갱신 : 2016-12-21

General Information About Breast Cancer

유방암에 대한 일반정보

Key Points for This Section

. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

. Health history can affect the risk of developing breast cancer.

. Breast cancer is sometimes caused by inherited gene mutations (changes).

. Possible signs of breast cancer include a lump or change in the breast.

. Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

. If cancer is found, tests are done to study the cancer cells.

. Certain factors affect prognosis (chance of recovery) and treatment options.

.요점

. 유방암은 유방의 조직에 악성(암)세포가 형성되는 질병이다.

. 연령과 건강 이력이 유방암 발병에 영향을 미칠 수 있다.

. 유방암은 때로는 유전된 유전자의 돌연변이에 의해 발병된다.

. 유방암의 위험신호는 멍울이나 유방의 변화 이다.

. 유방을 진찰하는 검사는 유방암의 탐색과 진단에 이용된다.

. 일단 암이 발견되면 여러 가지 검사를 통하여 암세포를 연구한다.

. 어떤 요인들은 예후와 치료선택에 영향을 미친다.

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter substances in a fluid called lymph and help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.

•Breast Cancer Prevention

•Breast Cancer Screening

•Breast Cancer Treatment and Pregnancy

•Male Breast Cancer Treatment

•Unusual Cancers of Childhood (for information about childhood breast cancer)

보다 자세한 정보는 다음의 PDQ요약을 보라 :

• 유방암 예방

• 유방암 검진

• 유방암 치료와 임신

• 남성 유방암 치료

• 희귀 소아암 (어린이 유방암에 관한 정보는)

Health history can affect the risk of developing breast cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for breast cancer include the following:

•Menstruating at an early age.

•Older age at first birth or never having given birth.

•A personal history of invasive breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), or benign (noncancer) breast disease.

•A family history (first-degree relative, such as mother, daughter, or sister) of breast cancer.

•Treatment with radiation therapy to the breast/chest.

•Breast tissue that is dense on a mammogram.

•Taking hormones such as estrogen and progesterone for symptoms of menopause.

•Obesity.

•Not getting enough exercise.

•Drinking alcoholic beverages.

•Being white.

NCI's Breast Cancer Risk Assessment Tool uses a woman's risk factors to estimate her risk for breast cancer during the next five years and up to age 90. This online tool is meant to be used by a health care provider. For more information on breast cancer risk, call 1-800-4-CANCER.

미국립암연구소의 유방암 위험 평가 수단으로 여성의 위험인자를 사용하여 90세까지를 대상으로 향후 5년간 유방암의 위험을 평가한다. 보다 자세한 정보는 1-800-4-CANCER에 전화하라.

Breast cancer is sometimes caused by inherited gene mutations (changes).

The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up about 5% to 10% of all breast cancer. Some mutated genes related to breast cancer are more common in certain ethnic groups.

Women who have certain gene mutations, such as a BRCA1 or BRCA2 mutation, have an increased risk of breast cancer. Also, women who have had breast cancer in one breast have an increased risk of developing breast cancer in the other breast. These women also have an increased risk of ovarian cancer, and may have an increased risk of other cancers. Men who have a mutated gene related to breast cancer also have an increased risk of this disease. For more information, see the PDQ summary on Male Breast Cancer Treatment.

There are tests that can detect (find) mutated genes. These genetic tests are sometimes done for members of families with a high risk of cancer. See the PDQ summary on Genetics of Breast and Ovarian Cancer for more information.

유방암은 때로는 물려받은 유전자의 돌연변이에 의해 유발된다.

세포 속의 유전자는 누구나 부모로부터 받은 유전자정보를 갖고 있다. 유전성 유방암은 모든 유방암의 5 내지 10 퍼센트를 차지한다. 유방암과 관련이 있는 일부 돌연변이 유전자는 특정 인종 집단에서 보다 흔하게 나타난다.

유방암과 관련된 돌연변이 유전자를 갖고 있는 여성들과 한쪽 유방에 유방암에 걸렸던 여성들은 다른 쪽 유방에 유방암이 발병할 위험이 증가한다. 이런 여성들은 난소암이나 다른 암의 발병 위험이 클 수 있다. 유방암과 관련된 돌연변이 유전자가 있는 남성들도 이병의 발병 위험이 크다. 보다 자세한 정보는 남성 유방암치료에 관한 PDQ 요약본을 보라.

돌연변이 유전자를 탐지할 수 있는 검사가 있다. 이런 유전자 검사는 때로는 암의 발병위험이 큰 가족들을 대상으로 치러진다. 보다 자세한 정보는 유방 및 난소암의 유전자에 관한 PDQ 요약본을 보라:

Possible signs of breast cancer include a lump or change in the breast.

Breast cancer may cause any of the following signs and symptoms. Check with your doctor if you have any of the following problems:

•A lump or thickening in or near the breast or in the underarm area.

•A change in the size or shape of the breast.

•A dimple or puckering in the skin of the breast.

•A nipple turned inward into the breast.

•Fluid, other than breast milk, from the nipple, especially if it's bloody.

•Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin that is around the nipple).

•Dimples in the breast that look like the skin of an orange, called peau d’orange.

Other conditions that are not breast cancer may cause these same symptoms.

유방암의 위험신호는 멍울과 유방의 변화 등이다.

유방암은 다음의 징후와 증상 중 한두 가지를 야기할 수 있다. 만일 당신에게 다음 문제 중 어느 것이라도 나타나면 의사와 체크하라:

. 유방 안쪽이나 근처 혹은 겨드랑이 안쪽에 멍울이나 비후肥厚(두꺼워짐)

. 유방의 크기나 모양의 변화

. 유방의 표면에 함몰이나 주름

. 유두가 유방 안으로 들어감

. 유두에서 젖이 아닌 액체 특히 핏빛의 액체가 나옴

. 유방과 유두 및 유륜(유두를 둘러싼 검은색의 부위)에 비늘 같고 붉고 부어오른 피부

. 오렌지 배꼽처럼 보이는 유두의 함몰.

유방암이 아닌 다른 질환도 이와 같은 증상을 유발할 수 있다.

Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

•Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

•Clinical breast exam (CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.

•Mammogram : An x-ray of the breast.

•Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.

.초음파검사 : 고에너지 음파(초음파)가 내부조직이나 장기에 부딪혀서 반향(메아리)을 만든다. 반향이 초음파 검사도라는 조직의 영상을 만든다. 이 영상은 프린트를 해서 추후에도 볼 수 있다.

•MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

•Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

•Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to remove a small piece of the lump. Four types of biopsies are as follows: Excisional biopsy : The removal of an entire lump of tissue.

Incisional biopsy : The removal of part of a lump or a sample of tissue.

Core biopsy : The removal of tissue using a wide needle.

Fine-needle aspiration (FNA) biopsy : The removal of tissue or fluid, using a thin needle.

조직검사(생검) : 암을 찾기 위해 병리학자가 현미경으로 볼 수 있도록 세포나 조직을 절제하는 것. 만일 가슴에 멍울이 발견되면 의사는 멍울의 작은 조각을 떼어낼 필요가 있다. 4종류의 조직검사는 다음과 같다:

. 절제생검 : 멍울 조직 전체를 제거하는 것

. 절개생검 : 멍울의 일부나 조직의 샘플을 제거하는 것

. 조직(핵심) 생검 : 넓은 바늘을 사용하여 조직을 제거함

. 세침천자생검 : 가느다란 바늘을 이용하여 조직이나 체액을 제거하는 것

If cancer is found, tests are done to study the cancer cells.

Decisions about the best treatment are based on the results of these tests. The tests give information about:

•how quickly the cancer may grow.

•how likely it is that the cancer will spread through the body.

•how well certain treatments might work.

•how likely the cancer is to recur (come back).

Tests include the following:

•Estrogen and progesterone receptor test : A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.

•Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and lapatinib.

•Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).

. Oncotype DX: This test helps predict whether stage I or stage II breast cancer that is estrogen receptor positive and node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.

. MammaPrint: This test helps predict whether stage I or stage II breast cancer that is node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.

. 다(중)유전자 검사 : 동시에 많은 유전자의 활동을 관찰하기 위해 조직의 샘플을 조사하는 검사. 이런 검사는 암이 다른 조직으로 퍼질 것인지 재발할 것인지를 예단하는데 도움이 된다.

. 온코형 DX : 이 검사는 에스트로겐 수용체가 있고(양성) 또 림프절 비전이(음성)인 1기 혹은 2기 유방암이 다른 부위로 퍼질지 여부를 예단하는데 도움이 된다. 만일 암의 전이 위험이 높으면, 화학요법으로 위험을 낮출 수 있다.

. 맘마 프린트 : 이 검사는 림프절 비전이(非傳移)인 1기 혹은 2기 유방암이 다른 부위로 퍼질지 여부를 예단하는데 도움이 된다. 암의 전이 위험이 높으면 화학요법으로 위험을 낮출 수 있다.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

•The stage of the cancer (the size of the tumor and whether it is in the breast only or has spread to lymph nodes or other places in the body).

•The type of breast cancer.

•Estrogen receptor and progesterone receptor levels in the tumor tissue.

•Human epidermal growth factor type 2 receptor (HER2/neu) levels in the tumor tissue.

•Whether the tumor tissue is triple-negative (cells that do not have estrogen receptors, progesterone receptors, or high levels of HER2/neu).

•How fast the tumor is growing.

•How likely the tumor is to recur (come back).

•A woman’s age, general health, and menopausal status (whether a woman is still having menstrual periods).

•Whether the cancer has just been diagnosed or has recurred (come back).

. 암의 병기

. 유방암의 종류

. 암의 조직 속의 에스트로겐과 프로게스트로겐 수용체의 수치

. 암의 조직 속의 HER2/neu의 수치

. 암의 조직이 세가지가 음성(세포에 에스트로겐 수용체, 프로게스트러겐 수용체, HER2/neu의 높은 수치가 없음)인지 여부

. 종양이 자라는 속도

. 암의 재발 가능성

. 여성의 연령, 일반적 건강 및 월경 여부

. 암이 초발인가 아니면 재발인가 여부