Breastlight：乳癌自检仪真能预防癌症吗？-英语点津

Breastlight: Cancer early warning or false reassurance?

拿一个大个儿“手电筒”，对准乳房照一照，就能看出可疑的乳腺癌“黑点”部位，这样方便的乳腺癌自检仪对广大女性来说可真是福音。专家指出，虽然检测有效率最高可达96%，但我们不能盲目依赖自检仪的检测结果，用自检仪给自己提个醒儿，发现不适之后去医院照X光片才是最靠谱的。

The pros and cons of the new Breastlight, a hand-held device for self-examination.

A powerful torch with a bright-red beam, shown to be effective in detecting malignant breast tumours – could be the answer to anyone worried about the effectiveness of self-examination.

The Breastlight, a hand-held device which emits a safe, LED-powered light, picked up 67 per cent of malignant tumours in a trial conducted at Sunderland City Hospital, which is due to be published this year. A previous trial was conducted in Ghana by a charity which has been using Breastlight as part of their screening process when examining women in rural areas. The results were published last year at the 2nd Annual African Breast Cancer Conference in Cairo, Egypt, and reported a success rate of 96 per cent. Mammographies typically pick up between 60 and 85 per cent of cancers. The torch can even spot tiny lumps – as small as 7mm – which are not considered large enough to be felt during a physical examination.

Doctors do not expect the torch to be used in hospitals – instead, the Breastlight may be ideal for thousands of women who are uncomfortable about performing monthly breast checks. It could also offer reassurance to those aged below 50 who are not eligible for the national breast screening programme.

According to Dr Sarah Burnett, consultant radiologist at King Edward VII Hospital, London, a Breastlight is not a substitute for a mammography, but it is a useful resource. "It works by shining a light through breast tissue," she explains. "The red light illuminates the red blood cells so that they appear black. Practically, it means you can see all the blood vessels in the breast clearly, like a road map."

"When a tumour takes hold in the breast, a new blood vessel grows to feed it. The Breastlight would show that up as a dark patch long before you could feel it as a lump through the skin."

The user stands in a darkened room, holding the torch underneath and to the side of their breast, against the skin. The beam lights up the tissue which appears red, so you can see the network of blood vessels (which appear black) that spread through the breast very clearly. In a healthy breast, these look like slender, wiggly lines – and every woman will have a different number. A tumour would show up as a dark spot or area attached to a blood vessel. You don't need to remember how your breast looks each month; just to watch out for dark patches attached to blood vessels.

Janette Shephard, a 38-year-old beauty therapist from Hertfordshire, found using the Breastlight much easier than performing a self-examination. "You're advised to get to know your own breasts," she says. "But I've always found it confusing. I never really knew what I was supposed to be feeling for."

A nurse friend offered her a Breastlight in April 2008. Janette says: "Three months after I first tried it, I found two new dark patches on my right breast. I couldn't feel anything. But I didn't panic. I knew that even if they were cancerous, they would have been caught early. Everyone around me was worrying, though."

Janette went to her GP, who could feel two lumps, and referred her to the Queen Elizabeth II hospital in Welwyn Garden City.

Here, a consultant suggested a mammogram and an ultrasound. Like all women under 50, Janette has dense breast tissue which can make mammograms less effective; in this case, ultrasounds offer a better result. Afterwards, she was told that the lumps looked benign, but to be vigilant in case they changed.

"I've used the Breastlight for that," she says, "and it's been reassuring to see the lumps actually shrinking."

Critics would argue that Janette had worried unnecessarily, and that the Breastlight encourages anxiety and needless examinations. The Scottish Breast Cancer Campaign, an independent voluntary group, has said it is "completely unconvinced about the efficacy" of the device. In a letter to Boots – asking the pharmacy not to sell the device – it said: "It could cause unnecessary distress if 'shadows' were misinterpreted."

Dr Lesley Walker, director of cancer information at Cancer Research UK, agrees that women should not rely on Breastlight. She said: "There is no clear evidence to show this sort of home-testing kit could reliably detect breast cancer. There's a danger that use of the device could leave some women with increased levels of anxiety and others with false reassurance."

Dr Burnett, herself a breast cancer survivor, does not agree. "I don't think I know any doctors who are good at self-examination, let alone patients. And if you can see something before you can even feel a lump, that has to be a good thing. The light may be anxiety-provoking for a very few, but for most it is reassuring. So far, women do not seem to be over-relying on it, with many using it as an additional tool in their monthly checks."

Figures from the Sunderland City Hospital study back this up. According to breast-cancer nurses, 88 per cent of women were "confident" in the Breastlight, and 84 per cent found it easy to use.

Where it really scores for Dr Burnett is in its potential for the under 50s – "younger women get more aggressive tumours than older women, yet there is no screening for them. These need to be picked up and seen as early as possible."