Department of Obstetrics and Gynecology and Breast Cancer Center, Klinikum Offenbach GmbH, Starkenburgring 66, D-63069 Offenbach, Germany.
Expert Rev Anticancer Ther. 2011 Feb;11(2):277-86. doi: 10.1586/era.10.218.
Following surgery for early breast cancer, the standard of care for postmenopausal women is adjuvant therapy with any combination of radiation therapy, endocrine therapy, chemotherapy and/or targeted therapy. Clinicians rely on many tools, including guidelines, to make these treatment decisions. Such guidelines include the St Gallen consensus statement, the American Society of Clinical Oncology guidelines and the National Comprehensive Cancer Network guidelines, as well as various regional and national guidelines. Recommendations may vary, because different methods and criteria were used to assess the strength of supporting data. This article provides an overview of global guidelines for the adjuvant treatment of breast cancer and points out the major differences. Ongoing changes are highlighted, particularly those regarding the adjuvant endocrine treatment of postmenopausal women with breast cancer. While previous guidelines recommended tamoxifen alone, all major guidelines now recommend using third-generation aromatase inhibitors either in sequence with tamoxifen or as upfront treatment.
早期乳腺癌手术后，绝经后女性的标准治疗方法是辅助治疗，包括放射治疗、内分泌治疗、化疗和/或靶向治疗的任意组合。临床医生依赖于许多工具，包括指南，来做出这些治疗决策。这些指南包括圣加仑共识声明、美国临床肿瘤学会指南和国家综合癌症网络指南，以及各种地区和国家指南。推荐可能会有所不同，因为不同的方法和标准被用于评估支持数据的强度。本文概述了全球乳腺癌辅助治疗指南，并指出了主要差异。强调了正在进行的变化，特别是关于乳腺癌绝经后女性辅助内分泌治疗的变化。虽然之前的指南推荐单独使用他莫昔芬，但所有主要指南现在都建议使用第三代芳香酶抑制剂，无论是与他莫昔芬序贯使用还是作为一线治疗。
