临床腋窝淋巴结阳性老年三阴性乳腺癌局部治疗策略
|
摘要
因老年乳腺癌患者多伴发基础疾病,在选择局部治疗方案时,除应考虑原发肿瘤本身因素外,还需评估患者重要器官功能及其对治疗的耐受能力。三阴性乳腺癌与其他亚型乳腺癌相比,主要表现为侵袭性强、预后不佳;而临床腋窝淋巴结阳性的老年三阴性乳腺癌患者,局部治疗的选择则更为棘手,对于此类特殊群体,尚需探索更为合理的个体化治疗方案。
Elderly patients with breast cancer are often involved in complicated comorbidities. Besides the primary tumor,when formulating effective local therapeutic plans,clinicians should also evaluate the function of important organs and tolerance of elderly patients to the treatment. Compared with other subtypes,triple negative breast cancer( TNBC) is mainly characterized by strong invasiveness and a poor prognosis. The choice of locoregional treatment is more difficult for elderly patients with TNBC and clinically positive axillary lymph nodes. For such a special group,more reasonable individualized treatments need to be explored.
Elderly patients with breast cancer are often involved in complicated comorbidities. Besides the primary tumor,when formulating effective local therapeutic plans,clinicians should also evaluate the function of important organs and tolerance of elderly patients to the treatment. Compared with other subtypes,triple negative breast cancer( TNBC) is mainly characterized by strong invasiveness and a poor prognosis. The choice of locoregional treatment is more difficult for elderly patients with TNBC and clinically positive axillary lymph nodes. For such a special group,more reasonable individualized treatments need to be explored.
引文
[1]Biganzoli L,Wildiers H,Oakman C,et al.Management of elderly patients with breast cancer:updated recommendations of the International Society of Geriatric Oncology(SIOG)and European Society of Breast Cancer Specialists(EUSOMA)[J].Lancet Oncol,2012,13:e148-e160.
[2]张萍,徐兵河,马飞,等.老年三阴性乳腺癌临床病理特征及预后分析[J].中国肿瘤临床与康复,2010,17:390-393.
[3]郑莹,吴春晓,张敏璐.乳腺癌在中国的流行状况和疾病特征[J].中国癌症杂志,2013,23:561-569.
[4]中国老年乳腺癌诊疗共识专家组.中国老年乳腺癌诊疗专家共识(2018版)[J].协和医学杂志,2018,9:196-201.
[5]Schonberg MA,Marcantonio ER,Li D,et al.Breast cancer among the oldest old:tumor characteristics,treatment choices,and survival[J].J Clin Oncol,2010,28:2038-2045.
[6]Jenkins EO,Deal AM,Anders CK,et al.Age-specific changes in intrinsic breast cancer subtypes:a focus on older women[J].Oncologist,2014,19:1076-1083.
[7]高静.老年三阴性乳腺癌的临床病理特征及治疗[J].国际肿瘤学杂志,2013,40:921-923.
[8]Karuturi M,Vanderwalde N,Muss H.Approach and Management of Breast Cancer in the Elderly[J].Clin Geriatr Med,2016,32:133-53.
[9]Ma CD,Zhou Q,Nie XQ,et al.Breast cancer in Chinese elderly women:Pathological and clinical characteristics and factors influencing treatment patterns[J].Crit Rev Oncol Hematol,2009,71:258-265.
[10]Jolly TA,Williams GR,Bushan S,et al.Adjuvant treatment for older women with invasive breast cancer[J].Womens Health,2016,12:129-146.
[11]张保宁,张慧明.老年人乳腺癌治疗的研究现状与展望[J].中华肿瘤杂志,2008,30:161-164.
[12]Sierink JC,Castro SMMD,Russell NS,et al.Treatment strategies in elderly breast cancer patients:Is there a need for surgery?[J].Breast,2014,23:793-798.
[13]Cortadellas T,Córdoba O,Gascón A,et al.Surgery improves survival in elderly with breast cancer.A study of465 patients in a single institution[J].Eur J Surg Oncol,2015,41:635-640.
[14]Carter SA,Lyons GR,Kuerer HM,et al.Operative and oncologic outcomes in 9861 patients with operable breast cancer:single-institution analysis of breast conservation with oncoplastic reconstruction[J].Ann Surg Oncol,2016,23:3190-3198.
[15]Swanick CW,Lei X,Xu Y,et al.Long-term Patient-Reported Outcomes in Older Breast Cancer Survivors:APopulation-Based Survey Study[J].Int J Radiat Oncol Biol Phys,2018,100:882.
[16]林燕,孙强,管珩,等.老年乳腺癌的手术方式选择[J].中国医学科学院学报,2012,34:605-608.
[17]Curigliano G,Burstein HJ,P Winer E,et al.De-escalating and escalating treatments for early-stage breast cancer:the St.Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017[J].Ann Oncol,2017,28:1700-1712.
[18]Qiu JD,Xue XY,Li R,et al.Clinicopathological features and prognosis of triple-negative breast cancer:a comparison between younger(<60)and elderly(≥60)patients[J].Eur J Cancer Care,2016,25:1065-1075.
[19]Chen QX,Wang XX,Lin PY,et al.The different outcomes between breast-conserving surgery and mastectomy in triplenegative breast cancer:a population-based study from the SEER 18 database[J].Oncotarget,2017,8:4773-4780.
[20]Angarita FA,Acuna SA,McCready DR,et al.Management of positive margins after initial lumpectomy in elderly women with breast cancer[J].Eur J Surg Oncol,2018,44:1048-1053.
[21]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2017版)[J].中国癌症杂志,2017,27:695-760.
[22]Shachar SS,Jolly TA,Jones E,et al.Management of Triple-Negative Breast Cancer in Older Patients:How Is It Different?[J].Oncology,2018,32:58-63.
[23]Kunkler IH,Williams LJ,Jack WJL,et al.Breastconserving surgery with or without irradiation in women aged65 years or older with early breast cancer(PRIME II):a randomised controlled trial[J].Lancet Oncol,2015,16:266-273.
[24]Hughes KS,Schnaper LA,Bellon JR,et al.Lumpectomy plus tamoxifen with or without irradiation in women age 70years or older with early breast cancer:long-term follow-up of CALGB 9343[J].J Clin Oncol,2013,31:2382.
[25]Haque W,Yuan DMK,Verma V,et al.Radiation therapy utilization and outcomes for older women with breast cancer:Impact of molecular subtype and tumor grade[J].Breast,2017,35:34-41.
[26]黄薇.放疗对老年早期乳腺癌预后的影响---基于SEER数据库的大样本回顾性研究[D].济南:山东大学,2018.
[27]王淑莲,李晔雄,宋永文,等.中高危老年乳腺癌患者改良根治术后放疗的意义[J].中华肿瘤杂志,2009,31:863-866.
[28]Horton JK,Jagsi R,Woodward WA,et al.Breast Cancer Biology:Clinical Implications for Breast Radiation Therapy[J].Int J Radiat Oncol Biol Phys,2018,100:23-37.
[29]Freedman RA,Foster JC,Seisler DK,et al.Accrual of older patients with breast cancer to alliance systemic therapy trials over time:protocol A151527[J].J Clin Oncol,2017,35:421.
[30]周斌,辛灵,程元甲,等.AJCC第8版乳腺癌预后分期重大更新及临床意义[J].协和医学杂志,2017,8:235-238.
[2]张萍,徐兵河,马飞,等.老年三阴性乳腺癌临床病理特征及预后分析[J].中国肿瘤临床与康复,2010,17:390-393.
[3]郑莹,吴春晓,张敏璐.乳腺癌在中国的流行状况和疾病特征[J].中国癌症杂志,2013,23:561-569.
[4]中国老年乳腺癌诊疗共识专家组.中国老年乳腺癌诊疗专家共识(2018版)[J].协和医学杂志,2018,9:196-201.
[5]Schonberg MA,Marcantonio ER,Li D,et al.Breast cancer among the oldest old:tumor characteristics,treatment choices,and survival[J].J Clin Oncol,2010,28:2038-2045.
[6]Jenkins EO,Deal AM,Anders CK,et al.Age-specific changes in intrinsic breast cancer subtypes:a focus on older women[J].Oncologist,2014,19:1076-1083.
[7]高静.老年三阴性乳腺癌的临床病理特征及治疗[J].国际肿瘤学杂志,2013,40:921-923.
[8]Karuturi M,Vanderwalde N,Muss H.Approach and Management of Breast Cancer in the Elderly[J].Clin Geriatr Med,2016,32:133-53.
[9]Ma CD,Zhou Q,Nie XQ,et al.Breast cancer in Chinese elderly women:Pathological and clinical characteristics and factors influencing treatment patterns[J].Crit Rev Oncol Hematol,2009,71:258-265.
[10]Jolly TA,Williams GR,Bushan S,et al.Adjuvant treatment for older women with invasive breast cancer[J].Womens Health,2016,12:129-146.
[11]张保宁,张慧明.老年人乳腺癌治疗的研究现状与展望[J].中华肿瘤杂志,2008,30:161-164.
[12]Sierink JC,Castro SMMD,Russell NS,et al.Treatment strategies in elderly breast cancer patients:Is there a need for surgery?[J].Breast,2014,23:793-798.
[13]Cortadellas T,Córdoba O,Gascón A,et al.Surgery improves survival in elderly with breast cancer.A study of465 patients in a single institution[J].Eur J Surg Oncol,2015,41:635-640.
[14]Carter SA,Lyons GR,Kuerer HM,et al.Operative and oncologic outcomes in 9861 patients with operable breast cancer:single-institution analysis of breast conservation with oncoplastic reconstruction[J].Ann Surg Oncol,2016,23:3190-3198.
[15]Swanick CW,Lei X,Xu Y,et al.Long-term Patient-Reported Outcomes in Older Breast Cancer Survivors:APopulation-Based Survey Study[J].Int J Radiat Oncol Biol Phys,2018,100:882.
[16]林燕,孙强,管珩,等.老年乳腺癌的手术方式选择[J].中国医学科学院学报,2012,34:605-608.
[17]Curigliano G,Burstein HJ,P Winer E,et al.De-escalating and escalating treatments for early-stage breast cancer:the St.Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017[J].Ann Oncol,2017,28:1700-1712.
[18]Qiu JD,Xue XY,Li R,et al.Clinicopathological features and prognosis of triple-negative breast cancer:a comparison between younger(<60)and elderly(≥60)patients[J].Eur J Cancer Care,2016,25:1065-1075.
[19]Chen QX,Wang XX,Lin PY,et al.The different outcomes between breast-conserving surgery and mastectomy in triplenegative breast cancer:a population-based study from the SEER 18 database[J].Oncotarget,2017,8:4773-4780.
[20]Angarita FA,Acuna SA,McCready DR,et al.Management of positive margins after initial lumpectomy in elderly women with breast cancer[J].Eur J Surg Oncol,2018,44:1048-1053.
[21]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2017版)[J].中国癌症杂志,2017,27:695-760.
[22]Shachar SS,Jolly TA,Jones E,et al.Management of Triple-Negative Breast Cancer in Older Patients:How Is It Different?[J].Oncology,2018,32:58-63.
[23]Kunkler IH,Williams LJ,Jack WJL,et al.Breastconserving surgery with or without irradiation in women aged65 years or older with early breast cancer(PRIME II):a randomised controlled trial[J].Lancet Oncol,2015,16:266-273.
[24]Hughes KS,Schnaper LA,Bellon JR,et al.Lumpectomy plus tamoxifen with or without irradiation in women age 70years or older with early breast cancer:long-term follow-up of CALGB 9343[J].J Clin Oncol,2013,31:2382.
[25]Haque W,Yuan DMK,Verma V,et al.Radiation therapy utilization and outcomes for older women with breast cancer:Impact of molecular subtype and tumor grade[J].Breast,2017,35:34-41.
[26]黄薇.放疗对老年早期乳腺癌预后的影响---基于SEER数据库的大样本回顾性研究[D].济南:山东大学,2018.
[27]王淑莲,李晔雄,宋永文,等.中高危老年乳腺癌患者改良根治术后放疗的意义[J].中华肿瘤杂志,2009,31:863-866.
[28]Horton JK,Jagsi R,Woodward WA,et al.Breast Cancer Biology:Clinical Implications for Breast Radiation Therapy[J].Int J Radiat Oncol Biol Phys,2018,100:23-37.
[29]Freedman RA,Foster JC,Seisler DK,et al.Accrual of older patients with breast cancer to alliance systemic therapy trials over time:protocol A151527[J].J Clin Oncol,2017,35:421.
[30]周斌,辛灵,程元甲,等.AJCC第8版乳腺癌预后分期重大更新及临床意义[J].协和医学杂志,2017,8:235-238.