保乳手术治疗BRCA1/2基因突变型乳腺癌的可行性

Breast cancer conservation therapy in breast cancer patients with BRCA1/2 mutations

保乳手术作为乳腺肿瘤外科一种重要的手术方式,对于其是否适用于BRCA1/2基因突变型乳腺癌患者,目前仍存在争议.由于家族性乳腺癌患者仍然具有单侧多发和对侧发病的高风险,对BRCA1/2基因突变型乳腺癌患者不推荐实施保乳手术,推荐行乳腺全切术和/或Ⅰ期乳房成形手术.但如果BRCA 1/2基因突变型乳腺癌患者有强烈的保乳意愿,在充分告知可能存在风险的前提下,保乳手术也是可行的,但是应考虑双侧卵巢切除或他莫昔芬治疗,同时需要进行更多的干预措施预防对侧乳腺发病.

As an important surgical approach, breast cancer conservation therapy is still controversial in breast cancer patients with BRCA1/2 mutations. Since the risk of unilateral muhiple and contralateral inci- dences is high in the familial breast cancer patients with BRCA1/2 mutations, breast cancer conservation therapy is not recommended but mastectomy and/or immediate mamoplasty. However, if carriers have a strong desire of breast cancer conservation therapy, it is feasible if they are fully informed the risks that may exist. At that time, we should need bilateral oophorectomy, tamoxifen therapy, and more interventions for the prevention of contralateral breast incidences.