一位 50 歲女性詢問護理師關於篩檢性乳房攝影的建議頻率。根據現行針對一般風險族群的健康促進指南，護理師最恰當的回答為何？
A 50-year-old female client asks the nurse about the recommended frequency for a screening mammogram. According to current health promotion guidelines for a client at average risk, which response by the nurse is most appropriate?
- AScreening should be done every 3 years starting at age 50.應從 50 歲開始每 3 年進行一次篩檢。
- BA mammogram is only necessary if you find a lump during self-examination.只有在自我檢查發現腫塊時才需要乳房攝影。
- CYou should have a mammogram performed every year.✓ 正解您應該每年接受一次乳房攝影檢查。
- DYou only need a mammogram if you have a first-degree relative with breast cancer.只有當您有一等親乳癌病史時才需要乳房攝影。
乳癌篩檢的核心概念是早期發現以降低死亡率。根據美國癌症協會 (ACS) 與多數主流臨床指引，45 至 54 歲的一般風險女性應每年接受一次乳房攝影。55 歲以後可選擇改為每兩年一次或維持每年一次。本題正確答案為 C，因為它符合 50 歲女性的標準預防性照護路徑。選項 B 是錯誤的，篩檢的目的就是在症狀出現前（無腫塊時）發現病灶；選項 A 的三年間隔太長，會增加漏掉早期病變的風險；選項 D 錯誤，因為乳癌篩檢是針對全民，而非僅限於有家族史的高風險群。護理師在進行健康衛教時，應強調篩檢的預防價值而非僅作為診斷工具。
The core concept of breast cancer screening is early detection to reduce mortality. According to the American Cancer Society (ACS) and most mainstream clinical guidelines, women aged 45 to 54 at average risk should have annual mammograms. From age 55 onward, women may either continue annual screening or change to every two years. The correct answer for this item is A, because it aligns with the standard preventive care pathway for a 50-year-old woman. Option B is incorrect because the purpose of screening is to detect lesions before symptoms (such as lumps) appear; option A with a three-year interval is too long and increases the risk of missing early lesions; option D is incorrect because breast cancer screening is recommended for the general population, not only those with a family history. When providing health education, the nurse should emphasize the preventive value of screening rather than treating it merely as a diagnostic tool.
在美國，篩檢指引較多元（如 ACS 與 USPSTF 有微小差異），且多依賴私人保險或 Medicare 支付；在台灣，國民健康署提供 45-69 歲女性每兩年一次免費乳房攝影，若有二等親家族史則提前至 40 歲。護理師在台灣執業時，應多強調國健署的補助政策以提高篩檢意願。