Apuri Susmitha
From the Department of Hematology and Oncology, H. Lee Moffitt Cancer Center and Research, Institute, Tampa, Florida.
South Med J. 2017 Oct;110(10):638-642. doi: 10.14423/SMJ.0000000000000703.
Breast cancer remains the most common cancer in women in the United States, the second most common cause of cancer death, and the main cause of death in women ages 45 to 55 years. Molecular analyses have shown that breast cancer is divided into several subtypes (luminal A, luminal B, human epidermal growth factor receptor 2 [HER2] enriched, and basal-like), based on microarray techniques. Patients diagnosed as having breast cancer may undergo adjuvant or neoadjuvant chemotherapy, depending on the tumor size, hormone receptor, HER2/neu status, and desire for breast preservation. Patients with positive estrogen and/or progesterone receptor status benefit from treatment with selective estrogen receptor modulators such as tamoxifen or aromatase inhibitors, based on menopausal status and risk of recurrence. HER2-targeted agents such as trastuzumab and pertuzumab are used in combination with chemotherapy in patients with HER2/neu breast cancer. Triple-negative breast cancer is a unique subtype that lacks specific targets, and its treatment primarily includes chemotherapy. This article reviews the current clinical approaches to the management of patients diagnosed as having breast cancer treated with neoadjuvant and/or adjuvant chemotherapy.
乳腺癌仍是美国女性中最常见的癌症，是癌症死亡的第二大常见原因，也是45至55岁女性死亡的主要原因。分子分析表明，基于微阵列技术，乳腺癌可分为几种亚型（管腔A型、管腔B型、人表皮生长因子受体2 [HER2] 富集型和基底样型）。被诊断患有乳腺癌的患者可能会接受辅助化疗或新辅助化疗，这取决于肿瘤大小、激素受体、HER2/neu状态以及保乳意愿。雌激素和/或孕激素受体状态呈阳性的患者，根据绝经状态和复发风险，可从选择性雌激素受体调节剂（如他莫昔芬或芳香化酶抑制剂）治疗中获益。HER2靶向药物（如曲妥珠单抗和帕妥珠单抗）用于HER2/neu乳腺癌患者的化疗联合治疗。三阴性乳腺癌是一种独特的亚型，缺乏特定靶点，其治疗主要包括化疗。本文综述了目前对诊断为乳腺癌并接受新辅助和/或辅助化疗的患者进行管理的临床方法。
