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乳がん検診で、マンモグラフィー(乳房X線撮影)だけを行い、乳房を見て触る視触診を省くと、がんを見落とす心配があることが東北大の研究でわかった。
乳がん検診の視触診とはどういったことを行うのか。公益財団法人日本対がん協会によると、次の通りである。
医師が目で乳房を観察してくぼみがないか、手で触れてしこりがないか、リンパ節が腫れていないか、乳頭から分泌物がないかなどを観察します。触診で発見できるものは、ある程度の大きさになったしこりです。しこりがすべて乳がんというわけではありませんが、視触診だけに頼っていると、しこりが乳がんであった場合、ある程度の大きさにならないと発見できない可能性があります。検診としての目的を達成できません。（日本対がん協会「乳がんの検診について」）
乳がん検診には、視触診、マンモグラフィー検査、超音波検査などがある。視触診は、見て触ってしこりを見つけることでがんを発見できるメリットがあるが、最近は視触診が行われない傾向が強いという。その理由について、朝日新聞は次のように報じている。
国は指針で原則、併用検診を勧めているが、医師不足などを理由に視触診を廃止する市町村が相次いでいる。研究チームは「やむを得ず、視触診を廃止や縮小するなら、年代を考慮すべきだ」と訴えている。（朝日新聞 2013/06/21 05:01）
なぜ視触診が必要なのか。検診の対象で比較的若い40代は乳腺の密度が高く、X線画像が真っ白にうつるため、画像だけでの判定が難しいからだ。視触診、マンモグラフィー、超音波などの検診を組み合わせることが、それぞれのデメリットを補うことになりそうだ。
5月には、女優のアンジェリーナ・ジョリーが遺伝性のがんを予防するために両乳房の切除手術を行ったことを明らかにした。乳がんを予防、早期発見するための議論や取り組みが今後も増えていくことが期待される。
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Celebrities With Breast Cancer
Maura Tierney(01 of11)
Tierney was diagnosed with breast cancer in 2009, but she didn\'t open up publicly about it until earlier this year. \"I remember thinking, \'I\'m so young, this can\'t be happening,\'\" she told People magazine.\n\n\"In 2009, I was diagnosed with breast cancer and found out I would need chemotherapy,\" she said in a video for the Chemotherapy Myths Or Facts campaign. \"I asked myself all these questions and was utterly terrified, not just because of the cancer diagnosis, but the fear of chemo itself.\"\n\nAnd that sense of the unknown is what triggered Tierney, whose cancer was found in its early stages, to sign up as a spokesperson for the campaign. \"It\'s important that you feel educated and confident during this time,\" she said in her introductory video. (credit:Getty Images)
Suzanne Somers(02 of11)
The \"Three\'s Company\" and \"Step By Step\" actress was first diagnosed with breast cancer in 2000. \"We were silent, hardly talking, in disbelief, like this can\'t be happening, wondering is this a little blip or the end of my life?\" she told People magazine in 2001, of hearing the news for the first time with her husband Alan Hamel.\n\nJust earlier this year -- more than a decade since her diagnosis -- Somers shared with People that she underwent an experimental breast reconstruction surgery, to repair the damage from a lumpectomy and radiation treatments. (credit:Getty)
Olivia Newton-John(03 of11)
The \"Grease\" star and singer was diagnosed with breast cancer in 1992 after feeling a lump in a self exam -- her treatment included surgery, chemotherapy, a radical mastectomy and reconstruction.\n\n\"When you\'re first diagnosed, people are pulling you in every direction: Do this! Do that! You really have to gather yourself, because you\'re the one who has to make the hard choices,\" she said in a Q&A on Susan G. Komen For The Cure\'s website. \"I researched a lot and felt satisfied with my course of treatment. It was sort of an East-meets-West approach.\"\n\nAnd that meant taking care of her whole body, not just the cancer.\n\n\"I did everything I could to take care of myself -- body, mind, and spirit,\" she told EverydayHealth.com. \"I look at my cancer journey as a gift: It made me slow down and realize the important things in life and taught me to not sweat the small stuff.\" (credit:Getty Images)
Giuliana Rancic(04 of11)
The 36-year-old \"E! News\" host announced last October on NBC\'s Today show that she has breast cancer, and that she was alerted to the cancer via a mammogram during her third in vitro fertilization attempt.\n\n\"Through my attempt to get pregnant for the third time, we sadly found out that I have early stages of breast cancer,\" she said on the Today show. \"It\'s been a shock. A lot of people have been asking, we saw that you went and got IVF, are you pregnant? But sadly, we\'ve had to put that off.\"\n\nRancic underwent a double lumpectomy and removal of several of her lymph nodes, but she later went on the TODAY show last December to say that the cancer was not completely cleared by those treatments and that she will undergo a double mastectomy. \n\nThis year, Rancic finally got her happy ending, with the birth of son Edward Duke via gestational surrogate on August 29. (credit:Getty)
Wanda Sykes(05 of11)
In a 2011 interview with Ellen DeGeneres, Wanda Sykes revealed that she had been diagnosed with breast cancer and underwent a double mastectomy.\n\n\"I had breast cancer. Yeah, I know it\'s scary,\" Sykes said in the interview. \"This was in February. I went for the reduction. I had real big boobs and I just got tired of knocking over stuff. Every time I eat ... Oh lord. I\'d carry a Tide stick everywhere I go. My back was sore so it was time to have a reduction.\"\n\nAfter the reduction, the pathology report found ductal carcinoma in situ in her left breast, which prompted Skykes, who has a family history of breast cancer, to opt for a double mastectomy.\n\nAnd while the diagnosis is scary, she hasn\'t lost her signature humor.\n\n\"I was like, \'I don\'t know, should I talk about it or what?\' How many things could I have? I\'m black, then lesbian. I can\'t be the poster child for everything ... At least with the LGBT issues we get a parade, we get a float, it\'s a party. [But] I was real hesitant about doing this, because I hate walking. I got a lot of [cancer] walks coming up.\"
Christina Applegate(06 of11)
In 2008, actress Christina Applegate shared in a \"Good Morning America\" interview that she had been diagnosed with breast cancer at the age of 36 -- she opted for a bilateral mastectomy instead of radiation or chemotherapy.\n\n \"I didn\'t want to go back to the doctors every four months for testing and squishing and everything. I just wanted to kind of get rid of this whole thing for me. This was the choice that I made and it was a tough one,\" she said in the interview. \"Sometimes, you know, I cry. And sometimes I scream. And I get really angry. And I get really upset, you know, into wallowing in self-pity sometimes. And I think that it\'s all part of the healing.\"\n\nPerhaps the best healing of all came in 2011 when Applegate gave birth to baby Sadie with musician Martyn LeNoble. \n\n\"She\'s healed me in so many ways. She\'s just made my life so much better. I\'ve been kind of sad for a long time, and she\'s just opened my whole soul,\" Applegate told People in an exclusive interview in 2011. \n (credit:Getty)
Melissa Etheridge(07 of11)
In 2005, rock-and-roll artist Etheridge underwent a lumpectomy and five rounds of chemotherapy and radiation to eradicate her breast cancer. \n\n\"I had been running along in my life at a fast pace. When I heard it was cancer, I just stood still,\" Etheridge told Shape magazine in a 2009 interview. \"My life passed over me like a big wave, and after, I was left there standing. This turned out to be a very good thing. I stopped. I looked at my life, I looked at my body and spirit.\"\n\nIn the midst of her treatment, Etheridge found out she was nominated for a Grammy for her song \"Breathe\" -- and while she wasn\'t sure she\'d make an appearance at first, Etheridge ultimately decided not only to attend, but to perform in a Janis Joplin tribute. Taking to the stage bald and with no eyebrows -- a side-effect of the chemo -- she belted out Joplin\'s classic, \"Piece Of My Heart.\"\n\n\"It was very special that I had been presented with a day, that I could come back into this entertainment world, and show everyone that you are back and okay, and thought, okay,\" Etheridge told MSNBC at the time. \"I\'m going to do this. And I\'m not gonna be afraid of the truth. The truth is, yes I had cancer. Yes, I got it out of me. Yes, I went through chemotherapy. Yes, I\'m bald.\"\n\nCheck out Etheridge\'s breast cancer causes on her Pink Rage website.
Robin Roberts(08 of11)
ABC\'s \"Good Morning America\" co-host Robin Roberts was diagnosed with breast cancer in 2007.\n\n\"I never thought I\'d be writing this. ... I have breast cancer,\" she said in a message released by ABC in August 2007. While working on a tribute to her colleague Joel Siegel, who had died from cancer, Robins reported on how key early detection is -- and, taking her own advice, she did a self breast exam and found a lump. \"Much as I was hoping the doctor would say it was nothing, she did a biopsy and confirmed that the lump I\'d found was indeed an early form of breast cancer,\" Robins continued in her statement.\n\nRobins underwent a partial mastectomy, chemotherapy and radiation. \n\nIn 2008, she told People magazine that she complemented her regular doctor\'s visits with acupuncture, exercise and advice from a nutritionist. \"Yes, I am living with cancer,\" she told People. \"But don\'t go \'woe is me.\' I don\'t want it. Don\'t need it. I\'m still in the game. I don\'t want to say \'survivor.\' I want to thrive.\"\n\nEarlier this year, Roberts announced that she was diagnosed with a rare blood disorder called myelodysplastic syndrome. (credit:Getty)
Kylie Minogue(09 of11)
Australian singer Minogue was first diagnosed with breast cancer in May 2005 and underwent surgery and chemotherapy treatment.\n\n\"When you are stripped of everything and you have to grow your eyelashes back, grow your hair back, it\'s just astonishing,\" Minogue told British Glamour magazine. \"It\'s hard to express what I\'ve learned from that, but a deep psychological and emotional shift has obviously taken place.\"\n\nThis open and honest approach to her diagnosis led Minogue to be voted the most inspirational breast cancer celebrity in an online British-based poll, Reuters reports. (credit:Getty)
Sheryl Crow(10 of11)
Singer Sheryl Crow was diagnosed with breast cancer in 2006 and, thanks to early detection, underwent a minimally invasive surgery and seven weeks of radiation therapy.\n\nCrow told Health magazine that she saw a nutritionist when she was first diagnosed and began a diet full of fish, walnuts, colorful vegetables, fiber and healthy spices.\n\n\"I kept my breast cancer tattoos -- where the radiation was lined up on my chest,\" Crow told Health. \"Once in a while I look at it to remind myself that I have to put on my oxygen mask first before I put it on anybody else.\"\n\nToday, Crow is focused on spreading the message of early detection. In 2010, she founded the Sheryl Crow Center as part of the Pink Lotus Breast Center, which was founded by her own surgeon, ABC News reports.\n\nThis past June, Crow also revealed that she was diagnosed late last year with a benign brain tumor. (credit:Getty)
Cynthia Nixon(11 of11)
In 2008, the \"Sex and the City\" star went public with her cancer diagnosis, revealing that she found a lump in its early stages and had it removed through radiation, The Huffington Post reported at the time.\n\nNixon wrote in a 2008 Newsweek article that her mother was diagnosed with breast cancer twice -- the first time, Nixon was just 13.\n\n\"I feel like I have a very concrete story to tell. My story isn\'t just my story, it\'s mine and my mother\'s story,\" the Susan G. Komen for the Cure spokesperson has said. (credit:Getty)