乳腺癌的今天
乳腺癌不像在20年前。因為健康意識不斷提高、更多的早期發現和治療技術的進步，乳腺癌患者的存活率大大提高。每年大概有200000美國人被診斷出患乳腺癌，他們有了新的希望。
乳腺癌的症狀
乳腺癌通常沒有什麽症狀，但女性有時會自己發現乳腺的問題，常見的症狀和體征主要以下幾點：
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無痛性的腫塊
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大小或形狀產生變化
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腋窩腫脹
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乳頭改變或流出乳液
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乳腺疼痛也是乳腺癌的一種症狀，但這並不常見。
炎症性乳腺癌的症狀
炎症性乳腺癌是一種罕見的、快速增長的腫瘤，通常沒有明顯的腫塊。然而乳腺皮膚變厚、紅，像橘子皮。該區可通常會感到發熱、起小疙瘩，像皮疹。
乳腺癌和乳腺x光片
乳腺癌發現的越早，治療越容易。乳腺X射線可以在腫塊未長大之前就發現。美國癌症研究所建議女性從40歲開始每年都應該做一次乳腺X射線。美國預防服務工作組建議50—74歲的女性每兩年檢查一次，考慮到定期檢查的利益關係，每個女人在50歲前都應該與自己醫生交談，哪一種篩查更利於她自己。
乳腺超聲和核磁共振（MRI）
除了X射線，醫生還會建議我們做乳腺彩超，這可以幫助我們確定是囊腫、液體囊還是癌症，而MRI和X光一起常用於檢查高風險婦女身上。
乳腺的自我檢查
一月一次乳腺的自我的檢查是曾經很多人建議的，但研究表明，乳腺的自我檢查在發現早期的乳腺癌裏是一個很小的部分，這樣做更多是可以了解乳房和觀察它的變化。如果真的要想檢查，一定要借用先進儀器和醫生的經驗。
如果你自己發現一個腫塊怎麽辦？
首先，別怕，乳腺腫塊百分之八十不是癌症，往往是無害的囊腫或組織變化而成，這與月經周期有關。但是你應該立即讓你的醫生知道你發現的問題。如果是癌，發現的早就好，如果確診後不是，就可以放棄顧慮了。
乳腺活檢
確定腫塊是不是癌症的金標準就是活檢，通常是用一個小針吸取或去整塊標本。如果是癌症，那麽是什麽類型的也要分辨出來，因為不同類型的癌治療方案不同。
激素敏感型乳腺癌Some types ofbreast cancer are fueled by the hormones estrogen or progesterone. A biopsy canreveal whether a tumor has receptors for estrogen (ER-positive) and/orprogesterone (PR-positive). About two out of three breast cancers are hormonesensitive. There are several medications that keep the hormones from promotingfurther cancer growth.
一些類型乳腺癌是受雌激素或孕激素刺激引起的。活檢可以揭示腫瘤是否有雌激素受體（ER）和/或孕酮（PR陽性）。大約2/3的乳腺癌是激素敏感型的。目前也有一些藥物是阻礙促使腫瘤生長的激素的。
The image shows a molecularmodel of an estrogen recepto
HER2陽性乳腺癌
In about 20% of patients,breast cancer cells have too many receptors for a protein called HER2. Thistype of cancer is known as HER2-positive, and it tends to spread faster thanother forms of breast cancer. It's important to determine whether a tumor isHER2-positive, because there are special treatments for this form of cance
在20%的患者中，乳腺癌細胞中有很多的HER2蛋白受體。這種類型的腫瘤被稱為HER2陽性，它往往比其他形式的乳腺癌擴散的更快。要確定是否是腫瘤的HER2陽性是很重要的，因為有特殊治療這種癌症方法。
乳腺癌的階段
Once breast cancer has beendiagnosed, the next step is to determine how big the tumor is and how far thecancer has spread. This process is called staging. Doctors use Stages 0-4 todescribe whether cancer is localized to the breast, has invaded nearby lymphnodes, or has spread to other organs, such as the lungs. Knowing the stage andtype of breast cancer will help your health care team formulate a treatmentstrategy
一旦乳腺癌確診，下一步是確定腫瘤有多大，癌症已經擴散到了多遠。這個過程被稱為分期。醫生使用階段0-4的描述是否腫瘤局限於乳腺，還是侵入鄰近的淋巴結，還是已擴散到其他器官，如肺。認識階段和乳腺癌的類型將幫助你的衛生保健小組製定治療策略。
乳腺癌患者的生存率
乳腺癌生存率和發現早晚有很大的關係。據美國癌症學會研究Ⅰ型乳腺癌的患者五年生存率達到88%，級別越高，生存率越低，Ⅳ型乳腺癌的5年生存率隻有15%。
乳腺癌手術
There are many types of breast cancer surgery, from taking outthe area around the lump (lumpectomy or breast-conservation surgery) toremoving the entire breast (mastectomy.) It's best to discuss the pros and consof each of these procedures with your doctor before deciding what's right foryou.
乳腺癌手術的類型有很多種，如：取出周圍腫塊（腫塊切除術或乳房保留手術）、整個乳腺（乳房切除術。）。最好是討論這些程序的優點和缺點，和你的醫生才能決定什麽對你來說是正確的。
乳腺癌的放射治療
Radiation therapy useshigh-energy rays to kill cancer cells. It may be used after breast cancersurgery to wipe out any cancer cells that remain near the tumor site. It canalso be used along with chemotherapy for treatment of cancer that has spread toother parts of the body. Side effects can include fatigue and swelling or asunburn-like feeling in the treated area
放射治療用高能射線殺死癌細胞。它可用於乳腺癌術後清除殘留的癌細胞在腫瘤部位。它也可以用在治療癌症已經擴散到身體的其他部位，副作用是在治療部位有疲勞、腫脹或曬傷樣的感覺。
乳腺癌化療
Chemotherapy uses drugs to kill cancer cells anywhere in thebody. The drugs are often given by IV, but are sometimes taken by mouth orshot. Chemotherapy may be done after surgery to lower the odds of the cancercoming back. In women with advanced breast cancer, chemotherapy can helpcontrol the cancer's growth. Side effects may include hair loss, nausea,fatigue, and a higher risk of infection
化療用藥物在身體的任何地方殺死癌細胞，這些藥物通常是IV階段采用。術後化療可以降低癌症複發的可能性。晚期乳腺癌患者，化療有助於控製腫瘤的生長。可能的副作用包括脫發，惡心，疲勞，和一個更高的感染風險。
激素治療乳腺癌
Hormone therapy is aneffective treatment for women with ER-positive or PR-positive breast cancer.These are cancers that grow more rapidly in response to the hormones estrogenor progesterone. Hormone therapy can block this effect. It is most often usedafter breast cancer surgery to help keep the cancer from coming back. It mayalso be used to reduce the chance of breast cancer developing in women who areat high risk
激素療法對患ER或PR陽性的乳腺癌的婦女來講是一種有效的治療方法。這些腫瘤生長很迅速，因為它們可以與雌激素或孕酮發生反應。激素治療則能阻斷這種效應。這是最常用的乳腺癌手術後阻止癌症複發的方法。它也可以用來減少高風險婦女患癌的概率。
乳腺癌的靶向藥物
Targeted therapies arenewer drugs that target specific properties within cancer cells. For example,women with HER2-positive breast cancer have too much of a protein called HER2.Targeted therapies can stop this protein from promoting the growth of cancercells. These drugs are often used in combination with chemotherapy. They tendto have milder side effects compared with chemotherapy. 靶向治療是針對性的殺死腫瘤細胞。例如，HER2陽性乳腺癌的婦女有太多的HER2蛋白。針對性的治療，可以阻止這種蛋白質從促進癌細胞的生長。這些藥物常用於聯合化療。
治療後的生活
There's no doubt thatcancer is a life-changing experience. The treatments can wear you out. You mayhave trouble managing daily chores, work, or social outings. This can lead tofeelings of isolation. It's crucial to reach out to friends and family forsupport. They may be able to go with you to treatments, help out with chores,or just remind you that you are not alone. Many people choose to join a supportgroup -- either locally or online
毫無疑問，癌症會改變一個人的生活。治療時穿的少了，在日常工作中、社交活動也會遇到較多的麻煩，這可能會導致孤立的感覺。朋友和家人會很好的支持你，他們幫你去幫忙做家務，和你聊天，你並不孤單。許多人也選擇加入一個支持小組——無論是本地的還是網絡的。
乳房重建
Many women who have abreast removed choose to undergo reconstructive surgery. This replaces theskin, nipple, and breast tissue that are lost during a mastectomy
許多有轉移乳腺癌患者的選擇接受整形手術。重置皮膚，乳頭和乳腺組織。做一個乳腺植入或從身體其他地方組織，如肚子。重建可以選擇與切除手術同步或術後幾個月。
乳腺癌：為什麽是我？
The most obvious riskfactor for breast cancer is being a woman. Men get the disease, too, but it isabout 100 times more common in women. Other top risk factors include being overage 55 or having a close relative who has had the disease. But keep in mindthat up to 80% of women with breast cancer have no family history of the illness
乳腺癌最明顯的風險因素是性別。男人也會的，但概率約是女性的1/100。其他危險因素包括年齡在55歲以上、有家族史、晚婚。但請記住，多達80%的女性乳腺癌患者無家族史。
乳腺癌基因
Some women have a very highrisk of breast cancer because they inherited changes in certain genes. Thegenes most commonly involved in breast cancer are known as BRCA1 and BRCA2.Women with mutations in these genes have up to an 80% chance of getting breastcancer at some point in life. Other genes may be linked to breast cancer riskas well
一些婦女有很高的患乳腺癌的風險，因為有相關遺傳基因。最常見的乳腺癌基因被稱為BRCA1和BRCA2。在這些基因突變的女性裏，再其人生的某個階段患乳腺癌的幾率約是80%。還有其他的一些基因也與乳腺癌有關聯。
最主要在於你自己對危險因素的控製
Being overweight, gettingtoo little exercise, and drinking more than one alcoholic beverage per day canraise the risk of developing breast cancer. Birth control pills and some formsof postmenopausal hormone therapy can also boost your risk. But the risk seemsto go back to normal after these medications are stopped. Among survivors, goodlifestyle choices may be helpful. Recent studies suggest that physical activitymay help lower the risk of a recurrence and it's a proven mood-boost
超重、運動量太少、每天飲用一種以上的酒精飲料能增加患乳腺癌的風險。避孕藥和絕經後激素治療也可以增加你的風險。但這些藥物停止後，風險也會消除。在幸存者中發現，健康的生活方式是很有益的。而最近的研究表明，體力活動可能有助於降低複發的風險，這個讓我們更容易做到去預防乳腺癌。
