识别复发风险高的早期 HR+ HER2- 乳腺癌患者。

IF 2.4 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Geburtshilfe Und Frauenheilkunde Pub Date : 2024-02-08 eCollection Date: 2024-02-01 DOI:10.1055/a-2238-3199
Peter A Fasching, Hans Kreipe, Lucia Del Mastro, Eva Ciruelos, Gilles Freyer, Agnieszka Korfel, Nadia Chouaki, Clemens Stoffregen, Francisco Sapunar, David Cameron
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引用次数: 0

摘要

在过去的二十年里,乳腺癌的发病率有所上升,与此同时,由于早期发现和治疗方法的改进,患者的生存率也有所提高。尽管情况有所改善,但在确诊为早期乳腺癌的妇女中,仍分别有高达 10% 和 30% 的人出现局部复发和远处转移。约 70% 的乳腺癌激素受体阳性(HR+)、人表皮生长因子受体 2 阴性(HER2-),在诊断/初次治疗后 20 年内仍有复发风险。我们结合在PubMed上的搜索结果和临床经验进行了叙述性综述,描述了患者的特征、生物标志物和基因组分析工具,供临床医生用于识别复发风险高的HR+、HER2-早期乳腺癌患者,并提供了将患者分为复发风险类别的建议。此外,还总结了国内和国际治疗指南。准确评估这些患者的复发风险至关重要,因为预测的风险可指导治疗决策;不准确的估计可能导致过度治疗或治疗不足,无论哪种情况都会给患者带来不良后果。建议对早期乳腺癌采用多种预后工具和因素,没有任何一种检测能单独提供准确的预后。由于没有一种检测能单独提供准确的预后,因此应综合使用多种工具。风险阈值对于指导HR+、HER2-早期乳腺癌患者做出优化和平衡的治疗决策非常重要。然而,预后评估应根据具体情况进行,因此,针对患者的预后方法对于避免过度治疗或治疗不足至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identification of Patients with Early HR+ HER2- Breast Cancer at High Risk of Recurrence.

Breast cancer incidence has increased in the last two decades and, simultaneously, survival has improved due to earlier detection and improved treatment options. Despite this improvement, locoregional recurrences and distant metastases occur in up to 10 and 30% of women diagnosed with early breast cancer, respectively. Around 70% of breast cancers are hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-), and associated with a persistent risk of relapse up to 20 years after diagnosis/initial treatment. We conducted a narrative review by combining PubMed searches with our clinical experience to describe patient characteristics, biomarkers, and genomic profiling tools available to clinicians for the identification of patients with HR+, HER2- early breast cancer at high risk of recurrence and to provide recommendations to classify patients into recurrence risk categories. National and international treatment guidelines are also summarised. Accurate assessment of the risk of recurrence in these patients is crucial as the predicted risk guides treatment decisions; imprecise estimations can result in over- or undertreatment, with either scenario having negative consequences for patients. Multiple prognostic tools and factors are recommended for early breast cancer, and no single test provides accurate prognosis in isolation. Since no single test can provide accurate prognosis in isolation, a combination of tools should be used. Risk thresholds are important to guide optimised and balanced therapeutic decisions in HR+, HER2- early breast cancer. However, prognostic assessment should be performed on a case-by-case basis, making patient-specific prognostic approaches essential to avoid over- or undertreatment.

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来源期刊
Geburtshilfe Und Frauenheilkunde
Geburtshilfe Und Frauenheilkunde 医学-妇产科学
CiteScore
2.50
自引率
22.20%
发文量
828
审稿时长
6-12 weeks
期刊介绍: Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.
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