乳腺癌新輔助化療后保乳手術研究進展△_《中國普外基礎與臨床雜志》

作者：

劉廣 ,  王永勝

山東省腫瘤醫院乳腺病中心山東省醫學科學院（濟南 250117）;

關鍵詞：

乳腺癌新輔助化療保乳手術腫瘤退縮模式

視頻：

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目的探討乳腺癌新輔助化療后的腫瘤退縮模式、殘留腫瘤的影像評估以及新輔助化療后保乳手術的選擇標準。方法綜述國內、外有關新輔助化療后乳腺癌的臨床、影像及病理研究的文獻。結果乳腺癌新輔助化療可以提高保乳的可行性，新輔助化療后腫瘤退縮模式及其相關因素尚不明確，MRI是目前新輔助化療效果最準確的影像學評價方法，M.D.Anderson預后指數及美國國立癌癥研究院確定的新輔助化療后降期保乳標準有助于指導手術方式的選擇。結論新輔助化療后的腫瘤退縮模式及其準確的影像評估是乳腺癌新輔助化療后保乳手術選擇及降低復發率的關鍵，也是將來的研究方向。

引用本文： 劉廣,王永勝. 乳腺癌新輔助化療后保乳手術研究進展△. 中國普外基礎與臨床雜志, 2010, 17(12): 1249-1252. doi: 復制

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2.	Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Clin Oncol, 1997; 15(7): 2483-2493.
3.	Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 [J]. J Clin Oncol, 2008; 26(5): 778-785.
4.	van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902 [J]. J Clin Oncol, 2001; 19(22): 4224-4237.
5.	Yuan Z, Qu X, Zhang ZT, et al. Neoadjuvant chemotherapy in patients with stages Ⅱ and Ⅲ breast cancer [J]. Chin Med J (Engl), 2009; 122(24): 2993-2997.
6.	Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Natl Cancer Inst Monogr, 2001; 30: 96-102.
7.	Asoglu O, Muslumanoglu M, Igci A, et al. Breast conserving surgery after primary chemotherapy in locally advanced breast cancer [J]. Acta Chir Belg, 2005; 105(1): 62-68.
8.	Mauriac L, MacGrogan G, Avril A, et al. Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicentre randomized trial with a 124-month median follow-up. Institut Bergonié Bordeaux Groupe Sein (IBBGS) [J]. Ann Oncol, 1999; 10(1): 47-52.
9.	Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
10.	Cebrecos I, Córdoba O, Deu J, et al. Can we predict local recurrence in breast conserving surgery after neoadjuvant chemotherapy? [J]. Eur J Surg Oncol, 2010; 36(6): 528-534.
11.	李金峰, 歐陽濤, 王天峰, 等. 局部進展期及較大乳腺癌的保乳治療 [J]. 中華外科雜志, 2005; 43(15): 1008-1010.
12.	Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis [J]. J Natl Cancer Inst, 2005; 97(3): 188-194.
13.	Mieog JS, van der Hage JA, van de Velde CJ. Preoperative chemotherapy for women with operable breast cancer [J]. Cochrane Database Syst Rev, 2007; (2): CD005002.
14.	Hortobagyi GN, Ames FC, Buzdar AU, et al. Management of stage Ⅲ primary breast cancer with primary chemotherapy, surgery, and radiation therapy [J]. Cancer, 1988; 62(12): 2507-2516.
15.	Rajan R, Poniecka A, Smith TL, et al. Change in tumor cellularity of breast carcinoma after neoadjuvant chemotherapy as a variable in the pathologic assessment of response [J]. Cancer, 2004; 100(7): 1365-1373.
16.	Akazawa K, Tamaki Y, Taguchi T, et al. Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy [J]. Breast J, 2006; 12(2): 130-137.
17.	Bahri S, Chen JH, Mehta RS, et al. Residual breast cancer diagnosed by MRI in patients receiving neoadjuvant chemotherapy with and without bevacizumab [J]. Ann Surg Oncol, 2009; 16(6): 1619-1628.
18.	Kim HJ, Im YH, Han BK, et al. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI [J]. Acta Oncologica, 2007; 46(7): 996-1003.
19.	Peintinger F, Kuerer HM, McGuire SE, et al. Residual specimen cellularity after neoadjuvant chemotherapy for breast cancer [J]. Br J Surg, 2008; 95(4): 433-437.
20.	El-Didi MH, Moneer MM, Khaled HM, et al. Pathological assessment of the response of locally advanced breast cancer to neoadjuvant chemotherapy and its implications for surgical management [J]. Surg Today, 2000; 30(3): 249-254.
21.	譚云山, 陳君雪, 紀元, 等. 乳腺癌新輔助化療后殘留癌組織的病理分析 [J]. 中國臨床醫學, 2000; 7(1): 58-60.
22.	Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
23.	Warren RM, Bobrow LG, Earl HM, et al. Can breast MRI help in the management of women with breast cancer treated by neoadjuvant chemotherapy? [J]. Br J Cancer, 2004; 90(7): 1349-1360.
24.	Straver ME, Loo CE, Rutgers EJ, et al. MRI-model to guide the surgical treatment in breast cancer patients after neoadjuvant chemotherapy [J]. Ann Surg, 2010; 251(4): 701-707.
25.	Yamashiro N, Tozaki M, Ogawa T, et al. Preoperative MRI marking technique for the planning of breast-conserving surgery [J]. Breast Cancer, 2009; 16(3): 223-228.
26.	Chen JH, Feig B, Agrawal G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy [J]. Cancer, 2008; 112(1): 17-26.
27.	Garimella V, Qutob O, Fox JN, et al. Recurrence rates after DCE-MRI image guided planning for breast-conserving surgery following neoadjuvant chemotherapy for locally advanced breast cancer patients [J]. Eur J Surg Oncol, 2007; 33(2): 157-161.
28.	Bhattacharyya M, Ryan D, Carpenter R, et al. Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer [J]. Br J Cancer, 2008; 98(2): 289-293.
29.	Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy [J]. Eur Radiol, 2003; 13(6): 1213-1223.
30.	Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
31.	Morris EA. Review of breast MRI: indications and limitations [J]. Semin Roentgenol, 2001; 36(3): 226-237.
32.	Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002; 347(16): 1233-1241.
33.	Sadetzki S, Oberman B, Zipple D, et al. Breast conservation after neoadjuvant chemotherapy [J]. Ann Surg Oncol, 2005; 12(6): 480-487.
34.	Rouzier R, Mathieu MC, Sideris L, et al. Breast-conserving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors [J]. Cancer, 2004; 101(5): 918-925.
35.	Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience [J]. J Clin Oncol, 2004; 22(12): 2303-2312.
36.	Newman LA, Buzdar AU, Singletary SE, et al. A prospective trial of preoperative chemotherapy in resectable breast cancer: predictors of breast-conservation therapy feasibility [J]. Ann Surg Oncol, 2002; 9(3): 228-234.
37.	Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy [J]. Cancer, 2005; 103(4): 689-695.
38.	Huang EH, Strom EA, Perkins GH, et al. Comparison of risk of local-regional recurrence after mastectomy or breast conservation therapy for patients treated with neoadjuvant chemotherapy and radiation stratified according to a prognostic index score [J]. Int J Radiat Oncol Biol Phys, 2006; 66(2): 352-357.
39.	Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
40.	Alm El-Din MA, Taghian AG. Breast conservation therapy for patients with locally advanced breast cancer [J]. Semin Radiat Oncol, 2009; 19(4): 229-235.

1. Goldhirsch A, Ingle JN, Gelber RD, et al. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009 [J]. Ann Oncol, 2009; 20(8): 1319-1329.
2. Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Clin Oncol, 1997; 15(7): 2483-2493.
3. Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 [J]. J Clin Oncol, 2008; 26(5): 778-785.
4. van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902 [J]. J Clin Oncol, 2001; 19(22): 4224-4237.
5. Yuan Z, Qu X, Zhang ZT, et al. Neoadjuvant chemotherapy in patients with stages Ⅱ and Ⅲ breast cancer [J]. Chin Med J (Engl), 2009; 122(24): 2993-2997.
6. Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18 [J]. J Natl Cancer Inst Monogr, 2001; 30: 96-102.
7. Asoglu O, Muslumanoglu M, Igci A, et al. Breast conserving surgery after primary chemotherapy in locally advanced breast cancer [J]. Acta Chir Belg, 2005; 105(1): 62-68.
8. Mauriac L, MacGrogan G, Avril A, et al. Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicentre randomized trial with a 124-month median follow-up. Institut Bergonié Bordeaux Groupe Sein (IBBGS) [J]. Ann Oncol, 1999; 10(1): 47-52.
9. Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
10. Cebrecos I, Córdoba O, Deu J, et al. Can we predict local recurrence in breast conserving surgery after neoadjuvant chemotherapy? [J]. Eur J Surg Oncol, 2010; 36(6): 528-534.
11. 李金峰, 歐陽濤, 王天峰, 等. 局部進展期及較大乳腺癌的保乳治療 [J]. 中華外科雜志, 2005; 43(15): 1008-1010.
12. Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis [J]. J Natl Cancer Inst, 2005; 97(3): 188-194.
13. Mieog JS, van der Hage JA, van de Velde CJ. Preoperative chemotherapy for women with operable breast cancer [J]. Cochrane Database Syst Rev, 2007; (2): CD005002.
14. Hortobagyi GN, Ames FC, Buzdar AU, et al. Management of stage Ⅲ primary breast cancer with primary chemotherapy, surgery, and radiation therapy [J]. Cancer, 1988; 62(12): 2507-2516.
15. Rajan R, Poniecka A, Smith TL, et al. Change in tumor cellularity of breast carcinoma after neoadjuvant chemotherapy as a variable in the pathologic assessment of response [J]. Cancer, 2004; 100(7): 1365-1373.
16. Akazawa K, Tamaki Y, Taguchi T, et al. Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy [J]. Breast J, 2006; 12(2): 130-137.
17. Bahri S, Chen JH, Mehta RS, et al. Residual breast cancer diagnosed by MRI in patients receiving neoadjuvant chemotherapy with and without bevacizumab [J]. Ann Surg Oncol, 2009; 16(6): 1619-1628.
18. Kim HJ, Im YH, Han BK, et al. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI [J]. Acta Oncologica, 2007; 46(7): 996-1003.
19. Peintinger F, Kuerer HM, McGuire SE, et al. Residual specimen cellularity after neoadjuvant chemotherapy for breast cancer [J]. Br J Surg, 2008; 95(4): 433-437.
20. El-Didi MH, Moneer MM, Khaled HM, et al. Pathological assessment of the response of locally advanced breast cancer to neoadjuvant chemotherapy and its implications for surgical management [J]. Surg Today, 2000; 30(3): 249-254.
21. 譚云山, 陳君雪, 紀元, 等. 乳腺癌新輔助化療后殘留癌組織的病理分析 [J]. 中國臨床醫學, 2000; 7(1): 58-60.
22. Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
23. Warren RM, Bobrow LG, Earl HM, et al. Can breast MRI help in the management of women with breast cancer treated by neoadjuvant chemotherapy? [J]. Br J Cancer, 2004; 90(7): 1349-1360.
24. Straver ME, Loo CE, Rutgers EJ, et al. MRI-model to guide the surgical treatment in breast cancer patients after neoadjuvant chemotherapy [J]. Ann Surg, 2010; 251(4): 701-707.
25. Yamashiro N, Tozaki M, Ogawa T, et al. Preoperative MRI marking technique for the planning of breast-conserving surgery [J]. Breast Cancer, 2009; 16(3): 223-228.
26. Chen JH, Feig B, Agrawal G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy [J]. Cancer, 2008; 112(1): 17-26.
27. Garimella V, Qutob O, Fox JN, et al. Recurrence rates after DCE-MRI image guided planning for breast-conserving surgery following neoadjuvant chemotherapy for locally advanced breast cancer patients [J]. Eur J Surg Oncol, 2007; 33(2): 157-161.
28. Bhattacharyya M, Ryan D, Carpenter R, et al. Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer [J]. Br J Cancer, 2008; 98(2): 289-293.
29. Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy [J]. Eur Radiol, 2003; 13(6): 1213-1223.
30. Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy [J]. AJR Am J Roentgenol, 2003; 181(5): 1275-1282.
31. Morris EA. Review of breast MRI: indications and limitations [J]. Semin Roentgenol, 2001; 36(3): 226-237.
32. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer [J]. N Engl J Med, 2002; 347(16): 1233-1241.
33. Sadetzki S, Oberman B, Zipple D, et al. Breast conservation after neoadjuvant chemotherapy [J]. Ann Surg Oncol, 2005; 12(6): 480-487.
34. Rouzier R, Mathieu MC, Sideris L, et al. Breast-conserving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors [J]. Cancer, 2004; 101(5): 918-925.
35. Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience [J]. J Clin Oncol, 2004; 22(12): 2303-2312.
36. Newman LA, Buzdar AU, Singletary SE, et al. A prospective trial of preoperative chemotherapy in resectable breast cancer: predictors of breast-conservation therapy feasibility [J]. Ann Surg Oncol, 2002; 9(3): 228-234.
37. Chen AM, Meric-Bernstam F, Hunt KK, et al. Breast conservation after neoadjuvant chemotherapy [J]. Cancer, 2005; 103(4): 689-695.
38. Huang EH, Strom EA, Perkins GH, et al. Comparison of risk of local-regional recurrence after mastectomy or breast conservation therapy for patients treated with neoadjuvant chemotherapy and radiation stratified according to a prognostic index score [J]. Int J Radiat Oncol Biol Phys, 2006; 66(2): 352-357.
39. Buchholz TA, Lehman CD, Harris JR, et al. Statement of the science concerning locoregional treatments after preoperative chemotherapy for breast cancer: a National Cancer Institute conference [J]. J Clin Oncol, 2008; 26(5): 791-797.
40. Alm El-Din MA, Taghian AG. Breast conservation therapy for patients with locally advanced breast cancer [J]. Semin Radiat Oncol, 2009; 19(4): 229-235.

《中國普外基礎與臨床雜志》

乳腺癌新輔助化療后保乳手術研究進展△

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

《中國普外基礎與臨床雜志》

乳腺癌新輔助化療后保乳手術研究進展△

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料