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中华乳腺病杂志(电子版) ›› 2026, Vol. 20 ›› Issue (01) : 1 -8. doi: 10.3877/cma.j.issn.1674-0807.2026.01.001

指南与共识

无手术适应证乳腺癌消融治疗专家共识(2025版)
中华医学会超声医学分会, 中国研究型医院肿瘤介入治疗委员会, 中国妇幼保健协会乳腺保健专业委员会, 中华医学会肿瘤学分会乳腺癌专业委员会, 中国抗癌协会乳腺癌专业委员会, 中国人体健康科技促进会乳腺专业委员会   
  1. 1. 100853 北京,解放军总医院第五医学中心肿瘤医学部介入超声科
    2. 100853 北京,解放军总医院第一医学中心普外医学部
    3. 210006 南京,南京医科大学第一附属医院乳腺外科
  • 收稿日期:2025-10-29 出版日期:2026-02-01

Expert consensus on ablation therapy for non-surgical breast cancer candidates (2025 edition)

Ultrasonography Branch of Chinese Medical Association, Oncology Interventional Therapy Committee of Chinese Research Hospitals Association, Breast Health Professional Committee of China Maternal and Child Health Association, Breast Cancer Professional Committee of Oncology Branch of Chinese Medical Association, Breast Cancer Professional Committee of Chinese Anti-Cancer Association, Breast Professional Committee of China Human Health Science and Technology Promotion Association   

  1. 1. Senior Department of General Surgery, Chinese PLA General Hospital, Beijing 100853
    2. Department of Breast Surgery, First Affiliated Hospital of Nanjing Medical University
    3. Senior Department of Oncology, Chinese PLA General Hospital, Beijing 100853
  • Received:2025-10-29 Published:2026-02-01
引用本文:

中华医学会超声医学分会, 中国研究型医院肿瘤介入治疗委员会, 中国妇幼保健协会乳腺保健专业委员会, 中华医学会肿瘤学分会乳腺癌专业委员会, 中国抗癌协会乳腺癌专业委员会, 中国人体健康科技促进会乳腺专业委员会. 无手术适应证乳腺癌消融治疗专家共识(2025版)[J/OL]. 中华乳腺病杂志(电子版), 2026, 20(01): 1-8.

Ultrasonography Branch of Chinese Medical Association, Oncology Interventional Therapy Committee of Chinese Research Hospitals Association, Breast Health Professional Committee of China Maternal and Child Health Association, Breast Cancer Professional Committee of Oncology Branch of Chinese Medical Association, Breast Cancer Professional Committee of Chinese Anti-Cancer Association, Breast Professional Committee of China Human Health Science and Technology Promotion Association. Expert consensus on ablation therapy for non-surgical breast cancer candidates (2025 edition)[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2026, 20(01): 1-8.

手术切除是乳腺癌的首选局部治疗方式。部分患者因合并症多、高龄、乳腺癌局部进展、术后复发等原因无法进行外科手术切除或拒绝手术,导致肿瘤失控性生长继而增加远处转移风险。影像引导下消融治疗具有创伤小、易耐受及灭活精准、肿瘤复发可重复治疗、美容效果好、保留腺体外形及功能等优点,在多种早期实体肿瘤治疗中取得与手术相当的临床疗效。目前,消融治疗在乳腺癌患者中的应用逐年增加。本共识依据最新研究进展并结合我国临床实际情况对无手术适应证乳腺癌消融治疗流程、操作标准进行规范,以提高无手术适应证乳腺癌消融治疗的安全性和有效性。

Currently, surgical resection remains the primary local treatment for breast cancer. However, some breast cancer patients are unable to undergo or refuse surgical resection due to multiple comorbidities, advanced age, locally advanced disease, or fear of recurrence. Lack of treatment for the local breast cancer leads to a high risk of both uncontrolled local progression and distant metastasis. Image-guided ablation therapy demonstrates advantages such as minimal invasiveness, high tolerability, precise tumor inactivation, repeatability for recurrent tumors, excellent cosmetic outcomes without scars, and preservation of glandular structure and function. Compared with surgery, ablation therapy has achieved similar clinical efficacy in early stage solid tumors. In recent years, the application of ablation therapy in breast cancer has been steadily increasing. Based on the latest research progress and China's clinical practice, the expert consensus standardizes treatment protocols and procedures of ablation therapy, in order to enhance the safety and efficacy of ablation therapy for non-surgical breast cancer candidates.

表1 证据等级标准
表2 推荐强度
图1 “液体隔离”技术示意图 A图示侵犯皮肤但未破溃的乳腺癌癌灶;B图示侵犯皮肤且破溃的乳腺癌癌灶;C图示侵犯乳头乳晕复合体的乳腺癌病灶;D图示“液体隔离”技术在乳腺癌消融中应用的超声图像 注:红色箭头示超声下的水隔离区域
图2 “回拉”技术与功率变化示意图 A图示病灶深部为高功率消融(60/50 W); B图示病灶浅层为中等功率消融(30 W);C图示靠近皮肤处为低功率消融(20 W);D图示病灶根治性消融
图3 肿瘤消融治疗推荐流程图
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[15] 脊髓电刺激治疗卒中后偏瘫中国专家共识编写组, 中华医学会神经外科学分会功能神经外科学组, 中国研究型医院学会神经外科学专业委员会, 世界华人神经外科协会功能神经外科专业委员会, 北京医学会神经外科学分会功能神经外科专业组, 北京医学会神经外科学分会周围神经外科专业组. 脊髓电刺激治疗卒中后偏瘫中国专家共识(2025年)[J/OL]. 中华脑科疾病与康复杂志(电子版), 2026, 16(01): 8-18.
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