中国乳腺癌外科治疗现状和新趋势

李培 吴炅

李培, 吴炅. 中国乳腺癌外科治疗现状和新趋势[J]. 中国肿瘤临床, 2022, 49(22): 1151-1155. doi: 10.12354/j.issn.1000-8179.2022.20211751
引用本文: 李培, 吴炅. 中国乳腺癌外科治疗现状和新趋势[J]. 中国肿瘤临床, 2022, 49(22): 1151-1155. doi: 10.12354/j.issn.1000-8179.2022.20211751
Pei Li, Jiong Wu. Current status and new trends of surgical treatment for breast cancer in China[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(22): 1151-1155. doi: 10.12354/j.issn.1000-8179.2022.20211751
Citation: Pei Li, Jiong Wu. Current status and new trends of surgical treatment for breast cancer in China[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(22): 1151-1155. doi: 10.12354/j.issn.1000-8179.2022.20211751

中国乳腺癌外科治疗现状和新趋势

doi: 10.12354/j.issn.1000-8179.2022.20211751
详细信息
    作者简介:

    李培:专业方向为乳腺癌的临床治疗及基础转化研究

    通讯作者:

    吴炅 wujiong1122@vip.sina.com

Current status and new trends of surgical treatment for breast cancer in China

More Information
  • 摘要: 近三十年来,乳腺癌手术范围逐渐缩小,病死率亦逐步降低,在多学科协作背景下,乳腺癌外科治疗在“至简至臻”中逐步演变,出现很多里程碑式的进展,其中乳腺癌手术包括乳房术式的选择和区域淋巴结处理2大部分。本文将就国内外乳腺癌外科治疗的现状及未来乳腺癌外科治疗的趋势进行综述。

     

  • 表  1  原发病灶的处理策略

    研究pCR
    定义
    基线肿瘤
    T分期
    例数(例)活检技术假阴性率(%)
    Heil等[16]ypT0T1~450VAB25.9
    Taoulis等[17]ypT0T1~316686% VAB18.7
    14% CNB
    Lee等[15]ypT0/isT1~34050% VAB30.8
    50% CNB
    MICRA[18]ypT0/isT1~4167CNB37.0
    ypT0:原发病灶无恶性肿瘤;ypT0/is:原发病灶无恶性肿瘤或仅残存原位癌成分;VAB:真空辅助活检;CNB:空芯针
    下载: 导出CSV
  • [1] Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021[J]. CA Cancer J Clin, 2021, 71(1):7-33. doi: 10.3322/caac.21654
    [2] Zhu L, Yan Y, Tian L, et al. Investigation of the current situation of nipple-sparing mastectomy: A large multicenter study in china (csbrs-003)[J]. Chin Med J(Engl), 2021, 134(7):806-813.
    [3] Wu ZY, Kim HJ, Lee JW, et al. Breast cancer recurrence in the nipple-areola complex after nipple-sparing mastectomy with immediate breast reconstruction for invasive breast cancer[J]. JAMA Surg, 2019, 154(11):1030-1037. doi: 10.1001/jamasurg.2019.2959
    [4] Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer[J]. N Engl J Med, 2002, 347(16):1233-1241. doi: 10.1056/NEJMoa022152
    [5] Veronesi U, Saccozzi R, Del Vecchio M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast[J]. N Engl J Med, 1981, 305(1):6-11. doi: 10.1056/NEJM198107023050102
    [6] Agarwal S, Pappas L, Neumayer L, et al. Effect of breast conservation therapy vs. mastectomy on disease-specific survival for early-stage breast cancer[J]. JAMA Surg, 2014, 149(3):267-274. doi: 10.1001/jamasurg.2013.3049
    [7] Hartmann-Johnsen OJ, Kåresen R, Schlichting E, et al. Survival is better after breast conserving therapy than mastectomy for early stage breast cancer: A registry-based follow-up study of norwegian women primary operated between 1998 and 2008[J]. Ann Surg Oncol, 2015, 22(12):3836-3845. doi: 10.1245/s10434-015-4441-3
    [8] van Maaren MC, de Munck L, de Bock GH, et al. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the netherlands: A population-based study[J]. Lancet Oncol, 2016, 17(8):1158-1170. doi: 10.1016/S1470-2045(16)30067-5
    [9] de Boniface J, Szulkin R, Johansson ALV. Survival after breast conservation vs mastectomy adjusted for comorbidity and socioeconomic status: A swedish national 6-year follow-up of 48986 women[J]. JAMA Surg, 2021, 156(7):628-637. doi: 10.1001/jamasurg.2021.1438
    [10] Flanagan MR, Zabor EC, Romanoff A, et al. A comparison of patient-reported outcomes after breast-conserving surgery and mastectomy with implant breast reconstruction[J]. Ann Surg Oncol, 2019, 26(10):3133-3140. doi: 10.1245/s10434-019-07548-9
    [11] Yu LX, Shi P, Tian XS, et al. A multi-center investigation of breast-conserving surgery based on data from the chinese society of breast surgery (csbrs-005)[J]. Chin Med J (Engl), 2020, 133(22):2660-2664.
    [12] 郑舒月,苏永辉,郭瑢,等.2017年中国110家医院乳腺癌保乳手术的现况调查[J].中华普通外科杂志,2020,35(4):314-318. doi: 10.3760/cma.j.cn113855-20190827-00497
    [13] 中国抗癌协会乳腺癌专业委员会,中国医师协会外科医师分会乳腺外科医师委员会.保留乳房治疗专家共识(2020年版)[J].中国癌症杂志,2020,30(11):912-967.
    [14] 邵鼎轶,苏永辉,修秉虬,等.中国110家中心乳腺癌保乳整形技术现况调查分析[J].中国实用外科杂志,2019,39(11):1176-1180.
    [15] Lee HB, Han W, Kim SY, et al. Prediction of pathologic complete response using image-guided biopsy after neoadjuvant chemotherapy in breast cancer patients selected based on mri findings: A prospective feasibility trial[J]. Breast Cancer Res Treat, 2020, 182(1):97-105.
    [16] Heil J, Schaefgen B, Sinn P, et al. Can a pathological complete response of breast cancer after neoadjuvant chemotherapy be diagnosed by minimal invasive biopsy[J]? Eur JCancer, 2016, 69:142-150.
    [17] Tasoulis MK, Lee HB, Yang W, et al. Accuracy of post-neoadjuvant chemotherapy image-guided breast biopsy to predict residual cancer[J]. JAMA Surg, 2020, 155(12):e204103. doi: 10.1001/jamasurg.2020.4103
    [18] van Loevezijn AA, van der Noordaa ME, van Werkhoven ED, et al. Minimally invasive complete response assessment of the breast after neoadjuvant systemic therapy for early breast cancer (micra trial): Interim analysis of a multicenter observational cohort study[J]. Ann Surg Oncol, 2021, 28(6):3243-3253.
    [19] 修秉虬,郭瑢,杨犇龙,等.中国乳腺癌术后乳房重建手术横断面调查研究[J].中华肿瘤杂志,2019,41(7):546-551.
    [20] Bauder AR, Gross CP, Killelea BK, et al. The relationship between geographic access to plastic surgeons and breast reconstruction rates among women undergoing mastectomy for cancer[J]. Ann Plast Surg, 2017, 78(3):324-329.
    [21] 陈颖,陈嘉健,陈嘉莹,等.中国乳腺癌术后乳房重建现况调查报告[J].中华肿瘤杂志,2014,36(11):851-857. doi: 10.3760/cma.j.issn.0253-3766.2014.11.011
    [22] Li L, Su Y, Xiu B, et al. Comparison of prepectoral and subpectoral breast reconstruction after mastectomies: A systematic review andmeta analysis[J]. Eur J Surg Oncol, 2019, 45(9):1542-1550.
    [23] Wang J, Xiu B, Guo R, et al. Autologous tissue reconstruction after mastectomy-a cross-sectional survey of 110 hospitals in china[J]. Eur J Surg Oncol, 2020, 46(12):2202-2207. doi: 10.1016/j.ejso.2020.07.008
    [24] 李培,陈嘉健,吴炅.乳腺癌前哨淋巴结的研究热点与评价[J].中国癌症杂志,2020,30(3):161-165.
    [25] Garcia-Etienne CA, Mansel RE, Tomatis M, et al. Trends in axillary lymph node dissection for early-stage breast cancer in europe: Impact of evidence on practice[J]. Breast, 2019, 45:89-96. doi: 10.1016/j.breast.2019.03.002
    [26] Peng Y, Liu M, Li X, et al. Application of the acosog Z0011 criteria to chinese patients with breast cancer: A prospective study[J]. World JSurg Oncol, 2021, 19(1):128.
    [27] 郭瑢,李伦,张琪,等.中国乳腺癌前哨淋巴结活检现状调查研究[J].中国癌症杂志,2020,30(3):166-173.
    [28] Taruno K, Kurita T, Kuwahata A, et al. Multicenter clinical trial on sentinel lymph node biopsy using superparamagnetic iron oxide nanoparticles and a novel handheld magnetic probe[J]. J Surg Oncol, 2019, 120(8):1391-1396.
    [29] Alvarado MD, Mittendorf EA, Teshome M, et al. Sentimagic: A non-inferiority trial comparing superparamagnetic iron oxide versus technetium-99m and blue dye in the detection of axillary sentinel nodes in patients with early-stage breast cancer[J]. Ann Surg Oncol, 2019, 26(11):3510-3516.
    [30] Yang B, Zheng S, Huang X, et al. A single-center, self-controlled, phase i clinical trial of mitoxantrone hydrochloride injection for lymph tracing for sentinel lymph node identification of breast cancer[J]. Gland Surg, 2021, 10(3):992-1001. doi: 10.21037/gs-20-694
    [31] Qiu PF, Cong BB, Zhao RR, et al. Internal mammary sentinel lymph node biopsy with modified injection technique: High visualization rate and accurate staging[J]. Medicine, 2015, 94(41):e1790. doi: 10.1097/MD.0000000000001790
    [32] Sun X, Wang XE, Zhang ZP, et al. Neoadjuvant therapy and sentinel lymph node biopsy in her2-positive breast cancer patients: Results from the peony trial[J]. Breast Cancer Res Treat, 2020, 180(2):423-428. doi: 10.1007/s10549-020-05559-9
    [33] Caudle AS, Yang WT, Krishnamurthy S, et al. Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: Implementation of targeted axillary dissection[J]. J Cin Oncol, 2016, 34(10):1072-1078.
    [34] Gentilini O, Veronesi U. Abandoning sentinel lymph node biopsy in early breast cancer? A new trial in progress at the European institute of oncology of Milan (SOUND: sentinel node vs observation after axillary ultrasound)[J]. Breast, 2012, 21(5):678-681. doi: 10.1016/j.breast.2012.06.013
    [35] Schaverien MV, Coroneos CJ. Surgical treatment of lymphedema[J]. Plast Reconstr Surg, 2019, 144(3):738-758.
    [36] Granzow JW. Lymphedema surgery: The current state of the art[J]. Clin Exp Metastasis, 2018, 35(5-6):553-558. doi: 10.1007/s10585-018-9897-7
    [37] Schaverien MV, Badash I, Patel KM, et al. Vascularized lymph node transfer for lymphedema[J]. SeminPlast Surg, 2018, 32(1):28-35.
    [38] Meattini I, Lambertini M, Desideri I, et al. Radiation therapy for young women with early breast cancer: Current state of the art[J]. Crit Rev Oncol Hematol, 2019, 137:143-153. doi: 10.1016/j.critrevonc.2019.02.014
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出版历程
  • 收稿日期:  2021-11-23
  • 录用日期:  2022-01-19
  • 网络出版日期:  2022-02-07

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