Shah Rupen, Rosso Kelly, Nathanson S David
Rupen Shah, Kelly Rosso, S David Nathanson, Department of Surgery, Wayne State Medical School at Henry Ford Health System, Detroit, MI 48334, United States.
World J Clin Oncol. 2014 Aug 10;5(3):283-98. doi: 10.5306/wjco.v5.i3.283.
Breast cancer is the most common cancer affecting women worldwide. Prediction models stratify a woman's risk for developing cancer and can guide screening recommendations based on the presence of known and quantifiable hormonal, environmental, personal, or genetic risk factors. Mammography remains the mainstay breast cancer screening and detection but magnetic resonance imaging and ultrasound have become useful diagnostic adjuncts in select patient populations. The management of breast cancer has seen much refinement with increased specialization and collaboration with multidisciplinary teams that include surgeons, oncologists, radiation oncologists, nurses, geneticist, reconstructive surgeons and patients. Evidence supports a less invasive surgical approach to the staging and management of the axilla in select patients. In the era of patient/tumor specific management, the advent of molecular and genomic profiling is a paradigm shift in the treatment of a biologically heterogenous disease.
乳腺癌是全球影响女性的最常见癌症。预测模型对女性患癌风险进行分层,并可根据已知且可量化的激素、环境、个人或遗传风险因素的存在情况指导筛查建议。乳腺钼靶摄影仍然是乳腺癌筛查和检测的主要手段,但磁共振成像和超声已成为特定患者群体中有用的诊断辅助手段。随着专业化程度的提高以及与包括外科医生、肿瘤学家、放射肿瘤学家、护士、遗传学家、重建外科医生和患者在内的多学科团队的合作增加,乳腺癌的管理有了很大改进。有证据支持在特定患者中采用侵入性较小的手术方法进行腋窝分期和管理。在患者/肿瘤特异性管理的时代,分子和基因组分析的出现是治疗这种生物学异质性疾病的范式转变。