关注乳腺癌伴随疾病的诊治

To strengthen the diagnosis and treatment of concomitant diseases of breast cancer

《“健康中国2030”规划纲要》提出“全方位、全周期保障人民健康”的“两全”健康管理方针。基于此，我国专家共同拟定首部《乳腺癌随访及伴随疾病全方位管理指南》，开始关注乳腺癌患者在急病治疗、慢病管理过程中所产生的“伴随疾病”，首次提出规范乳腺癌治疗随访期间对乳腺癌伴随疾病的预防与管理。目前被定义的乳腺癌伴随疾病主要有心血管及血脂异常、骨健康及精神心理问题。我们在临床实践中发现乳腺癌患者还伴发较高比例的睡眠障碍、脑认知功能障碍、糖尿病和糖尿病前期、甲状腺疾病、代谢综合征等，该类疾病也符合乳腺癌伴随疾病的定义。本文将对以上乳腺癌伴随疾病进行探讨，以加强对它们的预防与管理，提高乳腺癌患者的生存质量和改善预后。

The outline of ＂Healthy China 2030 Program＂ has put forward a ＂double-aspect＂ health man- agement policy of ＂ all-around and all-cycle protection of peoples＇ health＂. Therefore, Chinese experts started to draw up the ＂comprehensive management guidelines of following-up and concomitant diseases of breast cancer patients＂ which begins to focus on the concomitant diseases of breast cancer caused by the untoward effects of acute therapy and chronic treatment, and aims at providing integrated health care strategy in the convalescence period for clinicians and breast cancer patients. This is the first time to standardize the principles of preventing and managing concomitant diseases of breast cancer during cancer therapy and follow-ups. Currently, three kinds of disease entities regarding bone, cardiovascular and dyslipidemia, mental and psychiatric disorders were defined as concomitant diseases of breast cancer. Besides, authors have found higher prevalence of sleep disorder, cognitive dysfunction, diabetes and prediabetes, thyroid diseases and metabolic syndrome, in which these diseases should also be considered as concomitant diseases of breast cancer. We＇ll discuss these diseases in this paper to increase the consciousness in prevention and management of them, and improve the life quality and prognosis of breast cancer patients.