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婦女的心頭大患-淺談罹患率漸高的乳癌

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婦女的心頭大患-淺談罹患率漸高的乳癌

隨著時代進步,生活水準提高,大部分的疾病獲得控制,平均壽命也隨之提高。但有一項較為例外的是婦女的乳癌,不僅罹患率逐漸提高,相較於歐美地區,台灣婦女罹患乳癌的年紀也比較早,即停經前的罹患率高於歐美地區,至於原因則尚無定論。
而女性晚婚生產是工業化國家的共同趨勢,但是否因為台灣地區婦女哺乳率低引起則有待進一步研究。

乳癌的症狀,通常是一無痛性硬塊,所以必須強調自我檢查的重要性,因為它不會痛,所以不去觸摸它,根本難以發覺它的存在,這也是常常造成乳癌發現太慢的原因。事實上,可用手觸及的乳癌,大多已有一公分以上。分期上至少已屬第一期,五年存活率可達百分之八十五左右。

如要提高治癒率,則必需仰賴乳房攝影或超音波的檢查,可偵測出零點五公分或更小的病灶,如果是屬零期乳癌(即病灶局限於乳腺上皮細胞,未向外擴張),則五年存活率幾可達百分之百,而且治療時不需切除乳房,只需局部切除加上放射線治療即可,也可避免化學治療引起的不適。

換句話說,只要能「早期發現、早期治療」,不僅完全可治好,而且療程痛苦少,還可保存乳房的外觀和功能,過完全正常的生活,工作和社交不受影響,也不需勞煩家屬照料,和其它癌症帶給患者和家屬的痛苦可謂完全不一樣,但這一切的關鍵就在於-早期發現。

要能早期發現乳癌,端賴於自我警覺的認知,不僅要勤於自我檢查,更要定期到醫院檢查。

一般三十歲以上的婦女,每年至少要到醫院檢查一次。至於用超音波或乳房攝影,則待您和醫師商討後決定,因為這兩種檢查各有其特性:超音波檢查無痛苦,可立即知道結果,定位清楚,但對微小病灶敏感度稍差(視機型而定);乳房攝影對微小鈣化病灶可偵測出來,但若無鈣化現象較不易判斷,檢查時因需配合機器,略為疼痛,且無法立即得知結果,定位手續較麻煩。

以目前這兩種檢查方式在國內使用狀況,據乳房醫學會的報告,以超音波較為適合從事第一線的篩檢,至於國外的報告,則較推薦乳房攝影,這是因東西方婦女體質不同,國內一般婦女乳房較小,但組織密度卻較高所致。

乳癌是婦女健康的一大威脅,對個人身心乃至家庭生活影響至鉅。

隨著女性意識抬頭,婦女對自我的關懷加重,乳癌也備受社會重視,在此要再度強調「早期發現、早期治療」的重要性,而要能早期發現則端賴於定期的自我和醫院檢查,這是一輩子都要做的事,套句流行廣告用語,〝這是一定要的啦!〞

柯春安 醫師 / 天主教耕莘醫院新店總院 - 一般外科

來源:整合輔助醫療協會
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