Gutierrez Maya, Ben Abid Fatma, Ousbane Amale, Gazzah Anas, Debled Marc, Girre Véronique, Brain Etienne G C
Département d'oncologie médicale, Centre René-Huguenin, 35, rue Dailly, 92210 Saint-Cloud et Programme d'action concertée Gerico de la Fédération nationale des centres de lutte contre le cancer, 101, rue de Tolbiac, 75654 Paris Cedex 13, France.
Bull Cancer. 2008 May 28;95 FMC Onco:F51-6. doi: 10.1684/bdc.2007.0562.
Breast cancer is the most commonly diagnosed cancer and leading cause of cancer mortality in women worldwide. The elderly comprise a large part of the breast cancer population, and there are important specific considerations for this population. Late diagnosis and substandard local and systemic therapies are frequent, which is only partially "compensated" by a more indolent tumour behaviour due to the increasing likelihood according to age of potentially hormone sensitive tumour status. Endocrine treatment remains a key component of systemic treatment in both advanced and early setting. However chemotherapy is a valid option, with interest strengthened by proven efficacy in adjuvant setting for aggressive phenotypes, better management of side effects and attempts to develop predictive index for toxicity. The recently reported laboratory studies on potential mechanisms for resistance to endocrine therapies that involve crosstalk between growth factor signalling pathways and hormonal receptors stimulate also new therapeutic approaches.
乳腺癌是全球女性中最常被诊断出的癌症，也是癌症死亡的主要原因。老年患者占乳腺癌患者群体的很大一部分，针对这一群体有一些重要的特殊考量。晚期诊断以及不规范的局部和全身治疗很常见，不过由于随着年龄增长潜在激素敏感性肿瘤状态的可能性增加，肿瘤行为较为惰性，这在一定程度上“弥补”了上述不足。内分泌治疗在晚期和早期治疗中仍然是全身治疗的关键组成部分。然而，化疗也是一种有效的选择，辅助治疗中对侵袭性表型的疗效得到证实、副作用得到更好管理以及开发毒性预测指标的尝试，都增强了化疗的吸引力。最近报道的关于内分泌治疗耐药潜在机制的实验室研究，涉及生长因子信号通路和激素受体之间的相互作用，这也刺激了新的治疗方法的产生。
