Kida Kumiko, Murai Michiko, Yamauchi Hideko
Dept. of Breast Surgical Oncology, St. Luke's International Hospital.
Gan To Kagaku Ryoho. 2017 Feb;44(2):111-115.
Of all breast cancer cases, 5-10% occur because of inherited germline mutation. For hereditary breast and ovarian cancer (HBOC)syndrome, congenital knowledge and strategies for breast cancer treatment and risk reduction are necessary. Regarding the surgical procedure for the cancer site, the ipsilateral breast tumor recurrence rate following breast-conserving surgery in breast cancers with BRCA1/2 mutation is not significantly higher than that in sporadic breast cancers. In addition, prognosis did not differ according to surgical methods. Therefore, breast-conserving surgery for HBOC is not an absolute contraindication, although the risk of developing new primary tumors in the long term should be carefully considered. For the contralateral breast, 3 choices are available, surveillance, chemo-prevention, and risk-reducing mastectomy. Risk-reducing mastectomy is known to decrease the risk of breast cancer by 90%. Genetic counseling is essential for decision making in HBOC treatment. In this review, we reevaluated the current evidence for surgical decision making and systemic therapies for HBOC syndrome.
在所有乳腺癌病例中，5%-10%是由遗传性种系突变引起的。对于遗传性乳腺癌和卵巢癌（HBOC）综合征，了解先天性知识以及乳腺癌治疗和风险降低策略是必要的。关于癌症部位的手术程序，BRCA1/2突变型乳腺癌保乳手术后同侧乳腺肿瘤复发率并不显著高于散发性乳腺癌。此外，预后也不因手术方法而异。因此，HBOC的保乳手术并非绝对禁忌，尽管长期发生新原发性肿瘤的风险应仔细考虑。对于对侧乳房，有3种选择，即监测、化学预防和降低风险的乳房切除术。已知降低风险的乳房切除术可将乳腺癌风险降低90%。遗传咨询对于HBOC治疗的决策至关重要。在本综述中，我们重新评估了当前关于HBOC综合征手术决策和全身治疗的证据。
