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过去10年中,英国乳腺癌发病率上升的同时,患者的死亡率却显著下降15％,这与全国广泛采用全身辅助治疗相关,而且有越来越多的证据证明它有益于提高生存率。在仅接受局部治疗的可手术乳腺癌妇女中,有过半数死于远处转移。这说明乳腺癌在临床早期就存在微小转移。发生转移的主要危险因素包括腋窝淋巴结受累、组织学分级差、肿块巨大、肿瘤周围有脉管受侵的组织学证据。雌激素、孕激素受体阴性和人类表皮生长因子受体2(HER2)的过度表达也是不良预后因素。改善预后的方法是给予这些妇女系统的内科治疗,包括手术联合内分泌治疗、化疗或曲妥珠单抗的靶向治疗。
Over the past 10 years, the incidence of breast cancer in the United Kingdom increased at the same time, the patient’s mortality rate dropped significantly by 15%, which is widely associated with systemic adjuvant therapy, and there is growing evidence of its beneficial to improve survival. More than half of women who have undergone surgery for locally-treated breast cancer have died of distant metastases. This shows that there is a slight metastasis of breast cancer in early clinical. The major risk factors for metastasis include axillary lymph node involvement, poor histological grade, massive lumps, and histologic evidence of vascular invasion around the tumor. Overexpression of estrogen, progesterone receptor negative and human epidermal growth factor receptor 2 (HER2) is also a poor prognostic factor. The way to improve the prognosis is to give these women systemic medical treatment, including surgery combined with endocrine therapy, chemotherapy or targeted therapy with trastuzumab.