乳腺癌breastcancer筛查acs更新2015-课件.ppt

Breast Cancer Screening for Women at Average Risk:2015 Guideline Update From the American Cancer Society2023/2/20JAMA.2015 Oct 20;314(15):1599-614.IMPORTANCEBreastcancerisaleadingcauseofprematuremortalityamongUSwomen.Earlydetectionhasbeenshowntobeassociatedwithreducedbreastcancermorbidityandmortality.ACSRECOMMENDATIONSWomenshouldhavetheopportunitytobeginannualscreeningbetweentheagesof40and44years(qualifiedrecommendation).age45yearsscreeningmammographystarting(strongrecommendation)55yearsandoldershouldbiennialscreeningorhavetheopportunitytocontinuescreeningannually(qualifiedrecommendation).Womenshouldcontinuescreeningmammographyaslongastheiroverallhealthisgoodandtheyhavealifeexpectancyof10yearsorlonger(qualifiedrecommendation).6良性增殖性乳腺疾病良性增殖性乳腺疾病乳腺囊性增生症、纤维腺瘤、导管内乳头状瘤等7月经年龄月经年龄月经年龄早于12岁乳腺癌风险增加menarchemenarche8绝经年龄绝经年龄绝经年龄晚于55岁乳腺癌风险增加menopausemenopause9第一次生育年龄第一次生育年龄第一次生育年龄晚于35岁或从来未生育的女性患乳腺癌风险增加不可改变危险因素不可改变危险因素可改变的危险因素可改变的危险因素1BMIBMI指数指数研究表明，绝经后未使用雌激素替代治疗的超重或肥胖女性乳腺癌风险要高于体重正常的女性2饮酒饮酒饮酒越多，乳腺癌风险越高。每日饮酒的人乳腺癌风险是不饮酒的人的1.5倍。每增加10g，风险增加12%。目前没有证据表明红酒能增加癌症风险，但也没有防癌的作用3己烯雌酚己烯雌酚DES(diethylstilbestrol)DES(diethylstilbestrol)避免流产的药物。会轻度增加乳腺癌风险。怀孕的女性服用后，女儿在40岁以后的乳腺癌风险会轻度增加Approximately36%ofEastAsians(Japanese,Chinese,andKoreans)showacharacteristicphysiologicalresponsetodrinkingalcoholthatincludesfacialflushing(seeFigure1),nausea,andtachycardia1