Expert consensus on the diagnosis and treatment of bone metastasis in patients with breast cancer
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摘要: 骨骼是乳腺癌最常见的远处转移部位，约占所有转移性乳腺癌患者的60%～75%。骨转移灶形成的软组织包块可对周围重要神经血管形成压迫，导致肢体局部功能丧失，骨痛、病理性骨折、脊髓压迫及高钙血症等骨相关事件的出现，严重影响患者的自主活动能力及生存质量。为早期识别乳腺癌骨转移、控制骨转移灶进展并对骨转移灶及时进行干预，从而改善患者的生存质量，中国抗癌协会骨肿瘤和骨转移瘤专业委员会组织编写《乳腺癌骨转移诊疗专家共识》，以期对乳腺癌骨转移患者的诊疗给予指导与帮助。Abstract: The skeletal system is a common site for distant metastasis in patients with breast cancer, which accounts approximately 60%-75% of all metastatic breast cancers. Compression induced by the metastatic lesions on the neurovascular bundle often leads to a severe loss of the sensory and motor functions in the afflicted limb, including skeletal-related events (SREs), such as bone pain, pathologic fractures, and hypercalcemia spinal cord compression. The quality of life (QOL) of the patients is severely affected. Early diagnosis and timely intervention improve the QOL of patients with breast cancer and bone metastasis and reduce cancer-related mortality. The Bone Tumor and Bone Metastasis Committee of Chinese Anti-Cancer Association proposed this study titled “Expert consensus on the diagnosis and treatment of bone metastasis in patients with breast cancer,” as a clinical reference for the orthopedic oncologists.
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Key words:
- metastatic breast cancer /
- bone metastasis /
- consensus
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图 3 ESCC分级
A：0级为病变完全局限在脊椎骨内。Ⅰa级为侵犯硬膜外区，硬膜囊无变形。Ⅰb级为硬膜囊受压变形，未接触脊髓。Ⅰc级为硬膜囊受压变形，病变接触脊髓；B：Ⅱ级为脊髓受压，但仍可见脊髓周围脑脊液；C：Ⅲ级为脊髓受压，脊髓周围脑脊液消失
表 1 Mirels评分
变量 评分（分） 1 2 3 部位 上肢 下肢 转子周围 疼痛 轻度 中度 重度 病变性质 成骨性 混合 溶骨性 病变大小 <1/3 1/3-2/3 >2/3 ≤7分：病理骨折风险较低（<4%）；8分：骨折风险为15%；9分：骨折风险达到33%；≥8分：应进行预防性内固定 
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