Rabbani Shafaat A, Mazar Andrew P
Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.
Cancer Metastasis Rev. 2007 Dec;26(3-4):663-74. doi: 10.1007/s10555-007-9085-8.
There is an urgent need to understand distant metastases in breast cancer as they are the most lethal form of recurrence and a major cause of mortality in patients. Some predictors for distant metastases, including nodal status, tumor grade, and hormonal status, are useful in identifying patients at increased risk for distant metastases. Adjuvant endocrine therapy has been the treatment of choice for postmenopausal women with hormone-sensitive breast cancer, and some therapies have shown significant reductions in the risk of distant metastases. Skeletal metastases in breast cancer are treated with bisphosphonates with a certain level of success. With more new agents undergoing clinical trials, a thorough review of the specific and long-term safety of these agents is essential, as is a better understanding of the deterioration in the quality of life and cost concerns of patients who develop distant metastases. Gene-expression profiling is a new entrant in the field of distant metastases diagnosis, which is largely successful in defining gene signatures that predict the development of distant metastases. This review will discuss the biology and the impact of distant metastases on outcomes for patients with breast cancer; it also encompasses the current status, emerging focus, and future perspectives in treatment of skeletal metastases in patients with breast cancer.
迫切需要了解乳腺癌的远处转移情况，因为它们是最致命的复发形式，也是患者死亡的主要原因。一些远处转移的预测指标，包括淋巴结状态、肿瘤分级和激素状态，对于识别远处转移风险增加的患者很有用。辅助内分泌治疗一直是激素敏感性乳腺癌绝经后女性的首选治疗方法，一些治疗方法已显示出远处转移风险显著降低。乳腺癌的骨转移用双膦酸盐治疗取得了一定程度的成功。随着更多新药进入临床试验，全面评估这些药物的特异性和长期安全性至关重要，同时更好地了解发生远处转移患者的生活质量下降情况和成本问题也很重要。基因表达谱分析是远处转移诊断领域的新方法，在很大程度上成功地定义了预测远处转移发生的基因特征。本综述将讨论远处转移的生物学特性及其对乳腺癌患者预后的影响；还涵盖了乳腺癌患者骨转移治疗的现状、新关注点和未来展望。
