Morrow M
Department of Surgery, Northwestern University, Chicago, Illinois 60611.
Breast Cancer Res Treat. 1994;31(1):53-60. doi: 10.1007/BF00689676.
Multiple factors which increase a women's breast cancer risk have been identified. These range from conditions such as lobular carcinoma in situ which increase risk to relatively high levels, to reproductive factors such as nulliparity which are associated with only a small increase in risk. When determining an individual's risk, all her potential breast cancer risk factors must be considered. In order for risk information to be meaningful to a woman, risk must be expressed as absolute risk over a defined time interval since there is no uniform agreement on what risk level is high enough to require intervention. At present, careful follow-up or prophylactic mastectomy are the management options available for the woman at increased risk. The efficacy of follow-up including breast self exam, physician exams, and screening mammography for early detection of cancer in a high risk population is unknown. Prophylactic mastectomy, while highly effective, does not provide complete protection from breast cancer and is more radical than the surgery done for established cancer in many cases. Which of these options is chosen by an individual woman is dependent on how much risk she is willing to assume.
已确定多种增加女性患乳腺癌风险的因素。这些因素范围广泛，从诸如原位小叶癌等会将风险提高到相对较高水平的病症，到诸如未生育等仅与风险小幅增加相关的生殖因素。在确定个体风险时，必须考虑她所有潜在的乳腺癌风险因素。为了使风险信息对女性有意义，风险必须表示为在特定时间间隔内的绝对风险，因为对于何种风险水平高到足以需要干预尚无统一共识。目前，密切随访或预防性乳房切除术是可供风险增加的女性选择的管理方案。包括乳房自我检查、医生检查和筛查性乳腺钼靶在内的随访对于在高危人群中早期发现癌症的效果尚不清楚。预防性乳房切除术虽然非常有效，但并不能提供完全预防乳腺癌的保护，而且在许多情况下比针对已确诊癌症进行的手术更为激进。个体女性选择这些选项中的哪一个取决于她愿意承担多大的风险。
