Chen Fengxia, Pu Feifei
Department of Medical Oncology, General Hospital of The Yangtze River Shipping.
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Onco Targets Ther. 2017 Apr 6;10:2009-2016. doi: 10.2147/OTT.S123803. eCollection 2017.
Triple-negative breast cancer (TNBC), which represents 15%-20% of all breast cancers, is defined by the absence of estrogen receptor (ER) and progesterone receptor (PR) and overexpression of human epidermal growth factor receptor 2 (HER2). Owing to the absence of specific therapeutic targets and its aggressive biologic characteristics, TNBC patients often experience a high risk of disease progression and poor overall survival. Furthermore, TNBC exhibits an early pattern of recurrence with a peak recurrence risk at 2-3 years after surgery. Currently, chemotherapy continues to be the mainstay in TNBC patients; however, such treatment leaves them associated with a high rate of local and systemic relapses even in early-stage (T1-2N0-1M0). Therefore, in early-stage disease, greater emphasis is placed on locoregional treatments, based on radiation therapy (RT) after surgery, to reduce local and systemic relapses. However, there are no specific treatment guidelines for early-stage (T1-2N0-1M0) TNBC patients. In this review, we discuss the type of surgery received and the relevant adverse clinicopathologic factors and underlying BRCA1 mutation status regarding the influence of tailing postmastectomy radiotherapy (PMRT). In addition, we assess the role of PMRT in early-stage (T1-2N0-1M0) TNBC patients.
三阴性乳腺癌（TNBC）占所有乳腺癌的15%-20%，其定义为雌激素受体（ER）和孕激素受体（PR）缺失以及人表皮生长因子受体2（HER2）过表达。由于缺乏特定的治疗靶点及其侵袭性生物学特征，TNBC患者常面临疾病进展的高风险和较差的总生存率。此外，TNBC呈现早期复发模式，术后2-3年复发风险最高。目前，化疗仍是TNBC患者的主要治疗手段；然而，即使在早期（T1-2N0-1M0），这种治疗也会使患者局部和全身复发率较高。因此，在早期疾病中，更强调基于术后放疗（RT）的局部区域治疗，以减少局部和全身复发。然而，对于早期（T1-2N0-1M0）TNBC患者尚无具体的治疗指南。在本综述中，我们讨论了接受的手术类型以及相关不良临床病理因素和潜在的BRCA1突变状态对乳房切除术后追加放疗（PMRT）的影响。此外，我们评估了PMRT在早期（T1-2N0-1M0）TNBC患者中的作用。
