The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, USA.
Oncologist. 2012;17(4):508-11. doi: 10.1634/theoncologist.2012-0077. Epub 2012 Apr 4.
A 53-year-old postmenopausal woman was found to have a new area of microcalcification at the 10 o'clock position of her right breast during a routine screening mammogram. Ultrasound-guided core biopsy revealed a grade 2 invasive ductal carcinoma, estrogen receptor (ER)+ (90%), progesterone receptor positive (20%), and human epidermal growth factor receptor (HER)-2+ (3+ by immunohistochemistry). A right breast lumpectomy and sentinel node biopsy were performed. The invasive tumor measured 0.7 cm, no lymphovascular space invasion was identified, surgical margins were uninvolved, and the sentinel lymph nodes were negative for tumor. She was evaluated postoperatively in the medical oncology clinic to discuss an adjuvant treatment strategy. The question for our colleagues is: should she be offered adjuvant chemotherapy and trastuzumab prior to adjuvant radiation and 5 years of hormonal therapy?
一位 53 岁绝经后女性在常规筛查乳房 X 光检查时发现右侧乳房 10 点钟位置有新的微钙化区域。超声引导下核心活检显示 2 级浸润性导管癌，雌激素受体（ER）阳性（90%），孕激素受体阳性（20%），人类表皮生长因子受体（HER）-2 阳性（免疫组织化学 3+）。进行了右乳肿块切除术和前哨淋巴结活检。浸润性肿瘤大小为 0.7 厘米，未发现淋巴管血管侵犯，手术切缘无肿瘤累及，前哨淋巴结无肿瘤转移。她在肿瘤内科门诊接受了术后评估，以讨论辅助治疗策略。我们的同事们提出的问题是：在辅助放疗和 5 年激素治疗之前，她是否应该接受辅助化疗和曲妥珠单抗治疗？
