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中华乳腺病杂志(电子版) ›› 2025, Vol. 19 ›› Issue (06) : 321 -330. doi: 10.3877/cma.j.issn.1674-0807.2025.06.001

所属专题: 指南共识

指南与共识

乳腺癌新辅助治疗的疗效预测和疗效评价专家共识(2025版)
深圳市医学会乳腺病学分会, 深圳市医学会肿瘤学分会, 深圳市医师协会乳腺专科医师分会, 深圳市健康管理协会乳房健康与康复管理专业委员会, 深圳市抗癌协会乳腺癌专业委员会, 深圳市抗癌协会肿瘤放射治疗专业委员会, 深圳市中西医结合学会甲状腺乳腺病专业委员会   
  • 收稿日期:2025-10-11 出版日期:2025-12-01
  • 基金资助:
    深圳市医疗卫生三名工程项目(SZSM202211036); 深圳市第二人民医院临床研究项目(2023yjlcyj001)

Expert consensus on efficacy prediction and evaluation of neoadjuvant therapy for breast cancer (2025 edition)

Breast Disease Branch of Shenzhen Medical Association, Tumor Branch of Shenzhen Medical Association, Breast Specialist Physicians Branch of Shenzhen Medical Doctor Association, Breast Health and Rehabilitation Management Committee of Shenzhen Health Management Association, Breast Cancer Committee of Shenzhen Anti-Cancer Association, Tumor Radiation Therapy Committee of Shenzhen Anti-Cancer Association, Thyroid and Breast Diseases Committee of Shenzhen Integrated Traditional Chinese and Western Medicine Association   

  • Received:2025-10-11 Published:2025-12-01
引用本文:

深圳市医学会乳腺病学分会, 深圳市医学会肿瘤学分会, 深圳市医师协会乳腺专科医师分会, 深圳市健康管理协会乳房健康与康复管理专业委员会, 深圳市抗癌协会乳腺癌专业委员会, 深圳市抗癌协会肿瘤放射治疗专业委员会, 深圳市中西医结合学会甲状腺乳腺病专业委员会. 乳腺癌新辅助治疗的疗效预测和疗效评价专家共识(2025版)[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(06): 321-330.

Breast Disease Branch of Shenzhen Medical Association, Tumor Branch of Shenzhen Medical Association, Breast Specialist Physicians Branch of Shenzhen Medical Doctor Association, Breast Health and Rehabilitation Management Committee of Shenzhen Health Management Association, Breast Cancer Committee of Shenzhen Anti-Cancer Association, Tumor Radiation Therapy Committee of Shenzhen Anti-Cancer Association, Thyroid and Breast Diseases Committee of Shenzhen Integrated Traditional Chinese and Western Medicine Association. Expert consensus on efficacy prediction and evaluation of neoadjuvant therapy for breast cancer (2025 edition)[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2025, 19(06): 321-330.

新辅助治疗在乳腺癌综合治疗中的重要性日益凸显,特别是在中国高比例局部晚期乳腺癌患者中。为明确乳腺癌新辅助治疗的疗效预测与疗效评估等关键概念及其在临床决策中的应用,多学科专家基于现有循证医学证据和临床实践,通过系统文献回顾与专家意见相结合的方法制订本共识,提出了“疗效预测—动态评估—综合评价”的三维框架,构建多维度评估体系,包含临床、影像学、病理学和分子生物学等多维信息,并强调根据乳腺癌分子亚型实施个体化监测策略。具体内容包括:(1)治疗前全面基线评估与疗效预测方法;(2)治疗中动态监测与治疗调整原则;(3)治疗后疗效评估与辅助决策依据;(4)分子亚型特异性评估策略及长期随访要点;(5)特殊亚型和特殊人群的个体化评估方案。本共识旨在为临床医师提供规范化、标准化的指导,助力乳腺癌新辅助治疗的精准化管理,提高疗效,改善患者预后。

Neoadjuvant therapy becomes increasingly important in comprehensive treatment of breast cancer, especially in locally advanced patients who have a high proportion in China. This consensus, developed by a multidisciplinary expert panel, based on existing evidence-based medical evidence and clinical practice, clarifies key concepts such as efficacy prediction and evaluation of breast cancer neoadjuvant therapy and their application in clinical decision-making through a systematic literature review combined with expert opinions. The consensus proposes a three-dimensional framework of efficacy prediction-dynamic evaluation-comprehensive evaluation, establishes a multidimensional assessment system that incorporates clinical, imaging, pathological and molecular biological information, and emphasizes the implementation of individualized monitoring strategies based on molecular subtypes of breast cancer. The contents include: (1) comprehensive baseline assessment and efficacy prediction methods before treatment; (2) principles of dynamic monitoring and treatment adjustment during treatment; (3) evaluation of therapeutic efficacy and assistance in decision-making; (4) molecular subtype-specific evaluation strategies and key points for long-term follow-up; (5) individualized evaluation protocols for special subtypes and special populations. This consensus aims to provide clinicians with standardized and normalized guidance to facilitate the precision management of breast cancer neoadjuvant therapy, improve efficacy, and enhance patient outcomes.

表1 疗效预测和疗效评估的主要区别
表2 预测因子和预后因子的主要区别
表3 疗效评估和疗效评价的关键差异
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