Arch Inter Med：避免不必要的医学成像可降低女性患乳腺癌风险

来自美国医学研究所（IOM）的研究揭示了乳腺癌潜在的环境风险因子，包括农药、美妆、家用化学品以及制作水杯的塑料等，IOM表示，目前并没有充足的数据可以揭示暴露于这些风险因子中一定会引发乳腺癌。然而可以增加妇女绝经后激素替代疗法的风险以及接受医学成像暴露辐射的风险。

如今一项刊登在国际著名杂志Archives of Internal Medicine上的研究报告指出IOM的报告中乳腺癌与医学成像有关，并且给出建议如何降低这种风险。研究者表示避免不必要的医学成像可以降低乳腺癌风险。

女性应当知道要问自己的医生

当CT扫描和其他形式的医学成像具有医学革命性标志而且可以及时挽救患者生命的时候，女性患者必须参与到医生做出的任何医学诊断决定中，并且强调所有进行的辐射扫描对其的安全性和必要性。

她们必须理解风险和益处，并且让医生清楚地解释这种风险和益处。比如问一下问题：1）这种扫描是否完全必要？2）是否一定要做？3）如何做才能使得风险更小等等。（生物谷Bioon.com）

编译自：Breast Cancer Risk Can Be Lowered by Avoiding Unnecessary Medical Imaging

编译者：T.Shen

doi:10.1001/archinternmed.2012.2329
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Environmental Causes of Breast Cancer and Radiation From Medical Imaging

Rebecca Smith-Bindman, MD

Susan G. Komen for the Cure asked the Institute of Medicine (IOM) to perform a comprehensive review of environmental causes and risk factors for breast cancer. Interestingly, none of the consumer products (ie, bisphenol A, phthalates), industrial chemicals (ie, benzene, ethylene oxide), or pesticides (ie, DDT/DDE) considered could be conclusively linked to an increased risk of breast cancer, although the IOM acknowledged that the available evidence was insufficient to draw firm conclusions for many of these exposures, calling for more research in these areas. The IOM found sufficient evidence to conclude that the 2 environmental factors most strongly associated with breast cancer were exposure to ionizing radiation and to combined postmenopausal hormone therapy. The IOM's conclusion of a causal relation between radiation exposure and cancer is consistent with a large and varied literature showing that exposure to radiation in the same range as used for computed tomography will increase the risk of cancer. It is the responsibility of individual health care providers who order medical imaging to understand and weigh the risk of any medical procedures against the expected benefit. Susan G. Komen for the Cure, the largest grassroots network of breast cancer survivors and activists in the United States, asked the Institute of Medicine (IOM) to perform a comprehensive and evidence-based review of environmental causes and risk factors for breast cancer, with a focus on identifying evidence-based actions that women can take to reduce their risk.1 Environmental exposures were defined broadly to include all factors not genetically inherited, and the IOM committee appointed to write this report included academicians and chairs from departments of environmental health, toxicology, cancer epidemiology, preventive medicine, and biostatistics in addition to advocates for patients with breast cancer. Committee members conducted their own reviews of the peer-reviewed epidemiological and basic science literature, commissioned several papers specifically for their report, and drew on evidence-based reviews already completed by organizations such as the Agency for Research on Cancer and the World Cancer Research Fund International. The publication Breast Cancer and the Environment: A Life Course Approach was released online in December 2011.1