事件记录
Dr. 琼斯: You got your screening 乳房x光检查 report and it said that you had dense breast tissue. 这是什么意思？? 你应该担心吗？? 这是博士. Kirtly Jones 妇产科 at University of Utah Health Care, and this is 范围.
播音员: Covering all aspects of women's' health. 这是健康的7个领域. Kirtly Jones在Scope上报道.
乳腺组织的类型
Dr. 琼斯: 首先，谈谈乳房. 乳房主要有四种组织. 这是乳腺小叶, which is the part that makes the milk that is pretty quiet unless you're pregnant or breastfeeding. There are the breast ducts, which carry the milk to the nipple. There is the fibrous tissue around those other tissues that keep them from bumping into each other. 还有脂肪.
The difference between large breasts and small breasts is the amount of fat in the breast. 在年轻的, 绝经前女性, hormones keep the lobules and the ducts pretty active and the ups and downs of the hormones can increase the fibrous tissue. Weight gain can increase the fat, and weight loss can decrease the fat in the breast.
Detecting Breast Cancer: Thin vs Dense Breast Tissue
Of course there's also skin on the top of the breast, 还有乳头和它们的血管, 淋巴腺, 但它们并不算在 乳房x光检查 业务. 用传统的乳房x光检查, x-rays go easily through fat tissue but don't go through fibrous tissue very well, 不要很好地度过癌症. So fibrous tissue and ductal tissue looks white on a 乳房x光检查, and so does cancer. 当女人年轻的时候, 50岁以下的, 或绝经前, the breasts are more dense according to the 乳房x光检查. When you get older, the breasts become mostly fat and are easy to see through.
When a breast is easy to see through, it's easier to detect cancers. When the breast is dense, it's harder to see the little cancers. 致密的乳腺组织很常见. About two-thirds of 绝经前女性 have dense breasts, and about a quarter of 绝经后妇女. Put the two together, and about 40% of women have dense breasts. Postmenopausal women on hormone replacement therapy tend to have denser breasts.
When my patients were worried about the term dense breasts, I just told them that they had youthful breasts. Which is always nice to hear, but it made it harder for 乳房x光检查s to see through the entire breast.
收到一封密密麻辣的信件
那你该怎么做? 首先, the letter you received about the results of your 乳房x光检查 is often not understandable. 事实上, a recent letter to the journal of the American Medical Association noted that letters about dense breasts were written on average at the 11th grade reading level. Of course our Scope Radio listeners, wouldn't have any problem with that. But many people read much more below that level.
On top of that, about 24 states have legislated the wording of 密集乳房通知. 是的. 这就是立法的名称， 密集乳房通知. And we know how well the government explains things for those of you who do your own taxes. So if your report says you have dense breasts, it doesn't mean that you have cancer. It probably also said that your 乳房x光检查 was normal. Remember, if 40% of women have 乳房x光检查s have dense breasts, then it's normal.
和你的医生谈谈
然而, the wording is there and in many states it is legislated to be there so women can know that maybe their 乳房x光检查 isn't as good a screening test as it could be. This is the time to talk to your clinician about your 乳腺癌风险 and your worries, and there are several risk calculators out there on the web.
Other Methods of Breast Cancer Screening
There are other methods of screening if you're at high risk. If there's a lump that you or your clinician noted, then an 超声波 可能有用. If you carry a breast cancer gene that puts you at risk, then an 核磁共振成像 可能会被推荐.
为了大发娱乐所有人, 虽然, the invention of digital mammography several years ago made 乳房x光检查s much better at looking through dense breasts. So there's been less of a chance of missing something. 还有一些新技术.
乳房致密是正常的
So if you got the letter saying that your breasts were dense, don't freak out. 你很正常. If you're at high risk for breast cancer, talk with your doctor and maybe another imaging technique would be right for you. 你可以去网站看看 areyoudense.org and that can explain a little, and you can celebrate the fact that you still have young breasts. 至少在乳房x光检查上是这样.
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更新日期：2019年1月10日
最初发布日期：2016年5月19日