30余年做了6000余例乳腺癌手术！北京协和医院专家告诉你乳腺癌咋防治！
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">本文专家：孙强 北京协和医院乳腺外科<span style="color: black;">专家</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">北京协和医院乳腺外科孙强<span style="color: black;">专家</span>从事乳腺<span style="color: black;">疾患</span>诊治和<span style="color: black;">科研</span>30余年，累计主刀乳腺癌手术6000余例，<span style="color: black;">善于</span>采用隐秘切口进行乳腺癌保乳手术，并自创了环乳晕切口保乳手术及乳腺癌改良根治术加一期重建术。乳腺癌手诊准确率高，被<span style="color: black;">病人</span><span style="color: black;">叫作</span>为“活Ｂ超”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3月3日，北京协和医院乳腺外科主任孙强做客人民日报健康客户端《人民名医》直播节目，对女性关注的乳腺<span style="color: black;">专题</span>进行权威答疑。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">筛查：<span style="color: black;">那些</span>人易患乳腺癌？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中国乳腺癌的发病年龄有两个高峰，<span style="color: black;">第1</span>个高峰是45岁到55岁，第二个高峰是65岁到75岁。遗传<span style="color: black;">原因</span>、<span style="color: black;">大姨妈</span>初潮早、绝经年龄晚、易感基因突变等都是乳腺癌发病不可改变的危险<span style="color: black;">原因</span>；但<span style="color: black;">亦</span>有<span style="color: black;">能够</span>改变的危险因素，生育、哺乳、<span style="color: black;">掌控</span>体重、<span style="color: black;">恰当</span>运动、减少激素替代等都<span style="color: black;">能够</span>降低乳腺癌的发病<span style="color: black;">危害</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">家族遗传是乳腺癌的高危<span style="color: black;">原因</span>之一，因遗传<span style="color: black;">原因</span>患乳腺癌的<span style="color: black;">病人</span>比例为5%~10%。<span style="color: black;">倘若</span>一个女性的直系亲属，例如母亲、姐妹、女儿等患乳腺癌，<span style="color: black;">那样</span>她<span style="color: black;">自己</span>患乳腺癌的几率要比别人高4倍。<span style="color: black;">倘若</span>您有乳腺癌的遗传高危<span style="color: black;">原因</span>，<span style="color: black;">意见</span><span style="color: black;">重视</span>筛查，提前干预。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">要改变我国乳腺癌高<span style="color: black;">发掘</span>状，<span style="color: black;">必定</span>要做早筛早诊。<span style="color: black;">首要</span>，女性要<span style="color: black;">定时</span>对乳房进行自检，每月1次，<span style="color: black;">意见</span>绝经前女性在<span style="color: black;">大姨妈</span>来潮后7~14天<span style="color: black;">检测</span>。临床上看，<span style="color: black;">大概</span>80%的乳腺癌是<span style="color: black;">病人</span>自己<span style="color: black;">发掘</span>的。除了自检以外，<span style="color: black;">通常</span><span style="color: black;">危害</span>人群每1~2年应进行一次乳腺超声<span style="color: black;">检测</span>。如不具备乳腺超声<span style="color: black;">检测</span><span style="color: black;">前提</span>，可做个乳腺X线<span style="color: black;">检测</span>。高<span style="color: black;">危害</span>人群应每年进行一次乳腺超声联合乳腺X线摄影<span style="color: black;">检测</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗：乳腺癌有<span style="color: black;">那些</span>疗法？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术、化疗、放疗、内分泌治疗、靶向治疗，<span style="color: black;">此刻</span>还有免疫治疗，这些都是治疗乳腺癌的有效手段。手术和放疗属于局部治疗，化疗、内分泌治疗、靶向治疗等属于全身治疗。<span style="color: black;">针对</span><span style="color: black;">初期</span>乳腺癌，<span style="color: black;">意见</span>具备手术<span style="color: black;">前提</span>的<span style="color: black;">病人</span><span style="color: black;">首要</span>接受手术治疗，再进行全身治疗，预防复发及转移。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发、弥漫的、累及乳头乳晕的乳腺癌<span style="color: black;">通常</span>不宜施行保乳手术，但<span style="color: black;">倘若</span><span style="color: black;">病人</span>保乳意愿<span style="color: black;">剧烈</span>，<span style="color: black;">大夫</span><span style="color: black;">亦</span>可<span style="color: black;">按照</span><span style="color: black;">状况</span>去争取<span style="color: black;">前提</span>。<span style="color: black;">例如</span>针对累及乳头乳晕的病变，可把乳头乳晕去掉后重新做乳头乳晕再造；多中心病变<span style="color: black;">能够</span>分中心来切除病变。切除干净，成型满意是保乳原则。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">化疗后要<span style="color: black;">定时</span>做<span style="color: black;">检测</span>，<span style="color: black;">评定</span>疗效。我常<span style="color: black;">平常</span>到<span style="color: black;">有些</span>病人，做了<span style="color: black;">各样</span>治疗，但在效果不确定的<span style="color: black;">状况</span>下就换了<span style="color: black;">方法</span>，<span style="color: black;">非常</span><span style="color: black;">茫然</span>。<span style="color: black;">另外</span>，化疗中<span style="color: black;">显现</span>副<span style="color: black;">功效</span>不要恐慌。化疗本身有<span style="color: black;">必定</span>副<span style="color: black;">功效</span>，<span style="color: black;">包含</span>呕吐、手足麻木等，这些可能的副<span style="color: black;">功效</span>可进行预防和对症处理，<span style="color: black;">无</span>必要过分恐慌。其实，<span style="color: black;">按照</span>临床经验，符合化疗指征的<span style="color: black;">病人</span>化疗<span style="color: black;">通常</span>都能耐受，<span style="color: black;">因此呢</span><span style="color: black;">病人</span>不要有心理上的<span style="color: black;">包袱</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">恢复</span>：术后的<span style="color: black;">恢复</span><span style="color: black;">怎样</span>做？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">手术方式不一样，乳腺癌<span style="color: black;">病人</span>的<span style="color: black;">恢复</span>方式<span style="color: black;">亦</span>不<span style="color: black;">同样</span>。拿腋窝手术<span style="color: black;">来讲</span>，<span style="color: black;">倘若</span>做了腋窝淋巴结清扫术，可能就<span style="color: black;">必须</span>做<span style="color: black;">恢复</span>训练来尽早恢复上肢功能。在<span style="color: black;">非常多</span>医院的病房内，医护人员都会<span style="color: black;">指点</span><span style="color: black;">病人</span>进行术后上肢活动，用来减少并发症。乳腺癌术后，<span style="color: black;">膳食</span>上<span style="color: black;">通常</span><span style="color: black;">无</span>特殊<span style="color: black;">需求</span>。术后<span style="color: black;">倘若</span><span style="color: black;">评定</span>认为营养<span style="color: black;">情况</span>良好，保持<span style="color: black;">平衡</span><span style="color: black;">膳食</span>就<span style="color: black;">能够</span>了，不<span style="color: black;">必须</span>额外摄入其他<span style="color: black;">食品</span><span style="color: black;">或</span>补品。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">乳腺癌术后随访<span style="color: black;">检测</span>的目的是<span style="color: black;">发掘</span>肿瘤复发转移的迹象。乳腺癌容易转移的部位<span style="color: black;">第1</span>是骨头，第二是肺，其次是其他器官。<span style="color: black;">针对</span>肺部的<span style="color: black;">评定</span>，过去<span style="color: black;">咱们</span>会拍个胸片，<span style="color: black;">此刻</span>可用低剂量CT代替。<span style="color: black;">针对</span>骨转移的排除，可<span style="color: black;">定时</span>做全身骨扫描。<span style="color: black;">另外</span>，腹部、盆腔、乳腺及腋窝、颈部及锁骨上窝<span style="color: black;">亦</span>要<span style="color: black;">定时</span>进行超声<span style="color: black;">检测</span>。有时候PET-CT能<span style="color: black;">发掘</span><span style="color: black;">更加多</span>范围的病灶，但<span style="color: black;">由于</span><span style="color: black;">花费</span>高、辐射大，<span style="color: black;">初期</span>乳腺癌<span style="color: black;">或</span><span style="color: black;">无</span>可疑病灶时不<span style="color: black;">做为</span>常规<span style="color: black;">检测</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span>提问：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">乳腺纤维瘤不做手术有办法使其变小吗？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">答：纤维瘤发病较<span style="color: black;">青年</span>化，是一种良性肿瘤，<span style="color: black;">不外</span>相比正常组织，纤维瘤癌变的机会稍高<span style="color: black;">有些</span>。小的、单个的纤维瘤其实<span style="color: black;">没</span>需治疗，<span style="color: black;">能够</span>先进行观察。但对<span style="color: black;">有些</span><span style="color: black;">尤其</span>大的、影响外形、长得特别快、血流丰富的纤维瘤，<span style="color: black;">能够</span><span style="color: black;">经过</span>手术<span style="color: black;">处理</span>。<span style="color: black;">日前</span><span style="color: black;">无</span>保守治疗<span style="color: black;">办法</span>使其变小。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">做<span style="color: black;">彩超</span><span style="color: black;">发掘</span>乳房里有钙化点该怎么办？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">答：超声看到钙化大部分都是良性的。<span style="color: black;">倘若</span><span style="color: black;">安心</span>不下，还<span style="color: black;">能够</span>做个钼靶。正常的钙化我不<span style="color: black;">意见</span>手术，<span style="color: black;">由于</span>对<span style="color: black;">病人</span><span style="color: black;">无</span>影响。<span style="color: black;">能够</span><span style="color: black;">定时</span>做超声来做比较，<span style="color: black;">第1</span>次在三个月后复查，半年后再查一次。<span style="color: black;">倘若</span><span style="color: black;">始终</span><span style="color: black;">无</span></p>
谢谢、感谢、感恩、辛苦了、有你真好等。 哈哈、笑死我了、太搞笑了吧等。 顶楼主，说得太好了！
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