Recht A
Department of Radiation Oncology, Harvard Medical School, Boston, MA 02215, USA.
Surg Oncol Clin N Am. 2000 Jul;9(3):603-20, x-xi.
Most patients with locally advanced breast cancer should be treated with a combination of chemotherapy, mastectomy (with immediate reconstruction if the patient so desires), and radiotherapy. Nonetheless, it seems reasonable to offer breast-conserving treatment to selected individuals who respond well to neoadjuvant therapy. Postmastectomy radiotherapy clearly reduces the risk of local-regional and distant failure for patients with earlier-stage invasive breast cancer with involved axillary lymph nodes. Certain subgroups of patients, however, may have such low local-regional failure rates that patients will not routinely find the benefits of radiotherapy sufficient to undergo such treatment. Further investigation of this issue is needed.
大多数局部晚期乳腺癌患者应接受化疗、乳房切除术（如果患者有此意愿，可立即进行重建）和放疗的联合治疗。尽管如此，对于对新辅助治疗反应良好的特定个体，提供保乳治疗似乎是合理的。对于腋窝淋巴结受累的早期浸润性乳腺癌患者，乳房切除术后放疗显然可降低局部区域和远处复发的风险。然而，某些亚组患者的局部区域复发率可能很低，以至于患者通常不会认为放疗的益处足以接受这种治疗。需要对此问题进行进一步研究。
