Controversies in Breast Cancer Surgery.
Controversies in Breast Cancer Surgery.
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DOI：
10.1016/j.suc.2021.06.002
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Fayanju OM
中科院分区：
文献类型：
--
作者：
Gutnik L;Fayanju OM
乳腺外科肿瘤学是一个快速发展的领域，几十年来不断改变实践的研究和公共卫生计划。在美国，筛查的广泛传播增加了早期疾病的检测，并将乳腺癌转变为一种基本上可治愈的实体，尽管在筛查、诊断阶段和生存率方面存在显著差异。1-3对于晚期和生物学侵袭性亚型，包括HER2富集型（HER2+）和三阴性乳腺癌（TNBC），新辅助全身治疗（NST）的使用增加使得乳腺和腋窝手术治疗的降级成为可能。4，5然而，与其他几个国家相比，美国女性因单侧疾病继续接受对侧预防性乳房切除术（CPM）的比例很高，即使保乳治疗（BCT）可行，许多平均风险的女性也接受CPM。6具有讽刺意味的是，在接受新辅助化疗（NACT）的患者中观察到的CPM发生率高于接受辅助化疗或未接受化疗的患者。7因此，NACT作为促进BCT代替乳房切除术的一种手段的益处并不经常被实现，这促使人们探索毒性较小的新辅助全身性替代方案，如内分泌治疗（NET），这在美国不太常用。然而，值得注意的是，考虑到与腋窝淋巴结清扫术（ALND）相关的发病率，无论是否添加腋窝放射，都存在使用NACT降低腋窝局部区域治疗的强烈趋势。
Breast surgical oncology is a rapidly evolving field shaped by decades of practice-changing research and public health initiatives. Widespread dissemination of screening in the United States (US) enabled increased detection of early-stage disease and transformed breast cancer into a largely curable entity, although significant disparities in screening, stage at diagnosis, and survival persist. 1-3 For late-stage and biologically aggressive subtypes including HER2 enriched (HER2+) and triple-negative breast cancer (TNBC), increased use of neoadjuvant systemic therapy (NST) has enabled de-escalation of surgical treatment in the breast and axilla. 4, 5 Nevertheless, women in the US continue to undergo contralateral prophylactic mastectomy (CPM) for unilateral disease at high rates compared to several other countries, with many average-risk women undergoing CPM even when breast-conserving therapy (BCT) is feasible. 6Ironically, higher rates of CPM are observed among recipients of neoadjuvant chemotherapy (NACT) than among recipients of adjuvant or no chemotherapy. 7 Thus, the benefit of NACT as a means of facilitating BCT in place of mastectomy is realized less often than it could be, prompting exploration of less toxic neoadjuvant systemic alternatives such as endocrine therapy (NET), which is less commonly used in the US. Notably, however, there is a strong trend towards using NACT to de-escalate locoregional treatment of the axilla given the morbidity associated with axillary lymph node dissection (ALND) with or without the addition of axillary radiation.
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DOI：
10.1158/1055-9965.epi-15-0293
发表时间：
2015-11
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Chen L;Li CI
通讯作者：
Li CI
DOI：
10.1016/s1470-2045(14)70460-7
发表时间：
2014-11
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Donker M;van Tienhoven G;Straver ME;Meijnen P;van de Velde CJ;Mansel RE;Cataliotti L;Westenberg AH;Klinkenbijl JH;Orzalesi L;Bouma WH;van der Mijle HC;Nieuwenhuijzen GA;Veltkamp SC;Slaets L;Duez NJ;de Graaf PW;van Dalen T;Marinelli A;Rijna H;Snoj M;Bundred NJ;Merkus JW;Belkacemi Y;Petignat P;Schinagl DA;Coens C;Messina CG;Bogaerts J;Rutgers EJ
通讯作者：
Rutgers EJ
影响因子：
51.1
作者：
Galimberti, Viviana;Cole, Bernard F.;Goldhirsch, Aron
通讯作者：
Goldhirsch, Aron
影响因子：
3.6
作者：
Doren, Erin L.;Miranda, Roberto N.;Clemens, Mark W.
通讯作者：
Clemens, Mark W.
DOI：
10.1016/s1470-2045(17)30777-5
发表时间：
2018-01
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Early Breast Cancer Trialists' Collaborative Group (EBCTCG)
通讯作者：
Early Breast Cancer Trialists' Collaborative Group (EBCTCG)