— 健康促進與維護 · MEDIUM · MCQ —
一位有乳癌家族史的 40 歲個案詢問篩檢指引。護理師應提供哪些資訊？
A 40-year-old client with a family history of breast cancer asks about screening guidelines. What information should the nurse provide?
- AMammograms should begin at age 50 regardless of family history無論家族史為何，乳房攝影檢查應從 50 歲開始
- BBreast self-exams have been proven to reduce mortality乳房自我檢查已被證明可降低死亡率
- CIndividualized risk assessment is needed due to family history✓ 正解由於家族史，需要個別化風險評估
- DClinical breast exams are no longer recommended at all不再建議進行臨床乳房檢查
— Explanation · 中文詳解 —
對於有家族史的個案，篩檢建議不能僅套用一般大眾標準，需根據家族遺傳風險（如 BRCA 突變）進行個別評估，可能需提早開始篩檢。A 選項錯誤，家族史常需提早；D 選項雖醫界有爭議，但未完全排除臨床評估；B 選項錯誤，目前證據顯示自我檢查無法有效降低乳癌死亡率，重點在於影像學檢查。
Clients with a family history of breast cancer require an individualized risk assessment to determine appropriate screening guidelines, as they may need to start mammograms earlier than the general population. Routine breast self-exams are no longer emphasized as they have not been proven to reduce mortality, and clinical breast exams remain part of comprehensive care depending on current guidelines.
✦ 台美臨床差異
美國針對高風險群有明確的追蹤指南（MRI 併用）；台灣目前政策推廣 45-69 歲免費篩檢，高風險群建議醫師諮詢。