Goodson W H
Department of Surgery, University of California, San Francisco, 94143-0790, USA.
West J Med. 1996 Apr;164(4):355-8.
An astute clinician has an appreciation of the wide variation possible in normal breasts, but anticipates that the palpation of the breasts of an individual woman will be determined by basic facts concerning typical relative distribution of gland tissue, breast symmetry, the influence of life history, and possibly previous surgery. If the findings of a CBE are not as anticipated, the clinician must find out why this is so. This is a different frame of reference from asking whether a given lump or area should be considered suspicious for cancer. The basic questions are whether the findings of a CBE are consistent with typical breast structure and anatomy and in the context of the woman's life history. If these questions can be answered in the affirmative, the examination is complete; if not, further evaluation is necessary.
一位敏锐的临床医生了解正常乳房可能存在的广泛差异,但预计对个别女性乳房的触诊将由有关腺体组织典型相对分布、乳房对称性、生活史影响以及可能的既往手术等基本事实来决定。如果临床乳房检查(CBE)的结果与预期不符,临床医生必须找出原因。这与询问某个特定肿块或区域是否应被视为癌症可疑情况是不同的参照框架。基本问题是CBE的结果是否与典型的乳房结构和解剖结构一致,以及是否符合该女性的生活史背景。如果这些问题的答案是肯定的,检查即完成;如果不是,则需要进一步评估。