Oncology Frontier: Dr. Anderson， because of income restraints， some of the therapy that we see in the more wealthy countries may not be implemented in those countries that struggle with resources. How do you address that problem?

　　《肿瘤瞭望》：由于经济收入方面的限制，富有国家中所应用的一些治疗方法可能无法在低收入国家中实现。您认为我们应如何解决这一问题？

　　Dr. Anderson: Breast cancer is the most common cancer among women around the globe and it is the most likely reason that a woman will die from cancer. It is an increasing problem in low and middle income countries， actually today the majority of cases are occurring in low and middle income countries， and the majority of deaths are also occurring in this area. This is really quite an important question for countries around the world and in particular in China， where breast cancer rates may be raising as high as 5% per year. The way in which we address breast cancer is by building systems that manage this in a sequential way. You reference treatment， treatment is a component of what makes this functional. First you have to find the cancer at an early stage， you have to find out when it is before it has become advanced disease. You have to prove its cancer and then you need appropriate multimodality therapy. If the disease is very late at the point of which it is found and we tend not to do as well， we do poorly with outcomes from treatment. Of course we do need to make the treatments available to women once the cancer is found. The issues for a country like China would be establishing systems where by which woman are evaluated， where those most palpable lumps in the breast are not going to be cancer so you have to find a diagnostic system that helps you sort that out， and then once cancer is diagnosed which is by needle sampling， then it is a combination of surgery， radiotherapy， and drug therapy that minimizes the chances of cancer’s recurrence.

　　Anderson教授：乳腺癌是全球最常见的女性癌症，是女性癌症死亡的最常见原因。目前，中低收入国家的乳腺癌正成为日益严重的问题，实际上今天大多数乳腺癌患者均出现于中低收入国家，且大多数死亡也发生于上述区域。因此，乳腺癌已成为世界各国尤其中国的重要健康问题。在中国，乳腺癌发病率正以每年5%的速度在增长。应对乳腺癌需要创立能够序贯管理乳腺癌的系统。治疗是一种重要手段。首先，我们需要做到癌症的早期识别，在其发展到晚期阶段前就发现并确诊；然后需进行适当的多学科综合治疗。如果癌症被发现时已经处于晚期阶段，我们则无法很好地进行治疗，治疗预后通常较差。当然一旦发现女性患有乳腺癌时，我们需要提供适合的治疗措施。对中国这样的国家而言，则需建立一个能够实现对女性进行评估系统。鉴于通过该系统评估的大多数乳腺中扪及的肿块不都是癌症，还需一个有助于鉴别诊断的诊断系统。一旦细针穿刺采样确诊癌症后，则需采用外科手术、放射治疗、药物治疗行综合治疗，最大限度降低乳腺癌复发可能。

　　Oncology Frontier: You mention a startling statistic that Chinese breast cancer rate may be raising by 5%. That is significant and is there any understanding why that is happening?

　　《肿瘤瞭望》：您刚刚提到一个非常令人吃惊的统计数据，那就是中国乳腺癌发病率每年以5%的速度在增长。该增长速度非常迅猛，您认为原因是什么？

　　Dr. Anderson: It is probably not that there’s something terrible that the Chinese women are doing or having done to them， it is probably actually an element of the raising economy and raising access to healthcare， so when there is prevalence of breast cancer in any region， and particularly in countries which are accelerating quickly， which China is， and when healthcare access is becoming rapidly more available， that is when we see these elements raise. According to international statistics， survival in breast cancer is higher in China than it is in other countries of similar economic means. For reasons that I do not entirely understanding， it may be that healthcare in general is being addressed， it may be because there is an averaging between the regions and the countries that have more limited resources versus the cities where they have become modern quite quickly – this is like Shanghai and Beijing. The bottom line is that I think China is addressing the question and issues remain about how they should specifically adapt their system to this rapidly raising problem.

　　Anderson教授：其实，情况并没有那么可怕。这很可能是中国经济快速增长，人们获取医疗保健途径增加的结果。因此，在任何有乳腺癌发病的地区，尤其经济快速发展的国家如中国，医疗资源正日益快速变得能为公众所用，因此乳腺癌的发病不断增加也就不足为奇。据国际统计数据显示，与经济发展程度相当的其他国家相比，中国乳腺癌生存期更长。至于其原因，我现在也不完全了解，有可能与公众普遍更加注重医疗保健有关，可能与“相对更现代化的快节奏大城市如上海及北京相比，资源有限地区与国家存在差异”有关。我认为，中国现在正在努力解决乳腺癌问题，但仍需面临如何让医疗系统适应乳腺癌快速增长的问题。