Kurebayashi Junichi
Department of Breast and Thyroid Surgery, Kawasaki Medical School.
Nihon Rinsho. 2006 Oct;64(10):1963-9.
The age peak of breast cancer morbidity is younger in Japan in comparison with that in Western countries. This results in a higher incidence of premenopausal patients in Japan. There are specific concerns on the postoperative adjuvant therapy for premenopausal patients, such as its influences on pregnancy, delivery and lactation, and acute and chronic adverse events related to earlier ovarian dysfunction. International guidelines such as the recommendations by the St. Gallen consensus conference provide clinicians with useful information on the risk assessment for recurrence and treatment selection of postoperative adjuvant therapy. Recommendations on postoperative adjuvant therapy for premenopausal breast cancer patients are presented according to the guidelines and evidence established by clinical trials. On-going clinical trials to resolve unanswered questions on the adjuvant therapy are also reviewed. Finally, future perspectives on the adjuvant therapy are discussed.
与西方国家相比，日本乳腺癌发病的年龄高峰更为年轻。这导致日本绝经前患者的发病率更高。对于绝经前患者的术后辅助治疗存在一些特殊问题，比如其对妊娠、分娩和哺乳的影响，以及与早期卵巢功能障碍相关的急慢性不良事件。诸如圣加仑共识会议的建议等国际指南为临床医生提供了有关复发风险评估和术后辅助治疗选择的有用信息。根据临床试验确立的指南和证据，给出了绝经前乳腺癌患者术后辅助治疗的建议。还对旨在解决辅助治疗中未解决问题的正在进行的临床试验进行了综述。最后，讨论了辅助治疗的未来前景。
