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研究生:陳宥臻
研究生(外文):CHEN,YU-CHEN
論文名稱:中年婦女乳房攝影篩檢與乳癌危險因子評估
論文名稱(外文):MAMMOGRAPHY SCREENING AND RISK FACTORS OF BREAST CANCER AMONG MIDDLE-AGED WOMEN
指導教授:郭瓊文郭瓊文引用關係
指導教授(外文):KUO,CHIUNG-WEN
學位類別:碩士
校院名稱:元培科技大學
系所名稱:醫學影像暨放射技術研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
畢業學年度:102
語文別:中文
論文頁數:50
中文關鍵詞:乳癌乳房攝影BI-RADS
外文關鍵詞:Breast cancerMammographyBI-RADS
相關次數:
  • 被引用被引用:4
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:1
研究目的:
分析婦女接受國民健康署提供兩年一次之免費乳房攝影篩檢並利用BI-RADS分級結果及觀察與其他乳癌相關危險因子之評估。
材料與方法:
本研究收集2009年1月到2010年12月參加國民健康署免費乳篩之婦女共4548位,其影像結果以BI-RADS(Breast Imaging Reporting and Data System)做分類並將疑似乳癌病灶處以切片方式進行乳癌確診。依據臨床資料表記錄其乳癌風險相關因子,並使用邏輯式回歸分析法來分析出乳癌相關危險因子。與利用乳房攝影篩檢自我評量指標來評估醫師判讀能力。
結果:
研究收集4548位婦女,平均年齡為55±6.5歲,小於45歲婦女有24位( 0.5%),45至55歲婦女有2465位( 54.2% ),大於55歲婦女有2061位( 45.3%),其BI-RADS分級結果為BI-RADS 0:527位(11.6%),BI-RADS 1: 2228位(49%),BI-RADS 2:1750位(38.5%), BI-RADS 3:4位(0.1%),BI-RADS 4:36位(0.8%),BI-RADS 5:3(0.1%),BI-RADS 0中其召回率為 94.7%,回診率(Recall rate) 為12.4%。其診斷出疑似異常共93位(2.04%),確認罹患乳癌有37位(0.81%)。乳癌相關危險因子中以教育程度為專科/高中程度以上時的勝算比(OR)較教育程度低婦女的0.22倍(p<0.05)。有家族乳癌史之婦女為無疾病史婦女的勝算比為2.1倍(p<0.05)。
結論:
在這次研究中有37位婦女因篩檢而確認罹患乳癌,且高教育程度與有家族乳癌史的族群,為罹患乳癌的高危險群,為有效早期診斷婦女罹患乳癌,建議此高危險群婦女定期做乳房攝影篩檢。對於乳房攝影篩檢還是有助於婦女們早期診斷並得到早期治療。
關鍵字: 乳癌 、乳房攝影、BI-RADS

Purposes:
This study is aimed to analyze the project for female mammography screening once every two years which is provided by National Health Administration as well as to evaluate the risk factors related to other breast cancer through the method of BI-RADS classification results and observation.
Materials & Methods:
The study included 4548 females who participated in the project of mammography screening which is provided by National Health Administration from Jan. 2009 to Dec. 2010. Their screened images were classified by the BI-RADS and were confirmed for the diagnosis of breast cancer by the way of biopsy from suspected lesion of breast cancer.Risk factors related to breast cancer were recorded based on clinical records, and logistic regression analytical method was used to analyze risk factors related to breast cancer. In addition, indicators for self-rating scale on mammography screening were used to evaluate reading ability of doctors.
Results:
The study included 4548 females with mean age of 55±6.5, in which, the ages of 24 females were younger than 45(0.5%), 2465 females were aged within 45-55(54.2%) and the ages of 2061 females were older than 55(45.3%); Of them, the BI-RADS grading results are: BI-RADS 0: 527(11.6%), BI-RADS 1:2228(49%), BI-RADS 2:1750(38.5%), BI-RADS 3:4(0.1%), BI-RADS 4:36(0.8%), and BI-RADS 5:3(0.1%). The recall rate and revisit rate of BI-RADS 0 were 94.7% and 12.4% respectively. 93 (2.04%) females were suspected to be abnormal and 37(0.81%) females were confirmed to have the breast cancer by the diagnosis. The odds ratio(OR) in risk factors related to breast cancer of females with educational level above secondary college or senior high school were 0.22 times than those of lower educational level (p<0.05). OR of women with family history of breast cancer was 2.1 times higher than those without history of diseases (p<0.05).
Conclusion:
In this study, 37 females were confirmed as suffered from breast cancer by the screening, and the groups with higher educational level and family history of breast cancer were the high risk group of breast cancer. Given that early and effective diagnosis of breast cancer, it was suggested for these high risk women to have the screening of mammography on a regular basis. Screening of mammography is also indeed helpful for females to have the early diagnosis and treatment.
Keywords: Breast cancer、Mammography、BI-RADS

中文摘要 I
ABSTRACT II
致謝詞 III
目錄 IV
圖目錄 VI
表目錄 VII
第一章 緒論 1
1.1 前言 1
1.2 研究背景 2
1.3 文獻回顧 3
1.4 研究目的 6
第二章 基礎理論 8
2.1 乳房的構造 8
2.2 乳癌的介紹 9
2.3 乳癌的危險因子 11
2.4 乳房X光攝影 12
2.5 乳房攝影影像判讀系統 13
2.6 乳房攝影篩檢自我評量指標 16
第三章 材料與方法 18
3.1 研究樣本 18
3.2 相關風險因子收集 18
3.3 乳房攝影方式 19
3.4 影像結果判讀方式 21
3.5 統計方法 22
3.6 實驗架構 22
第四章 結果 24
4.1 研究對象 24
4.2 乳房攝影影像結果 26
4.3 乳癌相關危險因子評估 28
4.4 乳房攝影篩檢自我評量指標 29
第五章 討論 32
5.1 研究對象的探討 32
5.2 乳房攝影影像結果的探討 33
5.3 乳癌相關危險因子評估的探討 34
5.4 乳房攝影篩檢自我評量指標的探討 35
第六章 結論 38
6.1 結論 38
6.2 未來展望 38
參考文獻 39
附錄一、人體試驗委員會證書 42
附錄二、個案臨床調查表 43


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