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国际癌症研究机构估计,世界各地每年有1,270万起新的癌症病例。
其中最普遍的为肺癌(160万名,占新病患总人数的12 .6%)、女性乳癌(140万人,占新病患总人数的11.0%)、大肠癌(120万人,占新病患总人数的9.4%)及胃癌(100万人,占新病患总人数的7.9%)。它们占了新癌症病例总数的41%。
乳癌病例的增长速度惊人,已到达类属‘瘟疫’的阶段。2008年的数据显示,乳癌是20到59岁女性的第二号杀手。在美国,每三分钟就有一起新的乳癌病例, 每年就有六万三千起。在新加坡,乳癌更是女性的头号癌症杀手。
任何人都可能患上乳癌!
年纪增长
患上乳癌的风险跟患上其他癌症一样,随着女性年龄的增长而提高。95%的乳癌新病例和97%因乳癌而死亡者,都是40岁以上的女性。
遗传因素
如果您母亲、或姐妹曾患上乳癌,那您患上乳癌的机率将增加一倍。根据估计:
- 30至39岁的女性,每12人中有至少一人(8%)会在未来十年里患上乳癌;
- 40至49岁的女性,每5 人中有至少一人(20%)会在未来十年里患上乳癌。
家里若有人曾患上卵巢癌, 患上乳癌的风险也会增加。患有乳癌的女性患上第二种癌症的风险也更高。40岁前被诊断患上初期乳癌的女性病患,又再罹患其他癌症的风险是一般人的三倍;而乳癌复发的风险则是四倍半。
乳癌基因
只有5%至10%的乳癌病例,称之为乳腺癌1号基因及乳腺癌2号基因,是因从父母遗传而来的基因变异所造成的。具任何一种基因变异的妇女,在70岁时患上乳癌的风险为45%至60%。
误解
乳癌多属遗传性,家族里若不曾有人患上乳癌,就不必担心。
真相
大多数的乳癌属于偶发性。只有2 0 % 至3 0 % 的女性乳癌病人有家庭成员曾患上乳癌。这意味有70%至80%的女性乳癌病人并没有曾患乳癌的家庭病史。
您乳房的密度过高了吗?
乳房组织密度过高(在乳房X光检验下,其腺体组织和脂肪组织的比例)已被证实为独立的、会导致罹患乳癌的高风险因素。乳房组织密度较高的女性群,比乳房组织密度较低的女性群罹患乳癌的风险要高出4至6倍。
此外,以乳房X 光检验仪(Mammogram)检测乳癌时,会因乳房组织密度过高而功能受阻。
乳房组织密度高的女性, 她们乳房里有较少的脂肪及较多的乳腺细胞和缔结组织。由于乳腺细胞的比例大,罹患乳癌的风险也就高了。
数据显示,同时使用乳房热成像及乳房X光检验仪,能有效地为乳房密度高的女性检测是否患有乳癌。
乳房密度与罹患乳癌的风险
依据美国国家癌症中心刊物的报道,罹患乳癌的风险会随乳房密度的增加而提升。
以上的美国癌症学会数据分析显示:因乳房组织密度高而导致乳癌的风险,比其他非病理的因素都来得高。
乳癌能否预防?
乳癌为何与发炎症有关?
炎症和癌症长久以来都是息息相关的。流行病理学及许多科学研究皆有证据显示,发炎与导致癌症的倾向有着密切的关系。
随着癌的成型,人体组织会经历多方面的改变。癌肿瘤的成长会败坏组织的细胞结构,进而干扰细胞外基质。这些过程会激起发炎的症状,又再加速肿瘤的成长。
多项医药研究显示,当乳癌细胞接触到导致发炎的因子,细胞的突变速度会急剧增加,进而引发由发炎症导致的癌症。
倘若基因受损是导致癌症的火苗,那某一类的发炎症就是使火苗成灾的燃油了。
何谓细胞外基质?
细胞外基质是支撑细胞架构的组织,也同时执行多项重要的功能。
慢性炎症会破坏和干扰细胞外基质的结构和乳房等人体组织的功能。因此,要预防慢性疾病的发生及恶化,维持细胞外基质的稳定就是关键了。
为何预防乳癌如此重要?
不幸的是,所有女性都有患上乳癌的风险。事实上,每十位罹患乳癌的女性里,只有2-3位的家族成员曾患乳癌。
即使综合了遗传、生育、饮食、运动和酒精等所有传统风险因素, 美国还有一半以上的乳癌病例原因不明。越来越多科学验证显示,合成化学品和环境中的辐射与乳癌息息相关。
乳癌的恶性循环
曾经战胜乳癌的人,可能会因为荷尔蒙、基因及生活习惯所带来的综合风险,而更容易再次患上乳癌、卵巢癌、骨癌和子宫癌。
细胞外基质掌控细胞的寿命,维持细胞外基质的稳定,就能对抗乳癌及其他慢性疾病的起源或恶化。
乳房热成像带来的新希望
众所周知, 癌细胞从初期开始就需养分来维生并加速成长。为了达到这个目的, 血管得经常“敞开”,闲置的血管再次被激活,新的血管陆续形成,引发血管异生。
这些血管的活动会提高受影响部位的体温,此温度的上升可通过红外热成像摄像机探测到。
此外,刚形成或被激活的血管外形不一样,乳房热成像也可检测到。
乳房热成像是测量温度的差异。乳癌通常会引发血管异生, 使新血管内生进入肿瘤中, 为肿瘤提供养分和氧气。这些血管造成的额外血流量就会提升体温。
另外,乳癌细胞的新陈代谢比周遭组织来得快,加上癌症跟发炎症关系密切,所以患乳癌部位的温度会比周遭正常的乳房组织来得高。
乳房热成像最大的优势是它能比乳房X 光检验早几年发现到乳房的异常。研究人员斯啤特列尔(H.Spitalier)和葛瑞德(D.Giruaud)使用研究了十年的相同数据,确定6 0 % 被诊断患上癌症的女性,可从乳房热成像获取首个警告。
由于热成像检测能探测细胞层次的变化,研究显示热成像检测能比其他测试方法早八至十年测到异常活动。这独特优势让热成像检测能在肿瘤形成前,探测到不寻常的变化。
研究也显示,当肿瘤长到身体检查或乳房X光检验能检测到的大小时,它其实已经成型约七年左右,恶性细胞群至少翻了25倍。这意味着在五年里,共有1,048,576个细胞是乳房X光检验无法检测到的。在八年里,就有近40亿个细胞。乳房热成像并无辐
射危险,是获得美国食品药品监督管理局(FDA)认可,能与乳房X光检验同时使用以检测乳癌的技术。
人类乳房组织的热成像研究
乳房热成像是以数码红外成像拍摄,显示组织温度差异的高解析度图。红色代表温度较高,表示有发炎征兆,可能是过多或不寻常的血流量、组织受损、细胞新陈代谢加强和荷尔蒙失调等因素。
http://www.matrixcell.com/why-is-breast-cancer-prevention-important/?lang=zh
http://www.breastthermography.com/
http://www.breastthermography.com/breast_thermography_mf.htm
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The use of Digital Infrared Imaging is based on the principle that metabolic activity and vascular circulation in both pre-cancerous tissue and the area surrounding a developing breast cancer is almost always higher than in normal breast tissue. In an ever-increasing need for nutrients, cancerous tumors increase circulation to their cells by holding open existing blood vessels, opening dormant vessels, and creating new ones ( neoangiogenesis). This process frequently results in an increase in regional surface temperatures of the breast. DII uses ultra-sensitive medical infrared cameras and sophisticated computers to detect, analyze, and produce high-resolution images of these temperature variations. Because of DII’s extreme sensitivity, these temperature variations may be among the earliest signs of breast cancer and/or a pre-cancerous state of the breast (3,6,7,8,9).
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Current methods used to detect suspicious signs of breast cancer depend primarily on the combination of both physical examination and mammography. While this approach has become the mainstay of early breast cancer detection, more is needed. Since the absolute prevention of breast cancer has not become a reality as of yet, efforts must be directed at detecting breast cancer at its earliest stage. As such, the addition of Digital Infrared Imaging (Breast Thermography) to the frontline of early breast cancer detection brings a great deal of good news for women.
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WHAT MAKES DIGITAL INFRARED IMAGING SO UNIQUE
While mammography, ultrasound, MRI, and other structural imaging tools rely primarily on finding the physical tumor, DII is based on detecting the heat produced by increased blood vessel circulation and metabolic changes associated with a tumor’s genesis and growth. By detecting minute variations in normal blood vessel activity, infrared imaging may find thermal signs suggesting a pre-cancerous state of the breast or the presence an early tumor that is not yet large enough to be detected by physical examination, mammography, or other types of structural imaging (3,6,7,8,9).
Certain types of cancers will not be detected (approximately 20%) by mammography for various reasons(10), but some of these cancers will be discovered by DII (3,6,7,8,9).
Difficulties in reading mammograms can occur in women who are on hormone replacement, nursing or have fibrocystic, large, dense, or enhanced breasts (6,8). These types of breast differences do not cause difficulties in reading digital infrared scans.
DII AS A RISK MARKER FOR BREAST CANCER
Studies show that an abnormal infrared image is the single most important marker of high risk for developing breast cancer, 10 times more significant than a family history of the disease (5). Consequently, in patients with a persistent abnormal thermogram, the examination results become a marker of higher future cancer risk (4,5). Depending upon certain factors, re-examinations are performed at appropriate intervals to monitor the breasts. This gives a woman time to take a pro-active approach by working with her doctor to improve her breast health. By maintaining close monitoring of her breast health with infrared imaging, self breast exams, clinical examinations, mammography, and other tests, a woman has a much better chance of detecting cancer at its earliest stage and preventing invasive tumor growth.
Angiogenesis, or new blood vessel formation, is necessary to sustain the growth of a tumor. Digital Infrared Imaging may be the first signal that such a possibility is developing (3). |
Just as unique as a fingerprint, each patient has a particular infrared map of their breasts. Any modification of this infrared map on serial imaging (images taken over months to years) may constitute an early sign of an abnormality. However, if a pathology is suspected, this information is used to recommend further examinations and tests.
TECHNOLOGY, INTERPRETATION AND COMPARATIVE IMAGING
As is the case with mammography and all other imaging modalities, access to sophisticated technology and the expertise to interpret the findings are of prime importance. To help distinguish a normal process from an abnormal one requires proper training, clinical experience, strict adherance to protocols, and meticulous image acquisition. While not all tumors are visible on a mammogram, not all tumors are associated with a high level of blood vessel activity; thus, escaping infrared detection. Less aggressive lesions can be associated with less evident images. Therefore, in these select cases, DII may be an indicator suggesting a much better overall prognosis.
When digitally produced, and interpreted by qualified doctors, abnormalities or changes in infrared images provide invaluable information. This is particularly true in patients with dense breasts, non-specific physical or mammographic findings, or women with a previous history of breast surgery or radiation. The use of serial infrared imaging can draw additional attention to areas that require further evaluation or closer scrutiny during initial or subsequent exams. This further evaluation may include additional imaging such as mammography, ultrasound, or MRI. Used as a complimentary imaging technique, recent data suggests that DII may also help monitor the effects of some of the newer proposed anti-angiogenesis therapies (currently recognized as a promising treatment strategy) (6,8).
Since we have not been able to prevent breast cancer as of yet, there is a consensus among experts that more lives will be saved with earlier detection. Since both physical and mammographic examination cannot detect all cancers, particularly smaller tumors in younger patients and those with dense breast tissue, there is currently much interest in finding new ways to improve our abilities in early detection. While some new promising techniques have emerged such as MRI, doppler ultrasound, and scintimammography, most are designed to be used in selected cases where physical and mammographic examinations have already picked up an abnormality. These tests also do not address the limitations of combined physical examination and mammography in frontline detection. Consequently, we are left with too many patients who have undergone these two screening tests and are still left with undetected breast cancer. Therefore, experts have concluded that no one procedure or method of imaging is solely adequate for breast cancer screening (1,2,6).
EARLY DETECTION MEANS LIFE
Breast cancer is the most common cancer in women, and the risk increases with age (1). Risk is also higher in women whose close relatives have had the disease. Women without children, and those who have had their first child after age 30, also seem to be at higher risk. However, every woman is at risk of developing breast cancer. Current research indicates that 1 in every 8 women in the US will get breast cancer in their lifetime (1).
Studies show an increase in survival rate when breast thermography and mammography are used together(3). |
DII’s ability to detect thermal signs that may suggest a pre-cancerous state of the breast, or signs of cancer at an extremely early stage, lies in its unique capability of monitoring the temperature variations produced by the earliest changes in tissue physiology (function) (3,6,7,8,9). However, DII does not have the ability to pinpoint the location of a tumor nor can it detect 100% of all cancers. Consequently, Digital Infrared Imaging’s role is in addition (an adjunct) to mammography and physical examination, not in lieu of. DII does not replace mammography and mammography does not replace DII, the tests complement each other. Since it has been determined that 1 in 8 women will get breast cancer, we must use every means possible to detect cancers when there is the greatest chance for survival. Proper use of breast self-exams, physician exams, DII, and mammography together provide the earliest detection system available to date (3,7,8,9). If treated in the earliest stages, cure rates greater than 95% are possible (3,6).
REFERENCES
1. American Cancer Society – Breast Cancer Guidelines and Statistics, 2009-2010
2. I. Nyirjesy, M.D. et al; Clinical Evaluation, Mammography and Thermography in the Diagnosis of Breast Carcinoma. Thermology, 1986; 1: 170-173.
3. M. Gautherie, Ph.D.; Thermobiological Assessment of Benign and Malignant Breast Diseases. Am. J. Obstet. Gynecol., 1983; V 147, No. 8: 861-869.
4. C. Gros, M.D., M. Gautherie, Ph.D.; Breast Thermography and Cancer Risk Prediction. Cancer, 1980; V 45, No. 1: 51-56.
5. P. Haehnel, M.D., M. Gautherie, Ph.D. et al; Long-Term Assessment of Breast Cancer Risk by Thermal Imaging. In: Biomedical Thermology, 1980; 279-301.
6. P. Gamigami, M.D.; Atlas of Mammography: New Early Signs in Breast Cancer. Blackwell Science, 1996.
7. J. Keyserlingk, M.D.; Time to Reassess the Value of Infrared Breast Imaging? Oncology News Int., 1997; V 6, No. 9.
8. P.Ahlgren, M.D., E. Yu, M.D., J. Keyserlingk, M.D.; Is it Time to Reassess the Value of Infrared Breast Imaging? Primary Care & Cancer (NCI), 1998; V 18, No. 2.
9. N. Belliveau, M.D., J. Keyserlingk, M.D. et al ; Infrared Imaging of the Breast: Initial Reappraisal Using High-Resolution Digital Technology in 100 Successive Cases of Stage I and II Breast Cancer. Breast Journal, 1998; V 4, No. 4
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The following graph outlines the differences between mammography, medical infrared imaging (thermography), and ultrasound. Medical infrared imaging detects surface heat as a byproduct of biochemical reactions. As such, the test adds valuable physiologic information that cannot be obtained from any other imaging procedure. Thermography is designed to be used as an adjunct (an additional test) to a woman's regular breast health care.
Mammography
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Medical Infrared Imaging
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Ultrasound
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Uses X-rays to produce an image that is a shadow of dense structures. |
Uses infrared sensors to detect heat and increased vascularity (angiogenesis) as the byproduct of biochemical reactions. The heat is compiled into an image for computerized analysis. |
High frequency sound waves are bounced off the breast tissue and collected as an echo to produce an image. |
Structural imaging. Ability to locate the area of suspicious tissue. |
Functional imaging. Detects physiologic changes. Cannot locate the exact area of suspicion inside the breast. |
Structural imaging. Ability to locate the area of suspicious tissue. |
Early detection method. |
Early detection method. Used as an adjunctive imaging test. |
Lower spatial resolution (cannot see fine detail). Good at distinguishing solid masses from fluid filled cysts. Used as an adjunctive imaging test. |
Findings increase suspicion.
Cannot diagnose cancer. |
Findings increase suspicion.
Cannot diagnose cancer. |
Findings increase suspicion.
Cannot diagnose cancer. |
A biopsy is the only test that can determine if a suspected tissue area is cancerous.
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Can detect tumors in the pre-invasive stage. |
May provide the first signal that a problem is developing. |
Ability to detect some cancers not detected by mammography. |
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A positive infrared image represents the highest known risk factor for the existence of or future development of breast cancer – 10 times more significant than any family history of the disease.
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Average 80% Sensitivity (20% of cancers not detected), in women over age 50. Sensitivity decreases in women under age 50. |
Average 90% Sensitivity (10% of cancers not detected) in all age groups. |
Average 83% Sensitivity (17% of cancers not detected) in all age groups. |
Hormone use decreases sensitivity. |
No known effect. |
No known effect. |
Large, dense, and fibrocystic breasts cause reading difficulties. |
No effect. |
No known effect. |
Sources:
Index Medicus – ACS, NEJM, JNCI, J Breast, J Radiology, J Clin Ultrasound
Index Medicus – Cancer, AJOG, Thermology
Text – Atlas of Mammography: New Early Signs in Breast Cancer
Text – Biomedical Thermology
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