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病理完整反应对接受新辅助系统治疗和乳腺保护手术的患者的局部区域复发和生存的影响

Victoria Huynh¹, Alexa Glencer², Min Yi¹

¹Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Annals of surgical oncology

|August 5, 2025

概括

在新辅助疗法和乳腺保护手术 (BCS) 后达到病理完整反应 (pCR) 显著改善了侵袭性乳腺癌患者的生存结果. 然而,残留疾病的三阴性乳腺癌的复发率更高.

科学领域:

在瘤学瘤学.
乳腺癌研究研究乳腺癌研究
手术瘤学手术瘤学

背景情况:

新辅助全身疗法 (NST),其次是乳腺保护手术 (BCS),是侵袭性乳腺癌的标准治疗方法.
评估实现病理完整反应 (pCR) 与残留疾病 (RD) 对长期瘤结果的影响对于治疗分层至关重要.

研究的目的:

为了比较癌症结局,包括生存率和复发率,在获得pCR的患者和在NST和BCS后获得RD的患者之间,用于早期侵袭性乳腺癌.
确定影响这些结果的因素,特别是与瘤亚型有关的因素.

主要方法:

在1999年至2015年期间,对732名cT1-3N0侵袭性乳腺癌患者进行了回顾性分析,这些患者接受了NST和BCS治疗.
在pCR和RD组之间比较总生存率 (OS),疾病特异性生存率 (DSS),局部区域无复发生存率 (LRRFS) 和远程无复发生存率 (DRFS).
多变量分析以确定瘤结果的预测因素.

主要成果:

与RD患者相比,实现pCR的患者表现出明显改善的5年OS,DSS和DRFS.
瘤亚型显著影响了pCR率,与HR+/HER2疾病相比,HER2阳性和三阴性乳腺癌 (TNBC) 的发病率更高.
虽然LRR率一般较低,但TNBC与RD显示了更高的局部区域复发率.

结论:

病理完整反应 (pCR) 是经过新辅助疗法和BCS治疗后改善生存率 (OS,DSS) 和减少远程复发 (DRFS) 的重要预测因素.
在大多数亚型中,局部区域复发率 (LRR) 很低,但有着残留疾病的TNBC是显著的例外.

关键词:

乳腺癌是什么? 乳腺癌是什么乳腺保护手术是什么?当地-区域复发情况新辅助化学疗法新辅助化学疗法结果的结果.病理学的完整反应.幸存的生存方式

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