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中华乳腺病杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 245 -250. doi: 10.3877/cma.j.issn.1674-0807.2026.04.007

综述

乳腺癌全程管理中的肿瘤心脏病风险识别与长期随访
曾成1,2, 高颖3, 王佳妮1, 马飞1,()   
  1. 1 100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院肿瘤内科
    2 100730 北京,北京医院(国家老年医学中心)肿瘤内科/老年疾病国家临床医学研究中心/国家卫生健康委老年医学重点实验室/中国医学科学院老年医学研究院
    3 310000 杭州,浙江大学医学院附属第二医院心血管内科/经血管植入器械全国重点实验室/浙江省心脏功能重建重点实验室
  • 收稿日期:2026-04-21 出版日期:2026-08-01
  • 通信作者: 马飞
  • 基金资助:
    国家自然科学基金重点项目(82230058)

Cardio-oncology risk identification and long-term follow-up in the whole-course management of breast cancer

Cheng Zeng, Ying Gao, Jiani Wang   

  • Received:2026-04-21 Published:2026-08-01
引用本文:

曾成, 高颖, 王佳妮, 马飞. 乳腺癌全程管理中的肿瘤心脏病风险识别与长期随访[J/OL]. 中华乳腺病杂志(电子版), 2026, 20(04): 245-250.

Cheng Zeng, Ying Gao, Jiani Wang. Cardio-oncology risk identification and long-term follow-up in the whole-course management of breast cancer[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2026, 20(04): 245-250.

随着乳腺癌早诊早治水平不断提高及系统治疗持续优化,患者长期生存显著改善,治疗相关心血管并发症已成为影响治疗连续性、长期预后和生活质量的重要因素。近年来,乳腺肿瘤心脏病学的关注重点由单一药物相关毒性的识别转向覆盖治疗前、治疗中及治疗后的全程管理。治疗前的管理重点在于识别需要心血管评估的高危人群,包括既往心血管疾病患者、合并多种心血管危险因素者,以及拟接受蒽环类、抗HER-2治疗、胸部放射治疗或免疫治疗的患者。治疗中影响抗肿瘤治疗连续性的心血管问题主要包括心功能下降、免疫治疗相关心肌炎及内分泌治疗相关心血管事件等。治疗后长期幸存者远期心力衰竭、心肌梗死等心血管事件与总体不良预后相关,提示肿瘤复发监测与心血管危险因素管理应同时纳入长期随访。本文整合国内外最新指南、共识与代表性文献,系统阐述乳腺癌全程管理中的肿瘤心脏病学问题,以期指导临床实践。

图1 乳腺肿瘤心脏病全程管理路径图 注:LVEF为左心室射血分数;GLS为整体纵向应变;BNP为B型利钠肽;NT-proBNP为N末端B型利钠肽原;ICI为免疫检查点抑制剂
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