Division of Medical Oncology, Princess Margaret Hospital, Toronto, ON M5G 2M9, Canada.
Nat Rev Clin Oncol. 2011 May;8(5):272-9. doi: 10.1038/nrclinonc.2011.19. Epub 2011 Mar 1.
Adjuvant chemotherapy reduces the risk of relapse and mortality for women with early-stage breast cancer. However, many women diagnosed with early-stage breast cancer experience the toxic effects associated with adjuvant chemotherapy without any meaningful benefit. There are a variety of clinicopathological factors--including hormone receptor expression, histology, and proliferation markers such as Ki-67--that can be used to try to identify patients who can safely avoid adjuvant chemotherapy. In addition, novel molecular tools, including the intrinsic molecular subtypes, prognostic multigene assays, and levels of urokinase-type plasminogen activator, provide further prognostic and predictive information to the standard clinicopathological factors thereby improving the accuracy of risk-of-relapse estimation and of the likelihood of response to cytotoxic chemotherapy.
辅助化疗可降低早期乳腺癌女性复发和死亡的风险。然而，许多诊断为早期乳腺癌的女性在没有任何明显获益的情况下经历了辅助化疗相关的毒性作用。有多种临床病理因素，包括激素受体表达、组织学和增殖标志物如 Ki-67，可用于尝试识别可安全避免辅助化疗的患者。此外，新型分子工具，包括内在分子亚型、预后多基因检测以及尿激酶型纤溶酶原激活物水平，为标准临床病理因素提供了进一步的预后和预测信息，从而提高了复发风险评估的准确性和细胞毒性化疗反应的可能性。
