Dalhousie University School of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada.
Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Curr Oncol. 2022 Jul 1;29(7):4647-4664. doi: 10.3390/curroncol29070369.
Locoregional management of breast cancer is founded on evidence generated over a vast time period, much longer than the career span of many practicing physicians. Oncologists rely on specific patient and tumour characteristics to recommend modern-day treatments. However, some of this information may not have been available during prior periods in which the evidence was generated. For example, the comprehensive Early Breast Cancer Trialists' Collaborative Group (EBCTCG) meta-analyses published in the 2000s typically included older trials accruing patients between the 1960s and 1980s. This raises some uncertainty about whether conclusions from studies conducted in prior eras are as relevant or applicable to modern-day patients and treatments. Reviewing the chronological order and details of the evidence can be beneficial to understanding these nuances. This review discusses the evolution of locoregional management through some key clinical trials. We aim to highlight the time period in which the evidence was generated and emphasize the 10-year outcomes for the comparability of results. Evidence supporting surgical management of the breast and axilla, as well as details of radiotherapy are discussed briefly for all stages of breast cancer.
乳腺癌的局部区域治疗是基于在很长一段时间内产生的证据，其时间跨度远长于许多执业医生的职业生涯。肿瘤学家依靠特定的患者和肿瘤特征来推荐现代治疗方法。然而，在生成证据的先前时期，可能无法获得其中一些信息。例如，2000 年代发表的全面的早期乳腺癌试验者协作组（EBCTCG）荟萃分析通常包括较旧的试验，这些试验在 20 世纪 60 年代至 80 年代期间累积了患者。这引发了一些不确定性，即早期研究的结论是否与现代患者和治疗方法一样相关或适用。回顾证据的时间顺序和细节有助于理解这些细微差别。本综述通过一些关键临床试验讨论了局部区域治疗的演变。我们旨在强调生成证据的时间范围，并强调 10 年结果以比较结果的可比性。讨论了乳腺癌各个阶段的乳房和腋窝的手术治疗以及放射治疗的详细信息。
