Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brazil.
Rev Assoc Med Bras (1992). 2023 Aug 4;69(suppl 1):e2023S114. doi: 10.1590/1806-9282.2023S114. eCollection 2023.
Breast cancer treatment has evolved significantly over the years, both in terms of local and systemic approaches. Halsted's radical mastectomy gave way to modified mastectomies and to conservative surgeries, along with breast reconstruction and repair. Although the use of new drugs has directly increased the survival of patients submitted to adjuvant or neoadjuvant systemic therapies, the de-escalation of drugs may also be beneficial in numerous cases. Therefore, breast cancer treatment must be increasingly customized and assessed using a multidisciplinary approach. This study aimed to review the concept and therapy of early breast cancer.
A narrative review of the literature was carried out in the PubMed database in December 2022, where the keywords for the searches were as follows: early breast cancer, surgical treatment of breast cancer, systemic treatment of breast cancer, neoadjuvant chemotherapy in breast cancer, adjuvant treatment of luminal breast cancer, early triple negative tumor, and early positive Her-2 tumor. Articles that were historically important in the treatment of breast cancer and articles that impacted management with scientific relevance were selected for this review.
As new evidence continues to update existing knowledge, breast cancer treatment is becoming increasingly personalized and must now take into account the different tumor variants and their clinical stages, the age of patients and relevant comorbidities, as well as personal expectations and desires.
This literature review of current studies shows that the primary therapy for patients with early breast cancer continues to be surgery, although a customized and multidisciplinary approach is now required.
乳腺癌的治疗方法近年来发生了重大变化,无论是局部还是全身治疗方法都如此。Halsted 根治性乳房切除术已被改良乳房切除术和保乳手术取代,同时还有乳房重建和修复。尽管新药物的使用直接提高了接受辅助或新辅助全身治疗的患者的生存率,但药物的降级在许多情况下也可能是有益的。因此,乳腺癌的治疗必须越来越个性化,并采用多学科方法进行评估。本研究旨在回顾早期乳腺癌的概念和治疗方法。
2022 年 12 月,我们在 PubMed 数据库中进行了文献的叙述性回顾,搜索关键词如下:早期乳腺癌、乳腺癌的手术治疗、乳腺癌的全身治疗、乳腺癌的新辅助化疗、腔隙性乳腺癌的辅助治疗、早期三阴性肿瘤和早期阳性 Her-2 肿瘤。选择了在乳腺癌治疗中具有历史重要性的文章和具有科学相关性的影响管理的文章进行本综述。
随着新证据不断更新现有知识,乳腺癌的治疗方法变得越来越个性化,现在必须考虑到不同的肿瘤变体及其临床分期、患者的年龄和相关合并症,以及个人的期望和愿望。
对现有研究的文献回顾表明,早期乳腺癌患者的主要治疗方法仍然是手术,尽管现在需要采用定制化和多学科的方法。