Breast Surgery Service, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
Breast Surgery Service, Clínica São Vicente, Rio de Janeiro, RJ, Brazil.
Rev Bras Ginecol Obstet. 2020 Jun;42(6):356-364. doi: 10.1055/s-0040-1712125. Epub 2020 Jun 30.
The present paper reports on the local treatment of breast cancer from a historical perspective. A search for articles written in English was made in the Medline and EMBASE databases, and 40 papers were selected. Over the past 10 years, various randomized, controlled clinical trials on the local treatment of breast cancer indicated that patients with the same molecular subtype may receive different individualized surgical treatments aimed at optimizing systemic adjuvant therapy. With a view to retaining the gains made in disease-free and overall survival, surgical techniques have advanced from radical surgery to conservative mastectomies, thus reducing sequelae, while adjuvant and neoadjuvant therapies have contributed toward controlling the disease, both distant metastases and local recurrence. Current studies evaluate whether future breast cancer therapy may even succeed in eliminating surgery to the breast and axilla altogether.
本文从历史角度报告了乳腺癌的局部治疗。在 Medline 和 EMBASE 数据库中进行了英文文章检索，共选择了 40 篇论文。过去 10 年中，各种针对乳腺癌局部治疗的随机对照临床试验表明，相同分子亚型的患者可能会接受不同的个体化手术治疗，旨在优化全身辅助治疗。为了保留无病生存和总生存的获益，手术技术已从根治性手术发展为保乳手术，从而减少了后遗症，同时辅助和新辅助治疗有助于控制疾病，包括远处转移和局部复发。目前的研究评估了未来的乳腺癌治疗是否甚至有可能完全消除乳房和腋窝的手术。
