切换至 "中华医学电子期刊资源库"

中华乳腺病杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 195 -200. doi: 10.3877/cma.j.issn.1674-0807.2021.04.001

所属专题: 总编推荐 文献 指南共识

专题笔谈

第4版《年轻女性乳腺癌国际共识指南》更新要点解读
林锦娜1, 刘强1,()   
  1. 1. 510289 广州,中山大学孙逸仙纪念医院乳腺肿瘤中心
  • 收稿日期:2020-12-01 出版日期:2021-09-08
  • 通信作者: 刘强

Interpretation of updates to the 4th international consensus guidelines for breast cancer in young women

Jinna Lin1, Qiang Liu1,()   

  1. 1. Breast Cancer Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510289, China
  • Received:2020-12-01 Published:2021-09-08
  • Corresponding author: Qiang Liu
引用本文:

林锦娜, 刘强. 第4版《年轻女性乳腺癌国际共识指南》更新要点解读[J]. 中华乳腺病杂志(电子版), 2021, 15(04): 195-200.

Jinna Lin, Qiang Liu. Interpretation of updates to the 4th international consensus guidelines for breast cancer in young women[J]. Chinese Journal of Breast Disease(Electronic Edition), 2021, 15(04): 195-200.

乳腺癌是中国女性最常见的恶性肿瘤,且患病率增长迅速。乳腺癌的治疗是以手术、放射治疗、化疗、内分泌治疗、生物治疗等多学科协作的综合治疗。随着循证证据的积累,乳腺癌的治疗理念和方法也逐渐更新,新辅助化疗的应用越来越广泛。2020年5月,欧洲肿瘤内科学会发布了第4版《年轻女性乳腺癌国际共识指南》(BCY4),笔者对BCY4中乳腺癌诊断、治疗及随访等内容的更新要点进行解读,以飨读者。

Breast cancer is the most common malignant tumor in Chinese women, and its prevalence is increasing rapidly. The treatment of breast cancer is comprehensive treatment of multidisciplinary cooperation including surgery, radiotherapy, chemotherapy, endocrine therapy and biological therapy. With accumulation of evidence-based practice, the treatment strategies and methods of breast cancer are gradually updated, and neoadjuvant chemotherapy is widely applied. In May 2020, the European Society for Medical Oncology issued the 4th international consensus guidelines for breast cancer in young women (BCY4). In this article, we interpreted the updates on breast cancer diagnosis, treatment and follow-up in the BCY4 so as to provide a reference for clinicians.

表1 《年轻女性乳腺癌国际共识指南》中证据等级和推荐等级的划分[1]
[1]
Paluch-Shimon S, Cardoso F, Partridge AH, et al. ESO-ESMO 4th international consensus guidelines for breast cancer in young women (BCY4) [J]. Ann Oncol, 2020, 31(6): 674-696.
[2]
Azim HA Jr, Brohée S, Peccatori FA, et al. Biology of breast cancer during pregnancy using genomic profiling[J]. Endocr Relat Cancer, 201421(4): 545-554.
[3]
Stephens PJ, Tarpey PS, Davies H, et al. The landscape of cancer genes and mutational processes in breast cancer[J]. Nature, 2012, 486(7403): 400-404.
[4]
Azim HA Jr, Nguyen B, Brohée S, et al. Genomic aberrations in young and elderly breast cancer patients [J]. BMC Med, 2015, 13: 266.
[5]
Liao S, Hartmaier RJ, McGuire KP, et al. The molecular landscape of premenopausal breast cancer[J]. Breast Cancer Res, 2015, 17: 104.
[6]
Pereira B, Chin SF, Rueda OM, et al. The somatic mutation profiles of 2,433 breast cancers refines their genomic and transcriptomic landscapes[J]. Nat Commun, 2016, 7: 11 479.
[7]
Azim HA Jr, Michiels S, Bedard PL, et al. Elucidating prognosis and biology of breast cancer arising in young women using gene expression profiling[J]. Clin Cancer Res, 2012, 18(5): 1341-1351.
[8]
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015[J]. CA Cancer J Clin, 201565(1):5-29.
[9]
Li N, Wang X, Zhang H, et al. Young male breast cancer, a small crowd, the survival, and prognosis? A population-based study[J]. Medicine (Baltimore), 2018, 97(40): e12686.
[10]
Heymann S, Delaloge S, Rahal A, et al. Radio-induced malignancies after breast cancer postoperative radiotherapy in patients with Li-Fraumeni syndrome[J]. Radiat Oncol, 2010, 5: 104.
[11]
Ashworth A, Kong W, Whelan T, et al. A population-based study of the fractionation of postlumpectomy breast radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2013, 86(1): 51-57.
[12]
Smith BD, Bellon JR, Blitzblau R, et al. Radiation therapy for the whole breast: executive summary of an American Society for Radiation Oncology (ASTRO) evidence-based guideline[J]. Pract Radiat Oncol, 2018, 8(3): 145-152.
[13]
Francis PA, Pagani O, Fleming GF, et al. Tailoring adjuvant endocrine therapy for premenopausal breast cancer[J]. N Engl J Med, 2018, 379(2): 122-137.
[14]
Pagani O, Francis PA, Fleming GF, et al. Absolute improvements in freedom from distant recurrence to tailor adjuvant endocrine therapies for premenopausal women: results from TEXT and SOFT[J]. J Clin Oncol, 2020, 38(12): 1293-1303.
[15]
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(2019年版)[J]. 中国癌症杂志2019, 29(8): 609-679.
[16]
中国抗癌协会乳腺癌专业委员会. 中国早期乳腺癌卵巢功能抑制临床应用专家共识(2018年版)[J].中国癌症杂志201828(11):871-880.
[17]
Regan MM, Walley BA, Francis PA, et al. Concurrent and sequential initiation of ovarian function suppression with chemotherapy in premenopausal women with endocrine-responsive early breast cancer: an exploratory analysis of TEXT and SOFT[J]. Ann Oncol, 2017, 28(9): 2225-2232.
[18]
Lambertini M, Moore HCF, Leonard RCF, et al. Gonadotropinreleasing hormone agonists during chemotherapy for preservation of ovarian function and fertility in premenopausal patients with early breast cancer: a systematic review and meta-analysis of individual patient-level data[J]. J Clin Oncol, 2018, 36(19): 1981-1990.
[19]
Chen H, Xiao L, Li J, et al. Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in premenopausal women[J]. Cochrane Database Syst Rev, 20193(3): CD008018.
[20]
Moore HC, Unger JM, Phillips KA, et al. Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy[J]. N Engl J Med, 2015, 372(10): 923-932.
[21]
Lambertini M, Ceppi M, Poggio F, et al. Ovarian suppression using luteinizing hormone-releasing hormone agonists during chemotherapy to preserve ovarian function and fertility of breast cancer patients: a meta-analysis of randomized studies[J]. Ann Oncol, 2015, 26(12): 2408-2419.
[22]
Pan H, Gray R, Braybrooke J, et al. 20-Year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years[J]. N Engl J Med, 2017377(19):1836-1846.
[23]
Davies C, Pan H, Godwin J, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial[J]. Lancet, 2013, 381(9869): 805-816.
[24]
Gray RG, Rea D, Handley K, et al. aTTom: long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6953 women with early breast cancer[J]. J Clin Oncol, 2013, 31(15 suppl): 5.
[25]
Cluze C, Rey D, Huiart L, et al. Adjuvant endocrine therapy with tamoxifen in young women with breast cancer: determinants of interruptions vary over time[J]. Ann Oncol, 2012, 23(4): 882-890.
[26]
Llarena NC, Estevez SL, Tucker SL, et al. Impact of fertility concerns on tamoxifen initiation and persistence[J]. J Natl Cancer Inst, 2015, 107(10): djv202.
[27]
Hershman DL, Shao T, Kushi LH, et al. Early discontinuation and nonadherence to adjuvant hormonal therapy are associated with increased mortality in women with breast cancer[J]. Breast Cancer Res Treat, 2011, 126(2): 529-537.
[28]
Murphy CC, Bartholomew LK, Carpentier MY, et al. Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review[J]. Breast Cancer Res Treat, 2012, 134(2): 459-478.
[29]
Boccardo F, Rubagotti A, Amoroso D, et al. Endocrinological and clinical evaluation of two depot formulations of leuprolide acetate in pre-and perimenopausal breast cancer patients[J]. Cancer Chemother Pharmacol, 1999, 43(6): 461-466.
[30]
Noguchi S, Kim HJ, Jesena A, et al. Phase 3, open-label, randomized study comparing 3-monthly with monthly goserelin in pre-menopausal women with estrogen receptor-positive advanced breast cancer [J]. Breast Cancer, 2016, 23(5): 771-779.
[31]
范蕾,YEH Yu-Chen, 杜芬,等. 中国绝经前激素受体阳性乳腺癌辅助内分泌治疗最小成本分析[J]. 中国药物经济学2020, 15(4):5-10.
[32]
Burstein HJ, Lacchetti C, Anderson H, et al. Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: American Society of Clinical Oncology clinical practice guideline update on ovarian suppression [J]. J Clin Oncol, 2016, 34(14): 1689-1701.
[33]
Yeo W, Ueno T, Lin CH, et al. Treating HR+/HER2- breast cancer in premenopausal asian women: Asian breast cancer cooperative group 2019 consensus and position on ovarian suppression [J]. Breast Cancer Res Treat, 2019, 177(3): 549-559.
[34]
Partridge AH, Gelber S, Piccart-Gebhart MJ, et al. Effect of age on breast cancer outcomes in women with human epidermal growth factor receptor 2-positive breast cancer: results from a herceptin adjuvant trial[J]. J Clin Oncol, 2013, 31(21): 2692-2698.
[35]
Earl HM, Hiller L, Vallier AL, et al. 6 versus 12 months of adjuvant trastuzumab for HER-2-positive early breast cancer (PERSEPHONE): 4-year disease-free survival results of a randomised phase 3 non-inferiority trial[J]. Lancet, 2019, 393(10 191): 2599-2612.
[36]
Inno A, Barni S, Ghidini A, et al. One year versus a shorter duration of adjuvant trastuzumab for HER-2-positive early breast cancer: a systematic review and meta-analysis[J]. Breast Cancer Res Treat, 2019, 173(2): 247-254.
[37]
Gianni L, Pienkowski T, Im YH, et al. 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER-2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial[J]. Lancet Oncol, 2016, 17(6):791-800.
[38]
von Minckwitz G, Procter M, de Azambuja E,et al. Adjuvant pertuzumab and trastuzumab in early HER-2-positive breast cancer[J]. N Engl J Med, 2017, 377(2): 122-131.
[39]
von Minckwitz G, Huang CS, Mano MS, et al. Trastuzumab emtansine for residual invasive HER-2-positive breast cancer[J]. N Engl J Med, 2019, 380(7): 617-628.
[40]
Martin M, Holmes FA, Ejlertsen B, et al. Neratinib after trastuzumab-based adjuvant therapy in HER-2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet Oncol, 2017, 18(12):1688-1700.
[41]
Robson M, Im SA, Senkus E, et al. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation[J]. N Engl J Med, 2017, 377(17):1700.
[42]
Litton JK, Rugo HS, Ettl J, et al. Talazoparib in patients with advanced breast cancer and a germline BRCA mutation[J]. N Engl J Med, 2018, 379(8): 753-763.
[43]
Heemskerk-Gerritsen BA, Rookus MA, Aalfs CM, et al. Improved overall survival after contralateral risk-reducing mastectomy in BRCA1/2 mutation carriers with a history of unilateral breast cancer: a prospective analysis[J]. Int J Cancer, 2015, 136(3): 668-677.
[44]
Metcalfe K, Gershman S, Ghadirian P, et al. Contralateral mastectomy and survival after breast cancer in carriers of BRCA1 and BRCA2 mutations: retrospective analysis[J]. BMJ, 2014, 348: g226.
[45]
Kiely BE, Jenkins MA, McKinley JM, et al. Contralateral risk-reducing mastectomy in BRCA1 and BRCA2 mutation carriers and other highrisk women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer (kConFab)[J]. Breast Cancer Res Treat, 2010, 120(3): 715-723.
[1] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 844-848.
[2] 唐玮, 何融泉, 黄素宁. 深度学习在乳腺癌影像诊疗和预后预测中的应用[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 323-328.
[3] 康夏, 田浩, 钱进, 高源, 缪洪明, 齐晓伟. 骨织素抑制破骨细胞分化改善肿瘤骨转移中骨溶解的机制研究[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 329-339.
[4] 衣晓丽, 胡沙沙, 张彦. HER-2低表达对乳腺癌新辅助治疗疗效及预后的影响[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 340-346.
[5] 施杰, 李云涛, 高海燕. 腋窝淋巴结阳性Luminal A型乳腺癌患者新辅助与辅助化疗的预后及影响因素分析[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 353-361.
[6] 伍秋苑, 陈佩贤, 邓裕华, 何添成, 周丹. 肠道微生物在乳腺癌中的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 362-365.
[7] 谭巧, 苏小涵, 侯令密, 黎君彦, 邓世山. 乳腺髓样癌的诊治进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 366-368.
[8] 周婉丽, 钱铮, 李喆. 槐耳在乳腺癌免疫治疗中的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 369-371.
[9] 熊倩, 罗凤. 乳腺癌患者术后康复现状与对策的研究进展[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 372-374.
[10] 杨小菁, 姜瑞瑞, 石玉香, 王静静, 李长天. 乳腺孤立性纤维性肿瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 375-377.
[11] 冯雪园, 韩萌萌, 马宁. 乳腺原发上皮样血管内皮瘤一例[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 378-380.
[12] 中华医学会骨科学分会关节外科学组, 广东省医学会骨质疏松和骨矿盐疾病分会, 广东省佛山市顺德区第三人民医院. 中国髋部脆性骨折术后抗骨质疏松药物临床干预指南(2023年版)[J]. 中华关节外科杂志(电子版), 2023, 17(06): 751-764.
[13] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[14] 李智铭, 郭晨明, 庄晓晨, 候雪琴, 高军喜. 早期乳腺癌超声造影定性及定量指标的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 639-643.
[15] 李晓阳, 刘柏隆, 周祥福. 大数据及人工智能对女性盆底功能障碍性疾病的诊断及风险预测[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 549-552.
阅读次数
全文


摘要