林燕;
Expert Group for Treatment of Breast Carcinoma in Eldly Chinese Patients;

• 1:中国老年乳腺癌治疗共识专家组
• 2:北京协和医院乳腺外科

摘要(Abstract)：

老年(≥70岁)乳腺癌很少被临床研究所覆盖,同时老年人伴发的疾病往往复杂,故临床实践中对于老年乳腺癌的治疗存在较多争议和不确定性。中国老年肿瘤学会乳腺分委会的治疗共识专家组就老年乳腺癌的治疗问题经过充分讨论后,本着"关键问题上达成共识,争议问题上求同存异"的原则,在老年乳腺癌局部治疗、辅助全身治疗、解救治疗以及新辅助治疗等问题上形成此专家共识,以供临床医师参考。
Elderly( aged ≥70 years) patients with breast carcinoma are seldom included in clinical trials. On the other hand,elderly patients are often involved in complicated comorbidities. That gave rise to great controversies over the management of elderly cases with breast carcinoma. Specialists of the breast carcinoma committee of Chinese Geriatric Oncology Society( CGOS) created the principles of reaching consensus on key issues and reserving differences in controversial issues so as to provide evidence-based recommendations for the treatment of breast carcinoma in elderly individuals. The recommendations include local and adjuvant systematic treatments for primary breast carcinoma in elder individuals,neoadjuvant therapy,and treatment approaches for recurrent elderly patients.

关键词(KeyWords)： 老年;乳腺癌;治疗
elderly;breast carcinoma;treatment

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 林燕;
Expert Group for Treatment of Breast Carcinoma in Eldly Chinese Patients;

参考文献(References)：

• [1]Héry C,Ferlay J,Boniol M,et al.Quantification of changes in breast cancer incidence and mortality since 1990 in 35countries with Caucasian-majority populations[J].Ann Oncol,2008,19:1187-1194.
• [2]Schonberg MA,Marcantonio ER,Li D,et al.Breast cancer among the oldest old:tumor characteristics,treatment choices,and survival[J].J Clin Oncol,2010,28:2038-2045.
• [3]Martelli G,Boracchi P,Palo De M,et al.A randomized trial comparing axillary dissection to no axillary dissection in older patients with T1N0 breast cancer:results after 5 years of follow-up[J].Ann Surg,2005,242:1-6.
• [4]Martelli G,Miceli R,Daidone MG,et al.Axillary dissection versus no axillary dissection in elderly patients with breast cancer and no palpable axillary nodes:results after 15 years of follow-up[J].Ann Surg Oncol,2011,18:125-133.
• [5]Rudenstam CM,Zahrieh D,Forbes JF,et al.Randomized trial comparing axillary clearance versus no axillary clearance in older patients with breast cancer:first results of International Breast Cancer Study Group Trial 10-93[J].J Clin Oncol,2006,24:337-344.
• [6]Biganzoli L,Wildiers H,Oakman C,et al.Management of elderly patients with breast cancer:updated recommendations of the International Society of Geriatric Oncology(SIOG)and European Society of Breast Cancer Specialists(EUSOMA)[J].Lancet Oncol,2012,13:148-160.
• [7]Morrow M,Van Zee KJ,Solin LJ,et al.Society of surgical Oncology-American Society for Radiation Oncology-American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery with Whole-Breast Irradiation in Ductal Carcinoma in Situ[J].J Clin Oncol,2016,34:4040-4046.
• [8]Hughes KS,Schnaper LA,Berry D,et al.Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer[J].N Engl J Med,2004,351:971-977.
• [9]Hughes KS,Schnaper LA,Bellon JR,et al.Lumpectomy plus tamoxifen with or without irradiation in women age 70years or older with early breast cancer:Long-Term Follow-Up of CALGB 9343[J].J Clin Oncol,2013,31:2382-2387.
• [10]Kunkler IH,Williams LJ,Jack WJ,et al.Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer(PRIME II):a randomised controlled trial[J].Lancet Oncol,2015,16:266-273.
• [11]Biganzoli L,Licitra S,Claudino W,et al.Clinical decision making in breast cancer:TAM and aromatase inhibitors for older patients—a jungle?[J]Eur J Cancer,2007,43:2270-2278.
• [12]Muss HB,Tu D,Ingle JN,et al.Efficacy,toxicity,and quality of life in older women with early-stage breast cancer treated with letrozole or placebo after 5 years of tamoxifen:NCIC CTG intergroup trial MA.17[J].J Clin Oncol,2008,26:1956-1964.
• [13]Crivellari D,Sun Z,Coates AS,et al.Letrozole compared with tamoxifen for elderly patients with endocrine-responsive early breast cancer:the BIG 1-98 trial[J].J Clin Oncol,2008,26:1972-1979.
• [14]Pal SK,Katheria V,Hurria A.Evaluating the older patient with cancer:understanding frailty and the geriatric assessment[J].CA Cancer J Clin,2010,60:120-132.
• [15]Kornblith AB,Lan L,Archer L,et al.Quality of life of older patients with early-stage breast cancer receiving adjuvant chemotherapy:a companion study to cancer and leukemia group B 49907[J].J Clin Oncol,2011,29:1022-1028.
• [16]Joensuu H,Kellokumpu-Lehtinen PL,Huovinen R,et al.Adjuvant Capecitabine in Combination with Docetaxel,Epirubicin,and Cyclophosphamide for Early Breast Cancer:The Randomized Clinical Fin XX Trial[J].JAMA Oncol,2017,3:793-800.
• [17]Masuda N,Lee SJ,Ohtani S,et al.Adjuvant capecitabine for breast cancer after preoperative chemotherapy[J].N Engl J Med,2017,376:2147-2159.
• [18]Cardoso F,Costa A,Norton L,et al.ESO-ESMO 2nd international consensus guidelines for advanced breast cancer(ABC2)[J].Ann Oncol,2014,25:1871-1888.
• [19]徐兵河,江泽飞,胡夕春.中国晚期乳腺癌临床诊疗专家共识2016[J].中华医学杂志,2016,96:1719-1727.
• [20]Smorenburg CH,de Groot SM,van Leeuwen-Stok AE,et al.A randomized phaseⅢstudy comparing pegylated liposomal doxorubicin with capecitabine as first-line chemotherapy in elderly patients with metastatic breast cancer:results of the OMEGAstudy of the Dutch Breast Cancer Research Group BOOG[J].Ann Oncol,2014,25:599-605.
• [21]Smith RA,Saslow D,Sawyer KA,et al.American Cancer Society guidelines for breast cancer screening:update 2003[J].CA Cancer J Clin,2003,53:141-169.
• [22]Oeffinger KC,Fontham ET,Etzioni R,et al.Breast cancer screening for women at average risk:2015 Guideline Update From the American Cancer Society[J].JAMA,2015,314:1599-1614.