Memorial Sloan-Kettering Cancer Center, 300 East 66th Street, New York, NY 10065, USA.
Breast. 2013 Aug;22 Suppl 2:S106-9. doi: 10.1016/j.breast.2013.07.020.
The molecular subtype of breast cancer is the major determinant of the type of systemic therapy, but less attention has been paid to the impact of subtype on local therapy outcomes. Presenting features of breast cancer vary with hormone receptor status, with triple negative cancers being significantly less likely than hormone receptor positive cancers to have nodal metastases, and HER2 overexpressing cancers being more likely to be multifocal or multicentric and to have an extensive intraductal component. The risk of local recurrence varies with subtype as well, with triple negative cancers having the highest risk of local recurrence after both breast-conserving therapy and mastectomy, indicating that bigger surgery does not overcome bad biology.
乳腺癌的分子亚型是全身治疗类型的主要决定因素，但对亚型对局部治疗结果的影响关注较少。乳腺癌的表现特征因激素受体状态而异，三阴性癌症发生淋巴结转移的可能性明显低于激素受体阳性癌症，而 HER2 过表达癌症更有可能呈多灶性或多中心性，并具有广泛的导管内成分。局部复发的风险也因亚型而异，三阴性癌症在保乳治疗和乳房切除术之后局部复发的风险最高，这表明更大的手术并不能克服不良生物学。
