UW MEDICINE | PATIENT EDUCATION

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UW MEDICINE PATIENT EDUCATION SCREENING MAMMOGRAMS CHINESE 筛查乳房 X 光造影检查乳腺癌检查成像测试本手册解释筛查乳房 X 光造影检查, 包括为什么需要做该项检查何时做该项检查和如何为测试做准备什么是筛查乳房 X 光造影检查?

1 UW MEDICINE PATIENT EDUCATION SCREENING MAMMOGRAMS CHINESE 筛查乳房 X 光造影检查乳腺癌检查成像测试本手册解释筛查乳房 X 光造影检查, 包括为什么需要做该项检查何时做该项检查和如何为测试做准备什么是筛查乳房 X 光造影检查? 乳房 X 光造影检查是乳腺癌检查成像测试, 使用 X 光拍摄乳房图像有两类乳房 X 光造影检查 : 筛查乳房 X 光造影检查被用于检查没有乳房症状或问题妇女的乳腺癌诊断性乳房 X 光造影检查被用于查找症状的原因, 例如乳房内肿块我为什么应当接受筛查乳房 X 光造影检查? 筛查乳房 X 光造影检查有助于在您或您的医生感觉到您的乳房发生任何变化之前尽早发现乳腺癌这意味着我们能在乳腺癌较小的时候发现, 更容易治疗这可以拯救妇女的生命尽早发现癌症, 治愈的机率会更高我应当何时接受筛查乳房 X 光造影检查? 一位接受过特殊培训的女性技术员将帮助您以正确的姿势站立, 以便拍摄乳房图像几个团体制定了有关筛查乳房 X 光造影检查的指南, 其中包括美国癌症协会 (ACS) 美国预防服务特别工作组 (USPSTF) 和全美综合癌症网络 (NCCN) 上述每一个团体对接受测试的时间提出了不同的建议, 但所有团体均认为在 40 岁开始每年接受筛查乳房 X 光造影检查能够拯救更多人的生命这是为什么 ACS 和 NCCN 认为具有一般风险的女性应当选择在 40 岁开始每年接受筛查乳房 X 光造影检查所有的团体均认同, 每一名女性可能对何时接受筛查和筛查频率作出不同的决定一些女性可能选择在 40 岁以后开始接受筛查她们亦可能选择以较低的频率接受筛查, 例如每隔一年接受一次筛查第 1 页 / 共 4 页筛查乳房 X 光造影检查

2 具有患乳腺癌较高风险的女性应当在 40 岁以前开始接受筛查筛查乳房 X 光造影检查对于患有其他严重疾病的女性不一定合适请与您的医生讨论您的患乳腺癌风险您的价值观和愿望, 共同作出最适合您的选择有关乳房 X 光造影检查的更多信息在乳房 X 光造影检查过程中使用的 X 光被用于拍摄二维 ( 常规 ) 和三维 ( 断层融合 ) 图像两种图像均可帮助发现乳腺癌在二维乳房 X 光造影检查中, 从两个视角为每侧乳房拍摄两张图像 : 从上至下视角和侧面视角三维乳房 X 光造影检查从相同的两个视角拍摄多张图像, 从而生成一叠很薄的图像, 称为片段三维乳房 X 光造影检查帮助放射科医生更清楚地查看不健康的组织, 从而减少对在二维乳房 X 光造影检查中看起来可能不正常的组织进行后续测试的需求这是为什么华盛顿大学医疗中心 (UWMC) 和西雅图癌症护理联盟 (SCCA) 目前大多数情况下采用三维乳房 X 光造影检查的原因截至 2018 年 6 月, 华盛顿州医疗保险公司必须根据与筛查乳房 X 光造影检查相同的承保条款和条件为断层融合提供承保接受乳房 X 光造影检查有哪些风险? 对于大多数女性, 接受乳房 X 光造影检查的益处超过风险但是, 与所有的测试一样, 乳房 X 光造影检查也存在一些风险 : 大多数乳腺癌都能在乳房 X 光造影检查中发现, 但有些乳腺癌则无法发现如果您有乳房方面的担忧, 请与您的医生或乳房健康专科医生讨论您的症状即使您刚刚接受乳房 X 光造影检查并且显示没有任何问题, 也必须这样做乳房 X 光造影检查可能会导致假警报假警报是乳房 X 光造影检查显示可能存在问题, 但在进行更多的测试后证明并非癌症这些测试可能包括更多的成像检查或提取少量组织样本 ( 活组织检查 ) 进行化验在 UWMC 和 SCCA, 不到 10% 的女性 (100 名女性中不到 10 人 ) 会出现假警报该比例低于美国的健康护理设施的平均比例乳房 X 光造影检查是否安全? 当您接受乳房 X 光造影检查时, 您会接触低水平的辐射在我们的日常生活中, 我们都会接触存在于大自然中的背景辐射您从乳房 X 光造影第 2 页 / 共 4 页筛查乳房 X 光造影检查

3 检查中接受的辐射相当于生活在美国的人在两个月期间从大自然中接受的辐射量该低剂量的辐射很安全, 不太可能对您的健康造成伤害如果您对辐射有任何疑问, 请在接受检查当天向您的技术员 ( 为您拍摄乳房图像的人 ) 或您的医生洽询我如何为乳房 X 光造影检查做准备? 检查当天 : 不要在腋下或乳房上涂抹体香剂爽身粉或乳液这会有助于确保图像的最佳质量随身携带任何以前的乳房 X 光造影检查结果 ( 如有 ) 这对查看您的图像的医生 ( 放射科医生 ) 会有帮助检查前, 如果您有以下情况, 请告诉医生或技术员 : 乳房内发现任何新问题有乳房手术活检或植入物病史正在服用含有荷尔蒙或影响体内荷尔蒙水平的药物有乳腺癌家族史或个人病史已怀孕或有任何怀孕的可能在乳房 X 光造影检查过程中会做什么? 首先, 一位接受过特殊培训的女性技术员将帮助您以正确的姿势站立会将您的乳房放在一个特殊的平台上, 并短暂地用一块扁板挤压住一次拍摄一侧乳房的图像整个检查约需 15 分钟时间当乳房被扁板挤压拍摄图像时, 乳房感到压力是正常现象如果您感到疼痛, 请告诉技术员我们的技术员将尽最大努力让您尽量感到舒适谁解释结果? 一位接受过乳房成像培训的专家将读取和解释您的图像读取乳房 X 光造影检查图像的 UWMC 和 SCCA 放射科医生获得美国放射学委员会认证, 并接受了乳房成像方面的额外培训我们的放射科医生超越全国优异标准我如何获得结果? 您会在 7-10 个工作日内收到一封有关检查结果的通知信函您的健康护理服务提供者也会收到一份报告, 并可以回答您的任何问题第 3 页 / 共 4 页筛查乳房 X 光造影检查

4 如果您接受乳房 X 光造影检查 10 天后尚未收到结果通知, 请电洽如果我的结果通知要求我返回接受更多测试, 会怎样? 您的通知可能会要求您返回拍摄更多乳房 X 光造影图像或接受超声波检查如果出现这种情情况, 请勿担心这很常见只是表示放射科医生希望更好地查看您的乳房的某些部位或者因为您第一次乳房 X 光造影检查中的技术问题, 一些图像可能需要重拍请务必返回拍摄额外的图像我们可能会使用不同的方法和设备, 以确保获得最清晰的图像如需安排额外图像拍摄, 请电洽有问题吗? 我们非常重视您的问题如果您有问题或担忧, 请打电话给您的医生或健康护理服务提供者如需安排乳房 X 光造影检查, 请电洽 University of Washington Medical Center Published PFES: 2005, 2005, 2012, 2016, 2017, 2018 Clinician Review: 08/2018 Chinese translation by SCCA Interpreter Services Reprints on Health Online: 第 4 页 / 共 4 页筛查乳房 X 光造影检查

5 UW MEDICINE PATIENT EDUCATION Screening Mammograms An imaging test to find breast cancer This handout explains screening mammograms. It includes why they are used, when they should be done, and how to prepare for the test. What is a screening mammogram? A mammogram is an imaging test to find breast cancer. It uses X-rays to take images of the breasts. There are 2 types of mammograms: Screening mammograms are used to find breast cancer in women who do not have breast symptoms or complaints. Diagnostic mammograms are used to look for the cause of a symptom, such as a lump in the breast. A specially trained female technologist will help you get in the right position to take images of your breasts. Why should I have a screening mammogram? Screening mammograms help find breast cancers early, before you or your doctor can feel any changes in your breasts. This means we find the cancer when it is smaller and can be treated more easily. This can save a woman s life. When cancer is found early, the chance of cure is higher. When should I get a screening mammogram? Several groups have guidelines about screening mammograms, including the American Cancer Society (ACS), the United States Preventive Services Task Force (USPSTF), and the National Comprehensive Cancer Network (NCCN). Each of these groups suggests a different timeline for testing. All groups agree that starting yearly screening mammography at age 40 saves the most lives. That s why both the ACS and the NCCN agree that women with an average risk for breast cancer should have the choice to start yearly screening mammograms at age 40. All of the groups recognize that each woman Page 1 of 4 Screening Mammograms

6 might make a different decision about when and how often to have screening. Some women might choose to start screening later than age 40. They may also choose to have screening less often, such as every other year. Women with higher risk for breast cancer should start screening earlier than age 40. Screening mammograms may not be a good idea for women who have other serious health problems. Please talk with your doctor about your breast cancer risk, your values, and your desires. Together, you can make the choice that is best for you. More About Mammograms X-rays taken during a mammogram are used to make 2D (conventional) and 3D (tomosynthesis) images. Both types of images help find breast cancer. For 2D mammograms, an image of each breast is taken in 2 views: a top-to-bottom view and a side view. 3D mammograms take many images in the same 2 views. This creates a stack of very thin images called slices. 3D mammograms help your radiologist see any unhealthy tissue more clearly. This may lessen the need for follow-up tests of tissue that may appear abnormal on 2D mammograms. That s why the University of Washington Medical Center (UWMC) and Seattle Cancer Care Alliance (SCCA) now use 3D mammograms most of the time. As of June 2018, health insurance providers in Washington state are required to cover tomosynthesis under the same terms and conditions as they cover screening mammography. What are the risks of getting a mammogram? For most women, the benefits of getting a mammogram outweigh the risks. But, like all tests, mammograms have some risks: Most breast cancers can be seen on mammograms, but some cannot. If you have breast concerns, talk with your doctor or breast health specialist about your symptoms. It is important to do this even if you just had a mammogram that did not show any problems. A mammogram can result in a false alarm. A false alarm is when a mammogram shows a possible problem that turns out to not be cancer after more tests are done. These tests may include more imaging exams or having a small tissue sample (biopsy) taken for testing in the lab. Page 2 of 4 Screening Mammograms

7 At UWMC and SCCA, false alarms occur for less than 10% of women (fewer than 10 out of 100 women). This is better than the average rate for healthcare facilities in the U.S. Are mammograms safe? When you have a mammogram, you are exposed to a low level of radiation. In our daily lives, we are all exposed to the background radiation that is found in nature. The radiation you receive from a mammogram is about the same that someone living in the U.S. picks up from nature over a 2- month period. This low dose of radiation is very safe and is not likely to harm your health. If you have any questions about radiation, please talk with your technologist (the person who takes the images of your breasts) or doctor on the day of your exam. How do I prepare for a mammogram? On the day of your exam: Do not put deodorant, talcum powder, or lotion under your arms or on your breasts. This will help ensure that your images are the best quality. Bring any past mammograms (if you have them) with you. These are helpful to the doctor (radiologist) who will look at your images. Before your exam, tell your doctor or technologist if you: Have any new problems in your breasts Have a history of breast surgeries, biopsies, or implants Are taking medicine that contains hormones or affects the hormone levels in your body Have a family or personal history of breast cancer Are pregnant, or if there is any chance you might be pregnant What should I expect during the mammogram? First, a specially trained female technologist will help you get in the right position. Your breast will be placed on a special platform and briefly compressed with a paddle. Images are taken of one breast at a time. The entire exam takes about 15 minutes. It is normal to feel pressure on your breast when it is compressed by the paddle for each image. Tell the technologist if you feel pain. Our technologists will do all they can to make you as comfortable as possible. Page 3 of 4 Screening Mammograms

8 Who interprets the results? An expert trained in breast imaging will read and interpret your images. The UWMC and SCCA radiologists who read mammograms are certified by the American Board of Radiology and have received extra training in breast imaging. Our radiologists exceed the national criteria for excellence. How do I get the results? You will receive a letter with your results in the mail in 7 to 10 working days. Your healthcare provider will also receive a report and can answer any questions you have. If it has been 10 days since your mammogram and you have not received your results letter, please call What if my results letter asks me to return for more tests? Your letter may ask you to return for more mammogram images or for an ultrasound. Please do not worry if this happens. This is fairly common. It only means that the radiologist would like a better look at areas of your breast. Or, some images may need to be done again because of technical problems with your first mammogram. It is important that you return for this extra imaging. We may use different methods and equipment to make sure we get very clear images. To schedule extra imaging, please call Questions? Your questions are important. Call your doctor or healthcare provider if you have questions or concerns To schedule a mammogram, call University of Washington Medical Center Published PFES: 03//2005, 05/2005, 01/2012, 07/2016, 12/2017, 08/2018 Clinician Review: 08/2018 Reprints on Health Online: Page 4 of 4 Screening Mammograms

第一章　緒論

第一章　緒論 (informed consent) 6 . (Informed 23 Consent) 24 (Informed Consent) informed consent 1. 2. 7 3. 4. 5. 6.. 26 1. 8 2. 3. 4. 5. 6.. Braddock 1993 59 65 1057 (discussion of the patient s role in decision making)