乳腺癌的治疗

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1、会计学1乳腺癌的治疗乳腺癌的治疗123减少致癌因素加强高危人群的预防重视肿瘤筛查Guideline Development ComparisonGuideline Development ComparisonNCCN GuidelineASCO GuidelineSt Gallen ConsensusMethodologyEvidence-based consensusEvidence-based (consensus)(Evidence-based) consensusCoverageComprehensiveFocusedEarly diseaseCOI disclosureYesYesN

2、oFrequency of updates YearlyAs neededEvery 2 yearsAdvocate representativeYesUsuallyNo扩大根治术 Extensive Mastectomy乳癌根治术 Radical Mastectomy保乳手术 Breast Conservation前哨淋巴结活检 Sentinel Lymph Node Biopsy改良根治术 Modified Mastectomy乳腺癌辅助治疗的进展乳腺癌辅助治疗的进展SurgeryCMF1AnthracyclinesAC2, CAF3,FEC4Dose5,6CEF1207, 15FEC10

3、08EC9Meta-analysis12Taxanes10,11,13DI14 Sequence Biologics 1 Bonadonna 1976 2 B-15, B-23 1990, 2000 3 SECSG 1994 4 Coombes 1996 5 Bonadonna 1995 6 Wood 1994 7 MA-05 1998 8 FASG 2001 9 Belgium 2001 10 CALGB 200011 B-28 200012 EBCTCG 1998, 200013 TAC vs FAC14 CALGB 974115 MA.05 10 years!St. Gallen 200

4、7 Risk CategorySt. Gallen 2007 Risk CategoryLowIntermediateHighT2 & G1 &ER a/o PR+ & T2 or G23 orER&PR- or Node+(13) &ER & PR- & HER2+Node + 4HER2+ orAge2 or G23 orER&PR- or Node+(13) &ER & PR- & HER2+Node + 4HER2+ orAge35 orLVI extensiveHER2- &Age35 &LVI Non-extensiveRISKRISKNode- &Node- &Node+(13) & ER a/o PR+ & HER2-化疗的最大获益见于高危复发评分组化疗的最大获益见于高危复发评分组