Breast Surgery Division, Montefiore Einstein Center for Cancer Care, Bronx, NY.
Breast Surgery Division, Montefiore Einstein Center for Cancer Care, Bronx, NY.
Clin Breast Cancer. 2021 Apr;21(2):128-142. doi: 10.1016/j.clbc.2021.02.009. Epub 2021 Mar 17.
Tremendous progress has been made over the past several decades in the treatment of breast cancer. Mortality and recurrence rates continue to decline. Our ability to tailor patient- and tumor-specific treatments has rapidly advanced. The vast majority of our patients can safely have breast conservation. Unfortunately, for many patients, survivorship is burdened by ongoing quality-of-life issues. Most breast cancer patients are asymptomatic at presentation, and the onus is on us to preserve this. Surgery, radiation, and systemic therapy can result in long-term toxicities that can be amplified with multimodality approaches. We must strive to apply minimally effective therapies rather than a maximally tolerated approach. Breast cancer-related lymphedema (BCRL) is a particularly dreaded chronic complication. This review strives to give the reader a better understanding of BCRL and shed light on wisely choosing an integration of treatment modalities that minimizes BCRL risk. Key literature on emerging concepts is highlighted.
在过去的几十年中,乳腺癌的治疗取得了巨大的进展。死亡率和复发率持续下降。我们针对患者和肿瘤的个体化治疗能力迅速提高。绝大多数患者可以安全地进行保乳治疗。不幸的是,对于许多患者来说,生存质量问题仍然是一个负担。大多数乳腺癌患者在就诊时没有症状,因此我们有责任保持这种状态。手术、放疗和全身治疗可能会导致长期毒性,而多模式治疗方法会使毒性加剧。我们必须努力应用最低有效治疗方法,而不是最大限度耐受的方法。乳腺癌相关淋巴水肿(BCRL)是一种特别令人恐惧的慢性并发症。本文旨在帮助读者更好地了解 BCRL,并探讨明智地选择治疗方式的整合,以最大限度地降低 BCRL 的风险。强调了关于新兴概念的关键文献。