生育 Functioningovarian ve ri n tumor 卵巢肿瘤影响 Fibrocystic fa bro s st k disease 乳腺纤维囊性病 Radiationexposure 射线照射 Obesity 肥胖 Geneticpredisposition pri d sp z n 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 p st men p z l 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 RiskFactorsinYourControl BreastAnatomy outerupperquadrant 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 l bj l carcinoma 小叶癌 startsinthepartsofthebreast calledlobules l bju l thatproducemilk 产生乳汁的小叶 PathologicalChanges Breastcancermaybeinvasive n ves v 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 PathologicalChanges Comedocarcinoma 粉刺癌 隶属非浸润性癌中的导管内原位癌 DCIS highgrademalignant m l gn nt cells centralnecrosis ne kr s s microcalcifications k ls f ke n 高度恶性细胞 中央区域坏死 微钙化 Grossly 肉眼观 infiltrating n f ltret thesurroundingbreasttissues 乳腺组织周围浸润 stony st ni hardonpalpation p l pet 触诊坚硬如石 retracted r tr kt dimpling d mpl ofskin 皮肤收缩凹陷 Massorropy r p cords 团块状或丝状束 nocapsule 无被囊包被 infiltratingperipheral p r f r 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 ba l t r 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 r b r 切面呈橡皮样 andpoorlycircumscribed s k mskra b 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 l m f t k 淋巴道转移 Axillary k s l r node 腋窝淋巴结 Subclavian s b kle v n 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 Signsandsymptomstobeawareofmayinclude Apainlesslump l mp 无痛的肿物 inthebreast Changesinbreastsizeorshape 乳房大小和形状改变 Swellinginthearmpit mp t 腋窝处隆起 Nipplechangesordischarge 乳头变化或出现非生理性泌乳 Symptoms Signsandtests Testsusedtodiagnoseandmonitorpatientswithbreastcancer 用于诊断和监控乳腺癌患者的试验 mayinclude Mammography m m gr f 乳房X线摄影术 toscreenforbreastcancer 显示乳腺癌病灶 orhelpidentifythebreastlump 帮助辨别乳房肿物 Theearlierbreastcancerisfound theeasieritistotreat Andmammograms X raysofthebreast candetecttumors 能够探测肿瘤 beforetheyarelargeenoughtofeel 在它们生长到足够大以至于可以被感觉到之前 Signsandtests BreastMRI 乳房核磁共振成像 tohelpbetteridentifythebreastlump 帮助更好地辨别乳房肿物的性质 orevaluate v lj e t anabnormalchangeonamammogram 评估乳房造影摄片上可见的异常改变 Breastultrasound ltr sa nd 乳房超声检测 toshowwhetherthelumpissolid 固态的 orfluid filled 充满液体的 Anultrasoundcanhelpdeterminethepresenceofcysts fluid filledsacsthatarenotcancer 超声检测可以帮助判定病灶区包囊的出现和充满液体的囊并非都是癌症改变 MRI Magnetic m g net k Resonance rez n ns Imaging 核磁共振成像 Signsandtests Theonlysurewaytodeterminewhetheralumpiscanceristodoabiopsy ba ps 活体组织切片检查 Thisinvolvestakingatissuesampleforfurtherexaminationinthelab sometimesthroughasmallneedle 通过细小针头抽取 Sometimessurgeryisdonetotakepartofortheentirelumpfortesting 手术切除部分肿物送检 Theresultswillshowwhetherthelumpiscancer andifso whattype 活检结果会显示肿物是否为癌症 如果是还可以判定它的型别 Itwasoncewidelyrecommendedthatwomenchecktheirownbreastsonceamonth 一月一检 Butstudiessuggestthesebreastself examsplayaverysmallroleinfindingcancer 实际成效并不显著 Thecurrentthinkingisthat 现在的想法是 it smoreimportanttoknowyourbreasts 更重要的是要了解你的乳房 andbeawareofanychanges 并且及时注意你的乳房出现的任何改变 ratherthancheckingthemonaregularschedule 比定时规律地检查它们更加有效 Signsandtests BreastSelf Exams First don tpanic 首先不要恐慌 Eightypercentofbreastlumpsarenotcancerous 80 的乳房肿块并不是癌性的 Lumpsoftenturnouttobeharmlesscysts 常常被证明是无害的囊肿 ortissuechangesrelatedtoyourmenstrual menstr l cycle 或是与你的月经周期相关的组织改变 Butyoushouldletyourdoctorknowrightawayifyoufindanythingunusual 不寻常的 inyourbreast Ifitiscancer theearlierit sfoundthebetter Andifit snot testingcangiveyoupeaceofmind Signsandtests WhatIfYouFindaLump Oncebreastcancerhasbeendiagnosed 一旦被确诊为乳腺癌 thenextstepistodeterminehowbigthetumorisandhowfarthecancerhasspread Thisprocessiscalledstaging 这个过程称为分期 Staging DoctorsuseStages0 4todescribewhethercancerislocalized 是否局限于 tothebreast hasinvaded n ve d nearbylymphnodes 已经侵入临近淋巴结 orhasspreadtootherorgans 或是已经扩散到其他器官 suchasthelungs 常扩散到肺 Therearemanytypesofbreastcancersurgery fromtakingouttheareaaroundthelump lumpectomy l m p kt mi 乳房肿瘤切除术 orbreast conservation k ns ve n 保留 surgery 乳腺癌保乳治疗 toremovingtheentirebreast mastectomy m stekt m 外科 全乳房切除术 It sbesttodiscusstheprosandcons 各自的优缺点 ofeachoftheseprocedures pr si d 流程 withyourdoctorbeforedecidingwhat srightforyou Treatment Surgery RadiationTherapy er p 放射疗法 forBreastCancerRadiationtherapyuseshigh energyraystokillcancercells 用高能量的射线杀伤癌细胞 Itmaybeusedafterbreastcancersurgerytowipeoutanycancercellsthatremain 通常在乳腺癌手术之后采用放射疗法来清除任何残存的癌细胞 Itcanalsobeusedalongwithchemotherapy ki m er p kem 与化疗一同使用 fortreatmentofcancerthathasspreadtootherpartsofthebody 针对已经扩散到身体其他部位的乳腺癌 Sideeffectscaninclude 副作用包括 fatigue f ti g 疲劳 andswelling 水肿 orasunburn likefeelinginthetreatedarea 治疗局部有烈日灼烧感 Treatment AdditionalTreatments Treatment AdditionalTreatments ChemotherapyforBreastCancerChemotherapyusesdrugstokillcancercellsanywhereinthebody 化疗使用药物来杀伤体内任何部位的癌细胞 ThedrugsareoftengivenbyIV intravenousinjection通常采用静脉注射 butaresometimestakenbymouth 有时也经口服 Chemotherapymaybedoneaftersurgerytolowertheodds 优势 几率 ofthecancercomingback 术后进行化疗可以降低癌症的复发率 Inwomenwithadvancedbreastcancer 处于进展期乳腺癌的妇女 chemotherapycanhelpcontrolthecancer sgrowth 化疗可以帮助控制肿瘤的生长 Sideeffects 副作用 mayincludehairloss 脱发 nausea n s z 恶心 fatigue 疲劳 andahigherriskofinfection 更易受细菌感染 Hormone SensitiveBreastCancer 激素敏感型乳腺癌 Sometypesofbreastcancerarefueledbythehormonesestrogen estr d n 雌激素 orprogesterone pr d est r n 孕酮 某些类型的乳腺癌可由雌激素和孕酮刺激引起 Abiopsycanrevealwhetheratumorhasreceptorsforestrogen ER positive and orprogesterone PR positive 活检可以显示肿瘤是否有雌激素受体 ER阳性 和孕酮受体 PR阳性 Abouttwooutofthreebreastcancersarehormonesensitive 已证实约2 3的乳腺癌是激素敏感性的 Thereareseveralmedicationsthatkeepthehormonesfrompromotingfurthercancergrowth 已知有多种药物能够阻止这些激素进一步促进癌症的发展 Theimageshowsamolecular m lekj l model 分子模型 ofanestrogenreceptor 雌激素受体 Treatment FirstYouShouldKnow HormoneTherapyforBreastCancer 乳腺癌的激素疗法 HormonetherapyisaneffectivetreatmentforwomenwithER positiveorPR positivebreastcancer 激素疗法对ER阳性或PR阳性乳腺癌十分有效 Thesearecancersthatgrowmorerapidlyinresponsetothehormonesestrogenorprogesterone 即指对雌激素和孕酮的反应具有生长加速作用的乳腺肿瘤 Hormonetherapycanblockthiseffect 激素疗法可以阻断这个效应 Itismostoftenusedafterbreastcancersurgerytohelpkeepthecancerfromcomingback Itmayalsobeusedtoreducethechanceofbreastcancerdevelopinginwomenwhoareathighrisk 激素疗法同样也能减少乳腺癌易感妇女的患病几率 Treatment AdditionalTreatments HER2 PositiveBreastCancer 高雌激素应答者 2阳性乳腺癌 Inabout20 ofpatients 约有20 的病人 breastcancercellshavetoomanyreceptorsforaproteincalledHER2 乳腺癌细胞内有过多针对HER2蛋白的受体 ThistypeofcancerisknownasHER2 positive HER2 阳性 andittendstospreadfasterthanotherformsofbreastcancer 这类乳腺癌的发生发展要远远快于其他形式的乳腺癌 It simportanttodeterminewhetheratumorisHER2 positive 判定是否为HER 2阳性乳腺癌显得尤为重要 becausetherearespecialtreatmentsforthisformofcancer 因为这类乳腺癌有着特殊的治疗方法 AHER2 positivebreastcancercellisillustrated l stre t here 图解为一个HER2 阳性的乳腺癌细胞 withabnormalgrowthsignalsshowningreen 图中绿色标识为异常生长信号 Treatment FirstYouShouldKnow TargetedDrugs 靶向药物治疗 forBreastCancerTargetedtherapies 靶向药物疗法 arenewerdrugs 新药 thattargetspecificpropertieswithincancercells 具有攻击癌细胞的特性 Forexample womenwithHER2 positivebreastcancerhavetoomuchofaproteincalledHER2 举例来说 一个HER2 阳性乳腺癌妇女体内有过多的HER2蛋白 Targetedtherapiescanstopthisproteinfrompromotingthegrowthofcancercells 靶向药物可以阻断这些蛋白促进癌细胞生长的作用 Thesedrugsareoftenusedincombination k mb ne n withchemotherapy 这些药物经常与化疗结合使用 Theytendtohavemilder ma ld sideeffectscomparedtochemotherapy 相对化疗来说副作用较小 Treatment AdditionalTreatments There snodoubtthatcancerisalife changingexperience Thetreatmentscanwearyouout 使你精疲力尽 Youmayhavetroublemanagingdailychores t 日常家庭杂务 work 工作 orsocialoutings 社交 Thiscanleadtofeelingsofisolation 这可能会导致让你觉得自己被孤立了 It scrucialtoreachouttofriendsandfamilyforsupport 因而多接触朋友 获得家人的支持是至关重要的 Theymaybeabletogowithyoutotreatments helpoutwithchores orjustremindyouthatyouarenotalone Manypeoplechoosetojoinasupportgroup 许多患者会选择参加一个互助小组 eitherlocallyoronline 无论是本地的还是网上的 Expectations LifeAfterDiagnosis Manywomenwhohaveabreastremovedchoosetoundergoreconstructivesurgery 经受重建外科手术 Thisreplacestheskin nipple andbreasttissuethatarelostduringamastectomy 全乳房切除术 Reconstruction 乳房再造术 canbedonewithabreastimplant m pl nt 乳房假体 orwithtissuefromsomewhereelseinyourbody 或是来源于你身体上其他部位的组织 suchasthetummy t m 胃 肚子 Somewomenopttobeginreconstructionatthesametimeastheirmastectomy 一些妇女选择在做全乳房切除术的同时就进行乳房再造术 Butit salsopossibletohavereconstructivesurgerymonthsoryearslater 当然切除乳房后数月甚至数年再进行乳房再造术亦可 Expectations BreastReconstruction 乳房再造术 Analternativetobreastreconstruction 一种不做乳房再造术的替代方式 istobefittedfor 适合于 abreastform Thisisabreast shapedprosthesis pr s i s s pr s s s 这是一种类似乳房形状的假体 thatfitsinsideyourbra 能够适合于你的胸罩 Wearingabreastformallowsyoutohaveabalancedlook 和谐的外观 whenyouaredressed withoutundergoingadditionalsurgery 不用遭受额外的手术 Likereconstructivesurgery breastformsareo