如果你的测试结果异常该怎么做
What to Do if Your Test Results Are Abnormal
No matter how much thinking you do in advance, you may feel overwhelmed if testing shows that you have an abnormal breast cancer gene. You'll need practical advice and accurate information to help you handle this new fact in your life.
Practical guidelines to follow
- Carefully guard the privacy of your test results.
- Follow early cancer detection guidelines. Begin annual mammograms at age 25, or 10 years before the earliest age at which a family member was diagnosed—whichever comes first. Digital mammography may provide added benefit. MRI (magnetic resonance imaging) of the breast performed by experienced centers can also be very useful.
- Studies are under way to better define the value of these screening tests in women with abnormal breast cancer genes. And newer technologies, including PET (positron emission tomography) scanning are also being tested. If screening research studies are available to you, consider participating in them.
- Monitor your ovarian health with semiannual pelvic exams by a gynecologist, annual pelvic ultrasound with an intravaginal probe, and blood tests for a special protein called CA-125. Consider participating in a clinical trial evaluating newer methods of early detection.
- Ask your doctor whether you should take a cancer risk-reducing agent such as tamoxifen.
- Adopt a healthy lifestyle to stay well and possibly reduce the risk of cancer or its recurrence. This includes a low-fat, largely vegetarian diet, regular exercise, weight control, and only occasional consumption of alcohol.
- Consider family planning choices that may help lower your cancer risk. These include having children at a relatively early age (but only if you are ready to become a parent, of course) and avoiding any (or prolonged) use of hormone replacement therapy.
- If you don't want to have children, DON'T use birth control pills. Use barrier types of birth control: condoms or a diaphragm. Research has shown that birth control pills increase the risk of breast cancer in women with a BRCA1 or BRCA2 mutation.
- Consider preventive (prophylactic) surgery. A woman who has an abnormal breast cancer gene and develops breast cancer in one breast might opt for mastectomy of the affected breast and prophylactic removal of the other, healthy, breast. Because current ovarian cancer screening is limited, women with abnormal BRCA1 or BRCA2 genes may decide to have their ovaries removed once child-bearing is completed.
Getting emotional support
According to Sue Friedman, founder and executive director of Facing Our Risk of Cancer Empowered (FORCE) it's very important to be kind to yourself and give yourself the time you need to digest all the information, discuss all your options with an expert, and get the emotional support you need. "For those who test positive and haven't had cancer, there is a still an adjustment process, and often a grieving process," Friedman says. "Those who test positive have a right to vent and to grieve, just as much as someone who has been diagnosed with a disease."
Friedman continues: "Everyone is so different and there are as many different reactions to a positive test as their are people who test positive! Having said that, there tends to be a sense of immediacy, that someone has to take action tomorrow. I encourage women to give themselves permission to totally digest the information, to grieve and vent as much as they have to before making any definitive decisions on what risk-management strategy to choose. I encourage them to consult with specialists who have expertise in management of high-risk patients and get several opinions."
"I also think it can be helpful to connect with others who have had a positive test-either via the FORCE message boards, our toll-free help line or face-to-face via a support group. Sometimes family and friends who haven't faced these issues cannot totally understand and cannot always be as supportive as we wish. I know that personally, after learning I was positive, I couldn't find a single friend or family member who understood what I was going through. Later, down the road and after I founded FORCE it was so refreshing to connect with people who really 'got it.'"
如果测试显示你有异常的乳腺癌基因,不论之前有多少思想准备,你都会深受打击。你需要实际的建议和正确的信息以帮助你面对这个生命中的新事实。
操作指南
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细心保护你的私人测试结果。
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遵循早期癌症探测指导方针。在25岁或者在家族成员中最早诊断出乳腺癌的年龄提前10年开始做每年一次的乳房拍片。数字化的乳腺x光照相技术将提供更多的好处,有经验的中心拍出的乳房的MRI(磁共振成像)很有用。
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对有异常乳腺癌基因的女人做筛选测试,更好地定义这些筛选测试的价值的研究正在进行中,新近的科技,包括PET(正电子发射断层摄影术)扫描也在测试中。如果筛选研究用到你,考虑加入他们。
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监测你的卵巢健康情况,每半年由妇科医生作骨盆检测,每年用阴道探针做骨盆超声,血液检测一种特殊蛋白叫做CA—125 ,考虑参加临床试验早期检测新方法的测评。
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请教你的医生是否该吃降低癌症风险的还原剂,如三苯氧胺。
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采用健康的生活模式,不仅可以保持好的状态,还可能降低癌症或者复发的风险,这包括低脂肪,大量素食,经常锻炼,控制体重,只是偶尔的饮酒。
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考虑选择计划生育,这有助于降低癌症风险,包括在相对较早的年纪怀孕(当然这只是你准备做个家长的时候),并且避免(或者延长)任何激素替代疗法。
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如果你不想要孩子,千万不要使用口服避孕药!使用屏障模式的节育方式:避孕套或者隔膜。研究表明节育的口服避孕药通过BRCA1或BRCA2突变增加女人的乳腺癌风险。
获得情感上的支持
正如“面对癌症给的风险”(FORCE )的创始人和执行理事Sue Friedman所说,善待自己是非常重要的,给自己时间去消化所有信息,与专家讨论你的所有选择,得到你需要的情感支持。“对那些检测阳性并且没得过癌症的人,仍需要一个调整过程,这通常是个悲痛的过程”,Friedman说“那些测试阳性的人有权去发泄去悲痛,就像大多被诊断有病的人一样。”
Friedman继续说:“每个人都是如此的不同。作为人,检测结果阳性的人,对阳性的检测结果有许多种不同的反应,说了那些,直接感觉有人明天要采取行动了。我鼓励女人在选择制定任何最后的风险管理策略前给自己许可去完全消化信息,去悲伤,尽量去发泄。我鼓励她们与管理高风险病人方面有专业技能的专家商量,得到一些意见。”
“我也认为通过FORCE留言板、免费帮助电话,或者通过支持小组面对面与检测阳性的人联系是有帮助的,有时没有面对过这些问题的家属和朋友不能完全理解,不能总是象我们希望的那样支持。我知道就个人而言,学习之后,我积极了,我找不到一个孤独的朋友或者家庭成员,他们可以理解我的经历。后来,我步入正轨,创办了FORCE之后,它让人高兴的连接着确实‘学会它’的朋友”。
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如果你的测试结果异常该怎么做
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