一、乳房(fang)的自檢方(fang)法有哪(na)些
乳(ru)房(fang)(fang)是一(yi)個(ge)外(wai)(wai)胚(pei)層器官，起源于(yu)皮膚(fu)，屬于(yu)胸壁淺層結構。女孩從12～13歲(sui)起，乳(ru)房(fang)(fang)開始(shi)發(fa)育，至(zhi)15～17歲(sui)基本成(cheng)熟。盡(jin)管有(you)(you)人種、族群差異(yi)，大(da)(da)致上(shang)(shang)乳(ru)腺是由(you)15～20個(ge)腺葉(xie)組(zu)成(cheng)。乳(ru)房(fang)(fang)發(fa)育不(bu)良本質(zhi)上(shang)(shang)是一(yi)種組(zu)織缺少，故(gu)治療上(shang)(shang)宜增加乳(ru)房(fang)(fang)內容物(wu)，擴大(da)(da)體(ti)積、改善外(wai)(wai)形，使女性體(ti)現出特有(you)(you)的曲線美及其魅力。鏡前檢查(cha)：在鏡前，雙(shuang)手垂下(xia)，看看乳(ru)房(fang)(fang)外(wai)(wai)觀是否正常？乳(ru)頭有(you)(you)無(wu)(wu)(wu)凹陷、皮膚(fu)有(you)(you)無(wu)(wu)(wu)皺(zhou)縮、隆腫(zhong)……等現象？輕捏乳(ru)頭有(you)(you)無(wu)(wu)(wu)分泌物(wu)？接著檢查(cha)腋下(xia)，有(you)(you)無(wu)(wu)(wu)淋巴腺腫(zhong)？最后，將雙(shuang)手高(gao)舉過(guo)頭，反(fan)復再(zai)做一(yi)次。平(ping)躺(tang)檢查(cha)：仰臥床上(shang)(shang)，乳(ru)房(fang)(fang)豐(feng)滿者可放(fang)置一(yi)個(ge)小(xiao)(xiao)忱(chen)頭或(huo)折疊的毛(mao)巾于(yu)左(zuo)肩下(xia)，讓(rang)左(zuo)手枕(zhen)于(yu)腦后，將右手的手指并(bing)攏伸直，輕壓左(zuo)邊乳(ru)房(fang)(fang)，作小(xiao)(xiao)圈(quan)狀按(an)摩。此時可將乳(ru)房(fang)(fang)假(jia)想成(cheng)一(yi)個(ge)鐘面(mian)，自12點(dian)的位置，順時鐘方(fang)向(xiang)（亦可采逆時鐘方(fang)向(xiang)，但是方(fang)向(xiang)必須統一(yi)）檢查(cha)至(zhi)原(yuan)點(dian)，至(zhi)少按(an)摩3圈(quan)。依照(zhao)上(shang)(shang)列方(fang)法，改用左(zuo)手檢查(cha)右側乳(ru)房(fang)(fang)。
二、乳房檢查的七步驟
一(yi)、視(shi)面對(dui)(dui)(dui)鏡子兩(liang)手(shou)(shou)(shou)(shou)自然下垂，仔(zi)細(xi)(xi)觀(guan)(guan)察(cha)乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)兩(liang)邊(bian)是否大小(xiao)對(dui)(dui)(dui)稱、有(you)(you)(you)無(wu)(wu)(wu)不(bu)正常(chang)突起、表皮(pi)(pi)凹(ao)陷或(huo)隆起、脫屑(xie)、紅腫、起皺紋等，再注意乳(ru)(ru)(ru)(ru)頭(tou)(tou)有(you)(you)(you)無(wu)(wu)(wu)分泌物(wu)、變形(xing)(xing)或(huo)糜爛、凹(ao)陷。二、看雙手(shou)(shou)(shou)(shou)握住且置于腦后，手(shou)(shou)(shou)(shou)稍往前(qian)壓，注意觀(guan)(guan)察(cha)鏡中乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)外(wai)(wai)形(xing)(xing)、輪廓是否有(you)(you)(you)上述異常(chang)之(zhi)情形(xing)(xing)。再將(jiang)雙手(shou)(shou)(shou)(shou)放在(zai)腰(yao)部(bu)，上身(shen)往前(qian)傾，肩膀及手(shou)(shou)(shou)(shou)肘稍往前(qian)壓，觀(guan)(guan)察(cha)鏡中乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)有(you)(you)(you)無(wu)(wu)(wu)異常(chang)。三(san)、觸抬(tai)高(gao)手(shou)(shou)(shou)(shou)臂(bei)，右手(shou)(shou)(shou)(shou)將(jiang)指(zhi)頭(tou)(tou)并攏，仔(zi)細(xi)(xi)檢查(cha)左(zuo)(zuo)邊(bian)乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)，以(yi)手(shou)(shou)(shou)(shou)指(zhi)之(zhi)指(zhi)腹輕壓乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)，感(gan)覺是否有(you)(you)(you)硬塊，由乳(ru)(ru)(ru)(ru)頭(tou)(tou)開始做環狀順(shun)時針方(fang)向檢查(cha)，逐(zhu)漸向外(wai)(wai)（約(yue)3－4圈(quan)），至(zhi)全部(bu)乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)檢查(cha)完為止。此外(wai)(wai)，要特別(bie)注意乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)外(wai)(wai)上1/4及腋窩處(chu)，摸摸是否有(you)(you)(you)不(bu)尋常(chang)的(de)(de)(de)皮(pi)(pi)下腫塊。同時，輕輕擠乳(ru)(ru)(ru)(ru)頭(tou)(tou)，注意有(you)(you)(you)無(wu)(wu)(wu)分泌物(wu)。檢查(cha)完左(zuo)(zuo)邊(bian)乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)，再檢查(cha)右乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)。四、臥平躺下來，在(zai)左(zuo)(zuo)肩后墊個(ge)小(xiao)枕頭(tou)(tou)或(huo)浴(yu)巾，因(yin)肩部(bu)墊高(gao)，乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)重心(xin)會(hui)往內側移(yi)，使得(de)乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)變得(de)平扁易(yi)于檢查(cha)。右手(shou)(shou)(shou)(shou)指(zhi)頭(tou)(tou)并攏，將(jiang)乳(ru)(ru)(ru)(ru)房(fang)(fang)(fang)看成以(yi)乳(ru)(ru)(ru)(ru)頭(tou)(tou)為中心(xin)的(de)(de)(de)圓，由外(wai)(wai)往內一(yi)圈(quan)圈(quan)按壓檢查(cha)，再輕擠乳(ru)(ru)(ru)(ru)頭(tou)(tou)，注意是否有(you)(you)(you)分泌物(wu)。五、紅外(wai)(wai)線(xian)乳(ru)(ru)(ru)(ru)透檢查(cha) 無(wu)(wu)(wu)任何輻(fu)射，無(wu)(wu)(wu)損傷、快速直(zhi)觀(guan)(guan)，它(ta)(ta)能(neng)(neng)直(zhi)接顯(xian)示乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)血管的(de)(de)(de)走(zou)行、分布及管徑改變，六、乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)鉬(mu)靶(ba)X光(guang) 被(bei)公認為早期(qi)發(fa)現乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)癌(ai)的(de)(de)(de)重要檢查(cha)手(shou)(shou)(shou)(shou)段(duan)，當紅外(wai)(wai)線(xian)乳(ru)(ru)(ru)(ru)透檢查(cha)發(fa)現不(bu)明腫塊后，就(jiu)要在(zai)做一(yi)個(ge)鉬(mu)靶(ba)X光(guang)檢查(cha)。與普通X光(guang)不(bu)同，乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)鉬(mu)靶(ba)X光(guang)能(neng)(neng)精細(xi)(xi)地記錄(lu)下不(bu)同的(de)(de)(de)軟組織留下的(de)(de)(de)X線(xian)影像，特別(bie)是能(neng)(neng)捕捉到對(dui)(dui)(dui)乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)癌(ai)具有(you)(you)(you)診(zhen)斷意義的(de)(de)(de)微小(xiao)鈣化灶。臨(lin)床(chuang)應用證實，它(ta)(ta)能(neng)(neng)發(fa)現小(xiao)于5mm的(de)(de)(de)癌(ai)腫，可以(yi)至(zhi)少比(bi)臨(lin)床(chuang)手(shou)(shou)(shou)(shou)檢提前(qian)1年(nian)發(fa)現乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)癌(ai)。不(bu)過，出于對(dui)(dui)(dui)放射線(xian)輻(fu)射致(zhi)癌(ai)論的(de)(de)(de)顧慮，35歲以(yi)下的(de)(de)(de)婦女是否每年(nian)都進行常(chang)規乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)X線(xian)檢查(cha)仍(reng)存在(zai)爭議。七、彩色(se)B超(chao)檢查(cha) 無(wu)(wu)(wu)痛苦、無(wu)(wu)(wu)損傷，不(bu)會(hui)受(shou)到致(zhi)密型腺(xian)(xian)(xian)體(ti)的(de)(de)(de)影響，能(neng)(neng)比(bi)較準(zhun)確(que)地鑒別(bie)囊、實性病(bing)變。與前(qian)三(san)者(zhe)相比(bi)，乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)B超(chao)檢查(cha)最大的(de)(de)(de)優點(dian)在(zai)于它(ta)(ta)可以(yi)觀(guan)(guan)察(cha)動態(tai)的(de)(de)(de)乳(ru)(ru)(ru)(ru)腺(xian)(xian)(xian)影像。不(bu)過，B超(chao)對(dui)(dui)(dui)發(fa)現小(xiao)于5mm腫塊的(de)(de)(de)能(neng)(neng)力較差(cha)。
三、乳房檢查的注(zhu)意(yi)事項有哪(na)些
1、注重(zhong)(zhong)(zhong)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)病(bing)(bing)(bing)病(bing)(bing)(bing)史(shi)的(de)(de)(de)(de)(de)(de)特(te)殊性(xing)(xing)(xing)，特(te)別是月經(jing)婚育史(shi)、既(ji)往(wang)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)疾病(bing)(bing)(bing)史(shi)及乳(ru)(ru)(ru)(ru)(ru)腺癌(ai)家族史(shi)等，因(yin)這些病(bing)(bing)(bing)史(shi)對(dui)有(you)(you)(you)傾向性(xing)(xing)(xing)的(de)(de)(de)(de)(de)(de)體(ti)(ti)(ti)檢(jian)(jian)(jian)(jian)(jian)(jian)及進一步(bu)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)具有(you)(you)(you)重(zhong)(zhong)(zhong)要(yao)意(yi)義。2、重(zhong)(zhong)(zhong)視(shi)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)體(ti)(ti)(ti)格(ge)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，避(bi)(bi)免(mian)因(yin)過(guo)分依賴(lai)影像檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，忽略(lve)了具有(you)(you)(you)診(zhen)(zhen)斷價值的(de)(de)(de)(de)(de)(de)臨床體(ti)(ti)(ti)征(zheng)而誤診(zhen)(zhen)，或大(da)撒網似(si)地(di)開出許多檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，使(shi)患(huan)(huan)者(zhe)(zhe)因(yin)不(bu)(bu)恰當的(de)(de)(de)(de)(de)(de)輔(fu)助檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)而承(cheng)受不(bu)(bu)必(bi)要(yao)的(de)(de)(de)(de)(de)(de)各種(zhong)負擔。3、對(dui)初診(zhen)(zhen)的(de)(de)(de)(de)(de)(de)乳(ru)(ru)(ru)(ru)(ru)腺疾病(bing)(bing)(bing)患(huan)(huan)者(zhe)(zhe)，如(ru)(ru)體(ti)(ti)(ti)格(ge)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)不(bu)(bu)甚(shen)滿意(yi)時(shi)(shi)(shi)，可(ke)(ke)囑(zhu)患(huan)(huan)者(zhe)(zhe)配合，在最(zui)佳(jia)體(ti)(ti)(ti)檢(jian)(jian)(jian)(jian)(jian)(jian)時(shi)(shi)(shi)間再行檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，如(ru)(ru)在月經(jing)周期的(de)(de)(de)(de)(de)(de)第10天(tian)左右檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，以避(bi)(bi)免(mian)因(yin)月經(jing)周期中乳(ru)(ru)(ru)(ru)(ru)腺生(sheng)理變(bian)(bian)化(hua)而造成(cheng)的(de)(de)(de)(de)(de)(de)干擾。4、檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)時(shi)(shi)(shi)應(ying)光(guang)照充分，避(bi)(bi)免(mian)微小病(bing)(bing)(bing)變(bian)(bian)引起的(de)(de)(de)(de)(de)(de)體(ti)(ti)(ti)征(zheng)被(bei)忽略(lve)。5、注重(zhong)(zhong)(zhong)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)的(de)(de)(de)(de)(de)(de)對(dui)稱性(xing)(xing)(xing)，遵循兩(liang)側(ce)對(dui)比(bi)、先(xian)健側(ce)后(hou)患(huan)(huan)側(ce)的(de)(de)(de)(de)(de)(de)原(yuan)則(ze)(ze)；注重(zhong)(zhong)(zhong)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)的(de)(de)(de)(de)(de)(de)全面(mian)性(xing)(xing)(xing)，遵循先(xian)視(shi)診(zhen)(zhen)后(hou)觸診(zhen)(zhen)、先(xian)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)后(hou)全身的(de)(de)(de)(de)(de)(de)原(yuan)則(ze)(ze)，不(bu)(bu)遺漏(lou)每一個體(ti)(ti)(ti)征(zheng)、每一個細節(jie)，不(bu)(bu)遺漏(lou)腋窩淋巴結(jie)。6、必(bi)要(yao)時(shi)(shi)(shi)應(ying)用一些增強(qiang)(qiang)(qiang)體(ti)(ti)(ti)征(zheng)的(de)(de)(de)(de)(de)(de)特(te)殊方法，以確認(ren)某一重(zhong)(zhong)(zhong)要(yao)體(ti)(ti)(ti)征(zheng)。如(ru)(ru)乳(ru)(ru)(ru)(ru)(ru)頭(tou)凹陷回縮的(de)(de)(de)(de)(de)(de)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，為(wei)確認(ren)兩(liang)側(ce)乳(ru)(ru)(ru)(ru)(ru)頭(tou)是否在同一水平線上，可(ke)(ke)作彎腰試驗，即囑(zhu)患(huan)(huan)者(zhe)(zhe)上身前傾，兩(liang)臂(bei)向前伸直(zhi)，使(shi)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)下(xia)垂，此(ci)時(shi)(shi)(shi)患(huan)(huan)側(ce)乳(ru)(ru)(ru)(ru)(ru)頭(tou)可(ke)(ke)因(yin)纖維(wei)組(zu)織牽拉而抬高(gao)。另外，為(wei)了與先(xian)天(tian)性(xing)(xing)(xing)及良性(xing)(xing)(xing)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)疾病(bing)(bing)(bing)造成(cheng)的(de)(de)(de)(de)(de)(de)乳(ru)(ru)(ru)(ru)(ru)頭(tou)凹陷相鑒別，可(ke)(ke)用手(shou)輕輕向外摩挲，先(xian)天(tian)性(xing)(xing)(xing)及良性(xing)(xing)(xing)病(bing)(bing)(bing)變(bian)(bian)的(de)(de)(de)(de)(de)(de)乳(ru)(ru)(ru)(ru)(ru)頭(tou)凹陷常可(ke)(ke)復(fu)出，而乳(ru)(ru)(ru)(ru)(ru)腺癌(ai)造成(cheng)的(de)(de)(de)(de)(de)(de)乳(ru)(ru)(ru)(ru)(ru)頭(tou)凹陷則(ze)(ze)多不(bu)(bu)能(neng)復(fu)出。又如(ru)(ru)皮膚(fu)粘連(lian)的(de)(de)(de)(de)(de)(de)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，由于乳(ru)(ru)(ru)(ru)(ru)腺癌(ai)侵犯cooper’s 韌帶而致皮膚(fu)下(xia)陷形成(cheng)的(de)(de)(de)(de)(de)(de)"酒(jiu)窩征(zheng)"，有(you)(you)(you)時(shi)(shi)(shi)也需經(jing)加(jia)強(qiang)(qiang)(qiang)體(ti)(ti)(ti)征(zheng)才能(neng)確認(ren)，可(ke)(ke)在采光(guang)較好的(de)(de)(de)(de)(de)(de)室內，用手(shou)輕抬乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)，并(bing)囑(zhu)患(huan)(huan)者(zhe)(zhe)高(gao)舉雙臂(bei)，使(shi)皮膚(fu)張力(li)增強(qiang)(qiang)(qiang)，此(ci)時(shi)(shi)(shi)可(ke)(ke)在病(bing)(bing)(bing)灶(zao)上方見(jian)到皮膚(fu)凹陷。又如(ru)(ru)腫(zhong)瘤與胸(xiong)(xiong)壁粘連(lian)的(de)(de)(de)(de)(de)(de)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，可(ke)(ke)行胸(xiong)(xiong)大(da)肌(ji)(ji)試驗，即囑(zhu)患(huan)(huan)者(zhe)(zhe)兩(liang)手(shou)叉腰，用力(li)使(shi)胸(xiong)(xiong)肌(ji)(ji)收縮時(shi)(shi)(shi)，與胸(xiong)(xiong)肌(ji)(ji)發生(sheng)粘連(lian)者(zhe)(zhe)則(ze)(ze)乳(ru)(ru)(ru)(ru)(ru)房(fang)(fang)(fang)活動受限(xian)，放松時(shi)(shi)(shi)活動度增加(jia)。7、在有(you)(you)(you)關輔(fu)助檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)結(jie)果(guo)出來(lai)后(hou)，如(ru)(ru)仍難以確診(zhen)(zhen)，則(ze)(ze)應(ying)回過(guo)頭(tou)來(lai)再細致地(di)對(dui)病(bing)(bing)(bing)灶(zao)部位檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)，在綜合分析各種(zhong)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)結(jie)果(guo)時(shi)(shi)(shi)，體(ti)(ti)(ti)格(ge)檢(jian)(jian)(jian)(jian)(jian)(jian)查(cha)(cha)(cha)(cha)(cha)所得的(de)(de)(de)(de)(de)(de)重(zhong)(zhong)(zhong)要(yao)體(ti)(ti)(ti)征(zheng)對(dui)最(zui)后(hou)診(zhen)(zhen)斷的(de)(de)(de)(de)(de)(de)形成(cheng)意(yi)義重(zhong)(zhong)(zhong)大(da)。
四、X線(xian)檢查乳(ru)房的優(you)勢有哪些
1、早(zao)期(qi)診(zhen)斷(duan)可以(yi)(yi)檢查(cha)(cha)出醫生不能觸(chu)及(ji)的(de)(de)乳(ru)(ru)腺(xian)(xian)(xian)腫塊(kuai)、結(jie)(jie)節，即隱匿性(xing)乳(ru)(ru)癌和(he)(he)很早(zao)期(qi)的(de)(de)原位癌，提高早(zao)期(qi)診(zhen)斷(duan)率，比(bi)有經驗的(de)(de)醫生早(zao)兩(liang)年發(fa)現早(zao)期(qi)乳(ru)(ru)腺(xian)(xian)(xian)癌，因為對于臨床(chuang)上難以(yi)(yi)發(fa)現的(de)(de)以(yi)(yi)微小鈣化塊(kuai)為唯(wei)一表現的(de)(de)早(zao)期(qi)乳(ru)(ru)腺(xian)(xian)(xian)癌，只(zhi)有憑(ping)借(jie)軟(ruan)X線(xian)檢查(cha)(cha)才能被早(zao)期(qi)發(fa)現、診(zhen)斷(duan)。2、精準定位照片(pian)圖像清(qing)晰、直觀，可清(qing)楚顯示乳(ru)(ru)房內(nei)小于1cm的(de)(de)結(jie)(jie)節性(xing)病(bing)灶(zao)，明確病(bing)灶(zao)的(de)(de)位置、浸潤范圍(wei)、有無(wu)繼發(fa)癌灶(zao)等(deng)，在臨床(chuang)已廣泛應(ying)用。3、可靠鑒別比(bi)較(jiao)可靠地(di)鑒別出乳(ru)(ru)腺(xian)(xian)(xian)的(de)(de)良(liang)性(xing)病(bing)變(bian)和(he)(he)惡(e)性(xing)腫瘤。4、安全便(bian)捷是(shi)一種(zhong)相對無(wu)創性(xing)的(de)(de)檢查(cha)(cha)，其(qi)輻(fu)射劑(ji)量(liang)亦降(jiang)低至(zhi)每人次（兩(liang)側四(si)位）0.003Gy以(yi)(yi)下，對人體(ti)無(wu)損害(hai)，能比(bi)較(jiao)全面而正(zheng)確地(di)反應(ying)出整個乳(ru)(ru)房的(de)(de)大(da)體(ti)解剖結(jie)(jie)構。5、有效檢測對于乳(ru)(ru)腺(xian)(xian)(xian)癌患者進(jin)行放療、化療后的(de)(de)病(bing)變(bian)情況進(jin)行隨訪檢查(cha)(cha)，觀察療效，并對健側乳(ru)(ru)房進(jin)行定期(qi)監測。
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