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🌱來自: localized breast cancer

Local management with surgery and radiation-of-localized breast cancer

• Mastectomy = lumpectomy + RT in OS (NEJM 2002;347:1227)
• SLNB
• ALND
• RT: No OS for RT after BCS for pts >70 yo, ER+, & node (−) (CALGB 9343, JCO 2013;31:2382)
• Post mastectomy RT
• Consider addition of regional nodal irradiation to whole-breast irradiation after BCS if pos. LN (NEJM 2015;373:307; NEJM 2015;373:317)

General (neo)adjuvant principles

• Aims: ↓ recurrence risk & ↑ survival, NAC ∼ adj. (JCO 2008;26:778)
• aims of NAC in breast cancer
• Recurrence:
  • TNBC, HER2+ mostly in 1st 3-5 y.
  • ER+ steady risk 0-14 y
• Isolated local recurrence:
  • Tx decision case-by-case;
  • chemo benefit limited to ER-neg dz (CALOR, Lancet Onc 2014;15:156)

Siblings

• Local management with surgery and radiation-of-localized breast cancer
• Chemotherapy regimens for NAV or ADJ use in HR positive and TNBC-of-localized breast cancer
• Hormone positive disease-adjuvant endocrine treatment
• Hormone-positive disease-neoadjuvant therapy-of-localized breast cancer
• HER2-positive disease-of-localized breast cancer
• Considerations for young patients-of-localized breast cancer