Rugo Hope S
University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA 94115-1710, USA.
Breast. 2008 Jan;17 Suppl 1:S3-8. doi: 10.1016/S0960-9776(08)70002-X.
Breast cancer is a leading cause of cancer death in women worldwide. Survival from breast cancer is improving, but distant metastases remain the most common type of breast cancer recurrence, resulting in more than 40,000 deaths per year in the USA alone. Distant metastases are associated with the poorest outcomes when compared with loco-regional or contralateral recurrences and are also associated with greater health care costs and diminished quality of life. The risk of distant metastases increases with larger primary tumor size, lymph node positive cancer, higher tumor grade, and prior loco-regional recurrence. Yet, even patients with minimal risk factors may develop distant metastases. Thus, reducing the development of such relapses is an important goal in adjuvant therapy. As the development of distant metastases has been consistently associated with eventual mortality from breast cancer, a reduction in distant metastases may serve as a better surrogate marker for overall survival and provide earlier results from clinical trials testing new types of adjuvant therapy.
乳腺癌是全球女性癌症死亡的主要原因。乳腺癌患者的生存率正在提高，但远处转移仍然是最常见的乳腺癌复发类型，仅在美国每年就导致超过40000人死亡。与局部区域或对侧复发相比，远处转移的预后最差，还会带来更高的医疗成本和生活质量下降。远处转移的风险随着原发肿瘤体积增大、淋巴结阳性癌症、肿瘤分级较高以及既往局部区域复发而增加。然而，即使是风险因素最小的患者也可能发生远处转移。因此，减少此类复发的发生是辅助治疗的一个重要目标。由于远处转移的发生一直与乳腺癌最终死亡率相关，远处转移的减少可能作为总生存期更好的替代指标，并能为测试新型辅助治疗的临床试验提供更早的结果。
