复发/转移性乳腺癌标志物临床应用专家共识（2019年版）

复发/转移性乳腺癌治疗难度大、预后不佳,且90%以上的复发/转移性乳腺癌为治疗后再次进展,因此复发/转移性乳腺癌患者治疗上须综合参考临床和实验室证据,仔细权衡治疗产生的不良反应与预期临床获益之间的关系。目前临床主要依据肿瘤的雌激素受体(ERα)、孕激素受体(PR)表达及人表皮生长因子受体2(HER2)扩增状态对乳腺癌进行分层管理,选择综合治疗方案。

卡培他滨治疗晚期乳腺癌60例临床观察

目的观察卡培他滨(希罗达)对经蒽环类和(或)紫杉类药物治疗后复发或转移性乳腺癌的疗效分析和毒副反应。方法卡培他滨1250mg/m2,2次/d,餐后服用,连续服用2周,休息1周,至少2周期后评价疗效。结果全组60例无CR,PR16例(26.7%),SD32例(53.3%),PD12例(20%),总有效率26.7%,中位无进展生存时间9.8个月。常见副作用为手足综合征,皮肤色素沉着,腹泻,口腔发炎,恶心呕吐,白细胞及血小板减少,大部分为I-II度。结论应用卡培他滨单药治疗蒽环类和(或)紫杉类治疗后复发或转移性乳腺癌疗效确切,毒副反应轻,应用方便,值得临床推广使用。

Anal metastasis from recurrent breast lobular carcinoma:A case report

We report a case of isolated gastrointestinal metastasis from breast Iobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating Iobular cancer （pT1/G2/N2）. The patient received postoperative radiotherapy and hormonal therapy. Four years later, she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis. According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic.