Comprehensive therapy of early breast cancer after breast-conserving surgery

doi:10.3760/cma.j.issn.1673-422X.2015.07.016

Abstract

Abstract: For the patients with early breast cancer, the effects of breastconserving surgery combined with radiotherapy and radical resection are equal, and the former shows less adverse reactions and better aesthetic outcome. Because of individual differences and the inherent complexity of tumor, to obtain optimal effects, it is an inevitable trend of making an individual comprehensive therapy, which is a combination of radiotherapy, chemotherapy, endocrine therapy and targeted therapy.

Key words: Breast neoplasms, Combined modality therapy, Radiotherapy, Drug Therapy

Dong Yaqin, Yang Lin. Comprehensive therapy of early breast cancer after breast-conserving surgery[J]. Journal of International Oncology, 2015, 42(7): 535-538.

References

［1］ Keruakous AR, Sadek BT, Shenouda MN, et al. The impact of isolated tumor cells on locoregional recurrence in breast cancer patients treated with breastconserving treatment or mastectomy without postmastectomy radiation therapy［J］. Breast Cancer Res Treat, 2014, 146(2): 365-370. ［2］ Bartelink H, Maingon P, Poortmans P, et al. Wholebreast irradiation with or without a boost for patients treated with breastconserving surgery for early breast cancer: 20year followup of a randomised phase 3 trial［J］. Lancet Oncol, 2015, 16(1): 47-56. ［3］ START Trialists′ Group, Bentzen SM, Agrawal RK, et al. The UK standardisation of breast radiotherapy (START) trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial［J］. Lancet, 2008, 371(9618): 1098-1107. ［4］ START Trialists′ Group, Bentzen SM, Agrawal RK, et al. The UK standardisation of breast radiotherapy (START) trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial［J］. Lancet Oncol, 2008, 9(4): 331-341. ［5］ Cante D, Franco P, Sciacero P, et al. Hypofractionation and concomitant boost to deliver adjuvant wholebreast radiation in ductal carcinoma in situ (DCIS): a subgroup analysis of a prospective case series［J］. Med Oncol, 2014, 31(2): 838. ［6］郝福荣, 吕春燕, 刘杰, 等. 乳腺癌保留乳房术后大分割调强放疗初步临床观察［J］. 中华肿瘤防治杂志, 2013, 20(24): 1912-1916. ［7］邓垒, 惠周光, 王淑莲, 等. 早期乳腺癌保乳术后大分割三维放疗Ⅱ期临床观察［J］. 中华放射肿瘤学杂志, 2013, 22(1): 1-4. ［8］张秋宁, 王强, 冶秀鹏, 等. 早期乳腺癌保乳术后加速部分乳腺放疗的Meta分析［J］. 肿瘤学杂志, 2011, 17(7): 524-529. ［9］ Polgár C, Major T, Fodor J, et al. Highdoserate brachytherapy alone versus whole breast radiotherapy with or without tumor bed boost after breastconserving surgery: sevenyear results of a comparative study［J］. Int J Radiat Oncol Biol Phys, 2004, 60(4): 1173-1181. ［10］ Shah C, Badiyan S, Ben Wilkinson J, et al. Treatment efficacy with accelerated partial breast irradiation (APBI): final analysis of the American society of breast surgeons mammosite() breast brachytherapy registry trial［J］. Ann Surg Oncol, 2013, 20(10): 3279-3285. ［11］ Colleoni M, Cole BF, Viale G, et al. Classical cyclophosphamide, methotrexate, and fluorouracil chemotherapy is more effective in triplenegative, nodenegative breast cancer: results from two randomized trials of adjuvant chemoendocrine therapy for nodenegative breast cancer［J］. J Clin Oncol, 2010, 28(18): 2966-2973. ［12］ Arcangeli G, Pinnarò P, Rambone R, et al. A phase Ⅲ randomized study on the sequencing of radiotherapy and chemotherapy in the conservative management of earlystage breast cancer［J］. Int J Radiat Oncol Biol Phys, 2006, 64(1): 161-167. ［13］ Kim HJ, Kim JS, Chie EK, et al. The sequencing of chemotherapy and radiotherapy in breast cancer patients after mastectomy［J］. Tumori, 2010, 96(1): 28-33. ［14］ Rouёssé J, de la Lande B, BertheaultCvitkovic F, et al. A phase Ⅲ randomized trial comparing adjuvant concomitant chemoradiotherapy versus standard adjuvant chemotherapy followed by radiotherapy in operable nodepositive breast cancer: final results［J］. Int J Radiat Oncol Biol Phys, 2006, 64(4): 1072-1080. ［15］ Hickey BE, Francis D, Lehman MH. Sequencing of chemotherapy and radiation therapy for early breast cancer［J］. Cochrane Database Syst Rev, 2006, 4: CD005212. ［16］ Fisher B, Bryant J, Dignam JJ, et al. Tamoxifen, radiation therapy, or both for prevention of ipsilateral breast tumor recurrence after lumpectomy in women with invasive breast cancers of one centimeter or less［J］. J Clin Oncol, 2002, 20(20): 4141-4149. ［17］ Kim R, Tanabe K, Emi M, et al. Rationale for sequential tamoxifen and anticancer drugs in adjuvant setting for patients with node and receptorpositive breast cancer［J］. Int J Oncol, 2005, 26(4): 1025-1031. ［18］ Pierce LJ, Hutchins LF, Green SR, et al. Sequencing of tamoxifen and radiotherapy after breastconserving surgery in earlystage breast cancer［J］. J Clin Oncol, 2005, 23(1): 24-29. ［19］ Wang, XC, Huang XB, Zhang WD, et al. Sequential study of radiotherapy and hormonal therapy in breast cancer patients undergoing mastectomy or conservative surgery［J］. Zhonghua Yi Xue Za Zhi, 2009, 89(28): 1964-1969. ［20］ Balduzzi A, Leonardi MC, Cardillo A, et al. Timing of adjuvant systemic therapy and radiotherapy after breastconserving surgery and mastectomy［J］. Cancer Treat Rev, 2010, 36(6): 443-450. ［21］ Sorlie T, Tibshirani R, Parker J, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets［J］. Proc Natl Acad Sci USA, 2003, 100(14): 8418-8423. ［22］ Rakha EA, ElSayed ME, Green AR, et al. Prognostic markers in triplenegative breast cancer［J］. Cancer, 2007, 109(1): 25-32. ［23］ Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy［J］. Clin Cancer Res, 2005, 11(16): 5678-5685. ［24］ Swain SM, Baselga J, Kim SB, et al. Pertuzumab, trastuzumab, and docetaxel in HER2positive metastatic breast cancer［J］. N Engl J Med, 2015, 372(8): 724-734. ［25］ Finn RS, Dering J, Ginther C, et al. Dasatinib, an orally active small molecule inhibitor of both the src and abl kinases, selectively inhibits growth of basaltype/"triplenegative" breast cancer cell lines growing in vitro［J］. Breast Cancer Res Treat, 2007, 105(3): 319-326. ［26］ Cameron D, Brown J, Dent R, et al. Adjuvant bevacizumabcontaining therapy in triplenegative breast cancer (BEATRICE): primary results of a randomised, phase 3 trial［J］. Lancet Oncol, 2013, 14(10): 933-942.

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