25-39岁：
三年检查。每三年至少与您的医疗保健提供者沟通一次，进行风险评估、风险降低咨询和临床乳房检查。
乳腺癌
它是什么？
乳腺癌是始于乳房的癌症。虽然出生时被指定为女性的人更常见，但出生时被指定为男性的人也可能患上乳腺癌。
Breast cancer is highly curable if found early. Unfortunately, many breast cancers are diagnosed once it has already spread. Early Detection = Better Outcomes®, so it’s important to get screened, reduce your risk, and talk with your health care provider about your health history.
接受筛查
乳腺癌筛查指南适用于出生时被指定为女性且拥有乳房且风险处于平均水平的人。跨性别者应与医疗保健提供者讨论其特定的筛查需求。
如果您属于平均风险，请遵循以下筛查指南：*
*Source: National Comprehensive Cancer Network (NCCN)
从 40 岁开始：
每年进行一次体检和 2D 或 3D 筛查乳房 X 线摄影（乳房断层合成）。如果您处于平均风险水平，请每年进行一次筛查。与您的医疗保健提供者讨论筛查测试的益处和风险，并讨论哪种筛查方法适合您。
2D 或者 3D 乳房 X 光检查
2D 乳房 X 线摄影从侧面和上方拍摄乳房照片。3D 乳房 X 线摄影从不同角度拍摄多张乳房照片，以创建 3D 图像。这有助于提高检查的准确性，这对乳房组织致密的女性尤其有用，因为致密性可能使癌症更难被发现。两种类型的乳房 X 线摄影都是合适的筛查选择。
Increased risk: Earlier or more frequent testing
If you are at increased risk for breast cancer because of a genetic mutation or personal or family history, you may need to be screened differently (starting earlier, varied intervals or additional tests). Follow the recommendations of your health care provider. Other testing options, in addition to a 2D or 3D mammogram, may include magnetic resonance imaging (MRI) or breast ultrasound.
保险范围
Under federal law, private insurers and Medicaid are required to cover services that have an “A” or “B” grade by the U.S. Preventive Services Task Force (USPSTF). Some insurers may choose to cover services for additional groups of people. Medicare coverage for preventive services is limited to tests for which Congress has explicitly authorized coverage.
Guidelines from the USPSTF recommend biennial (every other year) mammograms for people ages 40 to 74. NCCN recommends annual (every year) mammograms for people 40 and older (with no “end” age).
Always check with your insurance provider to find out if you’ll be covered for routine breast cancer screening.
了解您的风险
虽然白人的乳腺癌发病率较高，但研究报告称，黑人的乳腺癌死亡率更高，而且黑人也更有可能在晚期才被诊断出患有乳腺癌。
如果您出生时被指定为女性，则您患乳腺癌的风险会增加。如果您符合以下情况，您的风险也会增加：
- Are overweight or medically classified as obese.
- 缺乏身体活动。
- 目前正在使用或最近曾经使用过避孕药。
- 超过 40 岁。
- 从未生过孩子或者 30 岁以后才生第一个孩子。
- 使用雌激素和孕激素的激素替代疗法（HRT）已超过 10 年。
- 有突变 BRCA1, BRCA2, PALB2 或其他基因。
- Have a personal or family history of breast, colorectal or ovarian cancer. (Talk to your health care provider about genetic testing.)
- Have dense breasts.
- 胸部接受了高剂量放射治疗。
- Use tobacco products, including cigarettes, or used them in the past.
- 过量饮酒。
- Have certain benign (non-cancerous) breast conditions, such as atypical hyperplasia or lobular carcinoma in situ (LCIS).
降低风险
You may reduce your risk of breast cancer through these lifestyle-related modifications:
Avoid all forms of tobacco.
If you do use tobacco, quit. Quitting will have an immediate positive impact on your cancer risk.
每周锻炼至少 5 天，每次至少 30 分钟。
Breastfeeding (chestfeeding) for at least one year during your lifetime (not per birth) may lower the risk of breast cancer.
避免或限制饮酒。
为了降低患癌症的风险，最好完全戒酒。如果你选择喝酒，如果你出生时被指定为女性，那么每天饮酒量不得超过一杯；如果你出生时被指定为男性，那么每天饮酒量不得超过两杯。
保持健康的体重。
根据指南和个人风险因素进行乳腺癌筛查。
体征和症状
如果您发现任何以下症状，请立即采取行动并与您的医疗保健提供者联系：
- 乳房出现肿块、硬结或增厚
- 腋下有肿块
- 乳房大小或形状发生变化
- 乳头疼痛、压痛或分泌物，包括出血
- 乳头发痒、起鳞屑、疼痛或出现皮疹
- 乳头内翻或内陷
- 皮肤颜色和纹理发生变化，如出现酒窝、皱纹或发红
- 乳房发热或肿胀
治疗方案
治疗取决于乳腺癌的类型和阶段以及您的医疗状况：
外科手术
The most common treatment is surgery to remove the cancer (lumpectomy), combined with radiation. In some cases, it is necessary to remove one or both breasts (mastectomy).
化疗
这是一种使用药物杀死癌细胞的治疗方法。它可以单独使用，也可以在手术前或手术后与其他疗法结合使用。
放射治疗
这种治疗方法使用高剂量的辐射杀死癌细胞并缩小肿瘤。它可以单独使用，也可以在手术前或手术后与其他疗法结合使用。
激素治疗
Since some types of breast cancer can use specific hormones to grow, this treatment may be used to slow or stop its growth. It may be used alone or in combination with another therapy before or after surgery.
免疫疗法
This type of cancer treatment utilizes your immune system to respond to the cancer to detect and destroy abnormal cells. It may be used alone or in combination with another therapy before or after surgery.
靶向治疗
Targeted therapy can be a drug or antibody that targets the genes or proteins that affect how cancer cells grow, divide and spread. It may be used alone or in combination before or after surgery.
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