Ⅳ期乳腺癌局部外科治疗策略  

Locoregional surgical strategies of stage IV breast cancer

作　　者：赵妍[1] 郑新宇[1] 

机构地区：[1]中国医科大学附属第一医院乳腺外科,辽宁沈阳110001

出　　处：《中国实用外科杂志》2015年第7期713-718,共6页Chinese Journal of Practical Surgery

摘　　要：综合治疗是Ⅳ期乳腺癌的主体治疗。尽管大多数回顾性研究提示切除原发病灶可以获得生存获益,然而,目前的指南并不推荐原发病灶的手术切除。现有有限的前瞻性临床研究并未发现总生存获益。所以,存在远处转移的原发病灶切除与否目前存在争议。然而,笔者建议应采用个体化治疗策略。对于那些需要缓解症状或即将出现并发症,如皮肤溃疡、出血和疼痛病人,如果手术能够保证肿瘤局部完全获得清除,而其他转移灶不会立即威胁生命,特别是在多学科讨论的基础上,并征询病人本人及家属的意愿,可以考虑行初始原发病灶姑息性手术切除。Systemic therapy is the mainstream treatment ofstage IV breast cancer. Current guidelines do not recommendlocoregional surgery for Stage Ⅳ breast cancer despite mostretrospective studies suggesting a survival benefit. Surgicalexcision of the primary breast cancer tumor in the presence ofsynchronous metastatic disease is debated since limitedprospective,randomized studies showing that surgicaltreatment of primary tumors in woman presenting with stage IVdisease does not produce an increase in OS. However,theauthor suggests the situation could be treated individually,initial surgery could be done for those women requiringpalliation of symptoms or with impending complications,suchas skin ulceration,bleeding and pain if complete localclearance of tumor may be obtained and if other sites ofdisease are not immediately threatening to life,especiallywhen it is offered in a multimodality treatment program andwith the preference of patients.

关 键 词：Ⅳ期乳腺癌 局部手术 综合治疗 

分 类 号：R6[医药卫生—外科学]