Friedman M A, Dorr F A, Perloff M
NCI Monogr. 1986(1):139-44.
Although approximately 50,000 cases of axillary node-negative breast cancer are diagnosed in the United States annually, the natural history of this heterogeneous disease is incompletely defined. Several series have reported 5-year relapse-free and overall survival ranging from 56% to 89% and 74% to 92%, respectively. Tumor necrosis and anaplastic morphology correlate with early treatment failure. The estrogen receptor and size of the primary tumor are probably also predictive of clinical course. Thus far, perioperative cyclophosphamide is the only systemic treatment demonstrated to prolong survival in a statistically significant fashion. Several ongoing studies are investigating the role of tamoxifen or cytotoxic chemotherapy, or both, in prospective randomized trials. However, too few patients with insufficient follow-up have been analyzed to permit definitive conclusions or recommendations.
尽管在美国每年约有50000例腋窝淋巴结阴性乳腺癌病例被诊断出来，但这种异质性疾病的自然病程尚未完全明确。有几个系列报道5年无复发生存率和总生存率分别为56%至89%和74%至92%。肿瘤坏死和间变形态与早期治疗失败相关。雌激素受体和原发肿瘤大小可能也可预测临床病程。迄今为止，围手术期环磷酰胺是唯一被证明能在统计学上显著延长生存期的全身治疗方法。几项正在进行的研究正在前瞻性随机试验中调查他莫昔芬或细胞毒性化疗或两者的作用。然而，由于分析的患者数量过少且随访不足，无法得出明确的结论或建议。
