Table CDR62787 Breast Cancer Treatment/乳腺癌治疗
ID Type Description_en Description_zh
w1 Word Micrometastases 微转移
w2 Word Basal-like 基底细胞样型
w3 Word Treatments 治疗
w4 Word negative 阴性
w5 Word Introduction 简介
w6 Word Postmastectomy 乳房切除术后
w7 Word Anastrozole 阿那曲唑
w8 Word Bisphosphonates 双磷酸盐
w9 Word Lapatinib 拉帕替尼
w10 Word Lymphedema 淋巴水肿
w11 Word Pertuzumab 帕妥珠单抗
w12 Word positive 阳性
w13 Word HER2+ HER2+过表达型
w14 Word Exemestane 依西美坦
w15 Word AND/OR 和/或
w16 Word Regimen 方案
w17 Word Normal 正常细胞样型
w18 Word Trastuzumab 曲妥珠单抗
w19 Word High Risk 高危
w20 Word Cytoxan (mg/m²) 环磷酰胺(mg/m²)
w21 Word Melanoma Treatment 黑色素瘤的治​疗
w22 Word Paclitaxel/Docetaxel (mg/m²) 紫杉醇/多西他赛(mg/m²)
w23 Word Systemic disease 全身转移
w24 Word Lobular histology ​小叶组织学
w25 Word Primary Therapy 主要治疗
w26 Word mTOR Inhibitors mTOR抑制剂
w27 Word Dose-dense AC-T 剂量密集AC-T
w28 Word Primary therapy 主要治疗
w29 Word Breast reconstruction 乳房再造
w30 Word Tumor size 肿瘤大小
w31 Word Intermediate Risk 中危
w32 Word Cytotoxic chemotherapy 细胞毒性化疗
w33 Word Doxorubicin (mg/m²) 阿霉素(mg/m²)
w34 Word Primary lymphoma 原发性淋巴瘤
w35 Word Deaths: 40,430 ​死亡病例数:40,430
w36 Word Local-regional treatment 局部-区域治疗
w37 Word Phyllodes tumor 叶状肿瘤
w38 Word Posttreatment ypN 治疗后ypN
w39 Word Low Risk 低危
w40 Word Luminal B Luminal B型
w41 Word Luminal A Luminal A型
w42 Word Contralateral Disease 同侧乳腺癌
w43 Word grade 1 1级
w44 Word Monoclonal antibodies 单克隆抗体
w45 Word Patient Group 患者分组
w46 Word Gastrointestinal Complications 胃肠道并发症
w47 Word Breast Reconstruction 乳房再造
w48 Word Systemic Therapy 全身治疗
w49 Word grade 1–2 1-2级
w50 Word Patient Evaluation 患者评估
w51 Word Inflammatory carcinoma 炎性癌
w52 Word Palpable tumors ​肿瘤可触及
w53 Word metastatic cancer 转移性乳腺癌
w54 Word Chemotherapy risks 化疗风险
w55 Word grade 2–3 2-3级
p1 Phrase Nausea and Vomiting 恶心与呕吐
p2 Phrase Benefit of chemotherapy 化疗获益
p3 Phrase Docetaxel and capecitabine 多西他赛联合卡培他滨
p4 Phrase Adjuvant Systemic Therapy 辅助全身治疗
p5 Phrase Sentinel node biopsy 前哨淋巴结活检
p6 Phrase Docetaxel plus trastuzumab 多西他赛联合曲妥珠单抗
p7 Phrase Treatment Option Overview 治疗方案概述
p8 Phrase Lapatinib plus paclitaxel 拉帕替尼联合紫杉醇
p9 Phrase Diagnostics and Survival 诊断和生存
p10 Phrase Pertuzumab plus trastuzumab 帕妥珠单抗联合曲妥珠单抗
p11 Phrase New cases: 235,030 ​新发病例数:235,030
p12 Phrase None or tamoxifen 无,或他莫昔芬
p13 Phrase Triple-Negative Breast Cancer 三阴性乳腺癌
p14 Phrase Preoperative neoadjuvant chemotherapy 术前新辅助化疗
p15 Phrase Postoperative adjuvant chemotherapy 术后辅助化疗
p16 Phrase Post-breast conservation surgery 保乳术后
p17 Phrase Vinorelbine and epirubicin 长春瑞滨联合表柔比星
p18 Phrase triple-negative breast cancer 三阴性乳腺癌
p19 Phrase Capecitabine and ixabepilone 卡培他滨联合伊沙匹隆
p20 Phrase Tamoxifen toxic effects 他莫昔芬的毒性作用
p21 Phrase Docetaxel plus pertuzumab 多西他赛联合帕妥珠单抗
p22 Phrase recurrent breast cancer 复发性乳腺癌
p23 Phrase –M0 includes M0(i+) –M0包括M0(i+)
p24 Phrase inflammatory breast cancer 炎性乳腺癌
p25 Phrase Tamoxifen and chemotherapy 他莫昔芬和化疗
p26 Phrase Lapatinib plus capecitabine 拉帕替尼联合卡培他滨
p27 Phrase Docetaxel and doxorubicin 多西他赛联合阿霉素
p28 Phrase Doxorubicin and paclitaxel 阿霉素联合紫杉醇
p29 Phrase Timing of surgery 手术时机
p30 Phrase Incidence and Mortality 发病率和死亡率
p31 Phrase Lapatinib plus trastuzumab 拉帕替尼联合曲妥珠单抗
p32 Phrase Overview of Chemotherapy 治疗概述
p33 Phrase Hormone Replacement Therapy 激素替代治疗
p34 Phrase T1 includes T1mi T1包括T1mi
p35 Phrase Docetaxel and cyclophosphamide 多西他赛联合环磷酰胺
p36 Phrase Positive axillary nodes 淋巴结转移阳性
p37 Phrase CMF: cyclophosphamide, methotrexate, 5-fluorouracil CMF:环磷酰胺,甲胺蝶呤,5-氟尿嘧啶
p38 Phrase Large tumors (T2 lesions) ​肿瘤较大(T2期病变)
p39 Phrase Premenopausal, ER-negative or PR-negative 绝经前,ER阴性或PR阴性
p40 Phrase stage IV breast cancer IV期乳腺癌
p41 Phrase Results have been inconsistent 研究结果并不一致
p42 Phrase Adult Hodgkin Lymphoma Treatment 成人霍奇金淋巴瘤的治疗
p43 Phrase Axillary lymph node surgery 腋窝淋巴结手术
p44 Phrase Ductal Carcinoma In Situ 导管原位癌
p45 Phrase HER2/neu receptor status testing HER2/neu表达情况检测
p46 Phrase stage II breast cancer II期乳腺癌
p47 Phrase Postmenopausal, ER-negative or PR-negative 绝经后,ER阴性或PR阴性
p48 Phrase Observation after diagnostic biopsy 诊断性活检后观察
p49 Phrase Sexuality and Reproductive Issues 性功能和生殖问题
p50 Phrase stage I breast cancer I期乳腺癌
p51 Phrase CAF: cyclophosphamide, doxorubicin, 5-fluorouracil CAF:环磷酰胺,阿霉素,5-氟尿嘧啶
p52 Phrase Posttreatment yp M classification 治疗后yp M分期
p53 Phrase ER or PR status ER或PR状态
p54 Phrase stage IIIB breast cancer IIIB期乳腺癌
p55 Phrase stage IIIC breast cancer IIIC期乳腺癌
p56 Phrase Lobular Carcinoma In Situ 小叶原位癌
p57 Phrase Prognostic and Predictive Factors 预后和预测因素
p58 Phrase Level of evidence: 1iiA 证据等级:1iiA
p59 Phrase BRCA1 and BRCA1 mutations BRCA1和BRCA2基因突变
p60 Phrase Recurrent local-regional breast cancer 局部-区域复发性乳腺癌
p61 Phrase Breast Cancer (PDQ®): Treatment 乳腺癌(PDQ®):治疗
p62 Phrase stage IIIA breast cancer IIIA期乳腺癌
p63 Phrase Adjuvant radiation and chemotherapy 辅助放疗与化疗
p64 Phrase CA: cyclophosphamide and doxorubicin CA:环磷酰胺,阿霉素
p65 Phrase Cardiac mortality decreased accordingly 心脏相关死亡率随之下降
p66 Phrase Sweats and Hot Flashes 潮热和盗汗
p67 Phrase Both T4a and T4b 同时满足T4a和T4b
p68 Phrase Premenopausal, ER-positive or PR-positive 绝经前,ER阳性或PR阳性
p69 Phrase Stroke RR, 1.06 (0.83–1.36) 卒中RR,1.06(0.83-1.36)
p70 Phrase Chemotherapy and tamoxifen risks 化疗联合他莫昔芬的风险
p71 Phrase Level of evidence: 1iDii 证据等级:1iDii
p72 Phrase Postmenopausal, ER-positive or PR-positive 绝经后,ER阳性或PR阳性
p73 Phrase ductal breast carcinoma in situ 导管原位癌
p74 Phrase Results are expected in 2016 预期将在2016年公布结果
p75 Phrase General Information About Breast Cancer 乳腺癌的基本信息
p76 Phrase Stage Information for Breast Cancer 乳腺癌分期
p77 Phrase Cellular Classification of Breast Cancer 乳腺癌的细胞学分型
p78 Phrase Adult Soft Tissue Sarcoma Treatment 成人软组织肉瘤的治疗
p79 Phrase Genetic Characteristics and Risk Factors 遗传学特征和危险因素
p80 Phrase Stage IV and metastatic disease IV期与转移性乳腺癌
p81 Phrase Carcinoma, NOS (not otherwise specified) ​癌,NOS(如无特殊说明)
p82 Phrase No regional lymph node metastases 无区域淋巴结转移
p83 Phrase Cycle Number and Duration (d) 疗程数与持续时间(天)
p84 Phrase Late toxic effects of radiation 放疗的迟发毒性作用
p85 Phrase lobular breast carcinoma in situ 小叶原位癌
p86 Phrase Docetaxel plus trastuzumab and pertuzumab 多西他赛、曲妥珠单抗联合帕妥珠单抗
p87 Phrase Dose-intensity, dose-density, and high-dose chemotherapy 剂量强度、剂量密度与大剂量化疗
p88 Phrase Ovarian ablation, tamoxifen, and chemotherapy 卵巢去势、他莫昔芬和化疗
p89 Phrase The stage of the disease 肿瘤分期
p90 Phrase ER and PR status testing ER和PR表达情况检测
p91 Phrase Breast-conserving surgery without radiation therapy ​保乳手术,不行放疗
p92 Phrase Added Pertuzumab as a new subsection 增添内容:帕妥珠单抗章节
p93 Phrase Tumors with an extensive intraductal component ​伴有大量导管内癌成分
p94 Phrase Tumor >50 mm in greatest dimension 肿瘤最大径>50 mm
p95 Phrase Total mastectomy with or without tamoxifen 乳房单纯切除术,加用或不加用他莫昔芬
p96 Phrase Cardiac toxic effects with adjuvant trastuzumab 曲妥珠单抗辅助治疗的心脏毒性反应
p97 Phrase No difference in OS was observed 两组OS无显著差异
p98 Phrase Shorter hypofractionation schemes achieve comparable results 短暂低剂量分次模式亦可获得类似疗效
p99 Phrase Tumor ≤1 mm in greatest dimension 肿瘤最大径≤1 mm
p100 Phrase Metastases in ipsilateral infraclavicular lymph node(s) 同侧锁骨下淋巴结转移
p101 Phrase Treatment Options for Patients With DCIS DCIS患者的治疗方案
p102 Phrase Metastases in ipsilateral supraclavicular lymph node(s) 同侧锁骨上淋巴结转移
p103 Phrase Metastases in 4–9 axillary lymph nodes 4–9枚腋窝淋巴结转移
p104 Phrase Metastases in 1–3 axillary lymph nodes 1-3枚腋窝淋巴结转移
p105 Phrase Genetics of Breast and Ovarian Cancer 乳腺癌和卵巢癌的遗传学
p106 Phrase Low Risk (Has All Listed Factors) 低危(满足下列所有条件)
p107 Phrase Timing of Primary and Adjuvant Therapy 主要治疗和辅助治疗的时机
p108 Phrase Metastases in ipsilateral supraclavicular lymph nodes 同侧锁骨上淋巴结转移
p109 Phrase Treatment Options for Patients With LCIS LCIS患者的治疗方案
p110 Phrase Metastases in ≥10 axillary lymph nodes 10枚及以上腋窝淋巴结转移
p111 Phrase Tumor ≤20 mm in greatest dimension 肿瘤最大径≤20 mm
p112 Phrase Slightly more than 20% had received chemotherapy 超过20%的患者已接受化疗
p113 Phrase Stage IV, Recurrent, and Metastatic Breast Cancer IV期、复发性与转移性乳腺癌
p114 Phrase Final results of this trial are pending 该试验最终结果尚未公布
p115 Phrase No regional lymph node metastasis identified histologically 组织学上未见区域淋巴结转移
p116 Phrase Oral Complications of Chemotherapy and Head/Neck Radiation 化疗与头颈部放疗的口腔并发症
p117 Phrase Proliferative capacity of the tumor (e.g., Ki67) 肿瘤增殖能力(例如Ki67水平)
s1 Sentence There was a similar effect on all-cause mortality 发现放疗对全因死亡率有相似影响
s2 Sentence ER = estrogen receptor; PR = progesterone receptor ER=雌激素受体;PR=孕激素受体
s3 Sentence Patients in this study had no interval treatment 该研究中的患者接受了无间歇治疗
s4 Sentence No regional lymph node metastases histologically, negative IHC 组织学上无区域淋巴结转移,IHC阴性
s5 Sentence The age and menopausal status of the patient ​患者年龄和是否绝经
s6 Sentence However, patients inevitably develop resistance to endocrine therapy 但患者不可避免会发生内分泌治疗耐药
s7 Sentence These issues are the subject of several trials 若干研究均致力于解决这些问题
s8 Sentence Size should be measured to the nearest millimeter 大小测量应以最接近的毫米读数为准
s9 Sentence The lead reviewer for Breast Cancer Treatment is: 乳腺癌治疗的首席审核人为:
s10 Sentence Bilateral prophylactic total mastectomy, without axillary node dissection 预防性双侧乳房单纯切除术,不行淋巴结清扫
s11 Sentence High Risk (Has at Least One Listed Factor) 高危(满足下列至少一项条件)
s12 Sentence Adjuvant radiation therapy postmastectomy in axillary node-positive tumors: 腋窝淋巴结阳性患者在乳房切除术后行辅助放疗:
s13 Sentence Metastases in infraclavicular (level III axillary) lymph nodes 锁骨下(III站腋窝)淋巴结转移
s14 Sentence Subsequent systemic therapy may consist of further chemotherapy 后续全身治疗可包括进一步化疗
s15 Sentence Some people include DCIS in breast cancer statistics 一些学者将DCIS纳入乳腺癌的相关统计数据中
s16 Sentence Treatment for systemic disease is palliative in intent 全身转移的治疗应以缓解症状为目标
s17 Sentence Such individuals should first be referred for counseling 这类人群应该首先向专业人士进行相关咨询
s18 Sentence Added Lapatinib plus trastuzumab as a new subsection 增添内容:拉帕替尼联合曲妥珠单抗章节
s19 Sentence This lesion is more appropriately termed lobular neoplasia 这种病变应更准确描述为小叶内瘤变
s20 Sentence Radiation therapy is regularly employed after breast-conservation surgery 保乳手术后需常规行放疗
s21 Sentence This summary discusses only primary epithelial breast cancers 本总结主要讨论原发性上皮细胞性乳腺癌
s22 Sentence Note: This treatment option is under clinical evaluation 注:该治疗方法目前正在接受临床评估
s23 Sentence Endometrial cancer RR, 1.74 (1.30–2.34, P = .0002) 子宫内膜癌RR,1.74(1.30-2.34,P=0.0002)
s24 Sentence This classification, with some modification, is described below: 该分类及其改良分类标准见下表:
s25 Sentence The ER and PR status of the tumor 肿瘤的ER和PR表达情况
s26 Sentence LCIS is usually multicentric and is frequently bilateral LCIS通常呈多灶性、常累及双侧
s27 Sentence Surgical staging of the axilla should also be performed 腋窝淋巴结手术分期也是必要的
s28 Sentence Ductal carcinoma in situ (DCIS) is a noninvasive condition 导管原位癌 (DCIS)是一类非浸润癌
s29 Sentence Ischemic heart disease RR, 0.76 (0.6–0.95, P = .02) 缺血性心脏病RR,0.76(0.6-0.95,P=0.02)
s30 Sentence Metastases to the infraclavicular (level III axillary lymph) nodes 锁骨下(III站腋窝)淋巴结转移
s31 Sentence Tumor >20 mm but ≤50 mm in greatest dimension 肿瘤最大径>20 mm但≤50 mm
s32 Sentence Radiation therapy also can be indicated for postmastectomy patients 全乳切除术后也可能需要行放疗
s33 Sentence –Postneoadjuvant therapy is designated with "yc" or "yp" prefix –新辅助治疗后需标明"yc"或"yp"前缀
s34 Sentence Tumor >10 mm but ≤20 mm in greatest dimension 肿瘤最大径>10 mm但≤20 mm
s35 Sentence Intermediate Risk (Risk Classified Between the Other Two Categories) 中危(危险度介于低危与高危之间)
s36 Sentence Standard treatment is 1 year of adjuvant trastuzumab therapy 标准治疗为1年曲妥珠单抗辅助治疗
s37 Sentence The histologic and nuclear grade of the primary tumor 原发肿瘤的组织学和核型分级
s38 Sentence Therefore, any of these standard regimens is acceptable therapy 因此这些标准方案均为可接受的方案
s39 Sentence The optimal time to initiate adjuvant therapy is uncertain 开始辅助治疗的最优时机仍有争议
s40 Sentence Until recently, the customary treatment of DCIS was mastectomy 截至目前,DCIS的常规治疗方案仍为乳房单纯切除术
s41 Sentence Concurrent docetaxel and carboplatin plus trastuzumab plus pertuzumab (×6) 多西他赛、卡铂、曲妥珠单抗、帕妥珠单抗同期治疗(6程)
s42 Sentence Regional lymph nodes cannot be assessed (e.g., previously removed) 区域淋巴结无法评估(例如已切除)
s43 Sentence Adjuvant chemotherapy 1970s to 2000: Anthracycline-based regimens versus CMF 20世纪70年代至2000年间的辅助化疗:以蒽环类药物为基础的化疗方案对比CMF
s44 Sentence No cardiac deaths were reported in the AVENTIS-TAX-GMA-302 trial AVENTIS-TAX-GMA-302试验中无心源性死亡报道
s45 Sentence Whether completely clear microscopic margins are necessary is debatable 是否需要切缘完全阴性仍有争议
s46 Sentence Tamoxifen to decrease the incidence of subsequent breast cancers ​使用他莫昔芬降低乳腺癌发生率
s47 Sentence Stage I, II, IIIA, and Operable IIIC Breast Cancer I、II、IIIA期与可手术的IIIC期乳腺癌
s48 Sentence Tumor >5 mm but ≤10 mm in greatest dimension 肿瘤最大径>5 mm但≤10 mm
s49 Sentence The term lobular carcinoma in situ (LCIS) is misleading   小叶原位癌(LCIS)一词容易造成误解
s50 Sentence Tamoxifen plus chemotherapy, tamoxifen alone, ovarian ablation, GnRH analog 他莫昔芬联合化疗,单独他莫昔芬治疗,卵巢去势,GnRH类似物
s51 Sentence Inoperable Stage IIIB or IIIC or Inflammatory Breast Cancer 不可手术的IIIB期或IIIC期或炎性乳腺癌
s52 Sentence Breast-conserving surgery and radiation therapy with or without tamoxifen ​保乳手术联合放疗,加用或不加用他莫昔芬
s53 Sentence Tumor >1 mm but ≤5 mm in greatest dimension 肿瘤最大径>1 mm但≤5 mm
s54 Sentence The local-regional control rate was 57% at 10 years 10年局部-区域控制率为57%
s55 Sentence Unusual Cancers of Childhood Treatment (breast cancer in children) 儿童罕见肿瘤的治疗​(儿童乳腺癌)
s56 Sentence ER status may change at the time of recurrence 复发时的ER状态可能改变
s57 Sentence Upfront AI or tamoxifen followed by AI +/- chemotherapy AI起始方案或他莫昔芬加AI+/-化疗
s58 Sentence None or upfront AI or tamoxifen followed by AI 无,或AI起始方案,或先他莫昔芬再AI
s59 Sentence However, specimens were evaluated retrospectively to determine HER2/neu status 但该研究仅回顾性地评估了标本的HER2/neu状态
s60 Sentence Other trials have clearly escalated doses beyond the standard range 其他试验所用递增剂量明显大于标准范围
s61 Sentence –N categories are the same as those used for pN –N分级同pN
s62 Sentence Thus, whole breast radiation therapy after breast-conserving surgery is recommended 因此,推荐保乳术后行全乳照射治疗
s63 Sentence Initial treatment with anthracycline-based chemotherapy and/or taxane-based therapy is standard 蒽环类化疗和(或)紫杉烷治疗为标准初步治疗
s64 Sentence The same is true for women with node-positive breast cancer 这同样适用于淋巴结阳性乳腺癌患者
s65 Sentence The relationship between tamoxifen and ovarian tumors requires further study 他莫昔芬与卵巢肿瘤之间的关系尚待进一步研究
s66 Sentence The following is a list of breast cancer histologic classifications 以下为乳腺癌的组织学分型
s67 Sentence Metastases to movable ipsilateral level I, II axillary lymph node(s) ​同侧I、II站腋窝淋巴结转移,淋巴结活动性好
s68 Sentence Stage IIIB, Inoperable IIIC, IV, Recurrent, and Metastatic Breast Cancer IIIB期、不可手术的IIIC期、IV期、复发性和转移性乳腺癌
s69 Sentence (Refer to the PDQ summary on Lymphedema for more information.) (具体可参见淋巴水肿​PDQ总结)
s70 Sentence Pathologically, breast cancer can be a multicentric and bilateral disease 乳腺癌在病理上可能为多灶、双侧病变
s71 Sentence The proper sequence of these therapies is currently not known 这些治疗的最优顺序目前不明
s72 Sentence Combination regimens that have shown activity in metastatic breast cancer: 对转移癌有效的联合方案:
s73 Sentence In premenopausal women, decreased bone mineral density is a possibility 绝经前女性也可能出现骨密度的降低
s74 Sentence (Refer to the PDQ summary on Pain for more information.) (更多信息请参考PDQ总结疼痛​)
s75 Sentence Micrometastases (>0.2 mm and/or >200 cells but none >2.0 mm) 微转移(>0.2 mm和/或>200个细胞但不超过2.0 mm)
s76 Sentence No regional lymph node metastases histologically, negative molecular findings (RT-PCR) 组织学上无区域淋巴结转移,分子学检测阴性(RT-PCR)
s77 Sentence Thus, these results are hypothesis generating and should be confirmed 因此这些结果成为一些假说的基础,需待证实
s78 Sentence A single cycle of immediate postoperative chemotherapy alone was inferior 术后立即给予1程化疗具有劣效性
s79 Sentence Dexrazoxane has a similar protective effect in patients receiving epirubicin 右雷佐生对表柔比星用药者有相似的保护作用
s80 Sentence Invasion of the dermis alone does not qualify as T4 仅侵犯皮肤不划分为T4
s81 Sentence Most (84%) of the patients in the study were hormone-receptor positive 研究中大多数(84%)患者为肿瘤激素受体阳性
s82 Sentence The role of this procedure in the neoadjuvant setting is uncertain 新辅助治疗中SLN活检的作用尚不明确
s83 Sentence Metastases in ipsilateral internal mammary lymph node(s) and axillary lymph node(s) 同侧内乳淋巴结和腋窝淋巴结转移
s84 Sentence Human epidermal growth factor type 2 receptor ( HER2/neu ) overexpression 人类表皮生长因子2受体(HER2/neu)是否有过表达
s85 Sentence ITCs may be detected by routine histology or by IHC methods ITC可以通过常规组织学检查或IHC法进行评估
s86 Sentence For example, favorable histologic types include mucinous, medullary, and tubular carcinoma 例如预后较好的组织学类型包括黏液癌、髓样癌和小管癌
s87 Sentence There is no evidence favoring any regimen as superior to another 尚无证据表明某种方案优于其他方案
s88 Sentence The use of molecular profiling in breast cancer includes the following: 乳腺癌的分子分型依赖于以下检测:
s89 Sentence Breast-conserving therapy (lumpectomy, breast radiation, and surgical staging of the axilla) 保乳治疗(肿瘤切除术、乳腺放疗、腋窝手术分期)
s90 Sentence Common toxic effects include nausea and vomiting, myelosuppression, alopecia, and mucositis 常见的毒性反应包括恶心呕吐、骨髓抑制、脱发和黏膜炎等
s91 Sentence A series of AE were low and existed in both arms 两组的AE发生率均较低,分布情况相似
s92 Sentence The relationship of these changes to thromboembolic phenomena is not clear 这些凝血因子的改变与血栓栓塞现象的关系尚不明确
s93 Sentence In several adjuvant studies, the incidence ranged from 1% to 2% 在若干辅助治疗研究中,其发生率介于1-2%
s94 Sentence A further radiation boost is commonly given to the tumor bed 通常还需给予肿瘤床加量照射
s95 Sentence In two of these trials, all patients also received adjuvant tamoxifen 其中2项研究里所有患者同时接受了他莫昔芬的辅助治疗
s96 Sentence However, data on this topic from prospective, randomized studies are lacking 但该事件缺乏前瞻性随机研究数据的支持
s97 Sentence Extension to the chest wall, not including only pectoralis muscle adherence/invasion 侵犯胸壁,不包括只造成胸大肌粘附/侵犯
s98 Sentence Because of the conflict in data, the optimal duration is controversial 由于现有数据存在冲突,因此他莫昔芬治疗的最佳疗程仍有待商榷
s99 Sentence For example, estrogen and/or progesterone receptor–positive patients will receive hormone therapy 例如,ER+和/或PR+患者需接受内分泌治疗
s100 Sentence Endocrine therapy is recommended for patients with metastatic hormone receptor-positive (HR+) disease 建议激素受体阳性(HR+)的乳腺癌转移患者采用内分泌治疗
s101 Sentence Axillary lymph node dissection is not necessary in the management of LCIS LCIS治疗中无需行腋窝淋巴结清扫
s102 Sentence Tamoxifen use may also be associated with an increased risk of strokes 他莫昔芬治疗还可能与卒中发生风险增加相关
s103 Sentence The AJCC has designated staging by TNM classification to define breast cancer AJCC采用TNM分期法对乳腺癌进行分期
s104 Sentence For more than four nodes or extranodal involvement: regional radiation is advised 4枚或更多阳性淋巴结或结外受累:建议行区域放疗
s105 Sentence These trials raise important questions about the optimal duration of endocrine therapy 这些临床试验都提出了关于内分泌治疗最佳疗程的重要问题
s106 Sentence No differences were seen in DFS or OS among the three groups 这三组的DFS与OS无差异
s107 Sentence No evidence is available that re-excision to obtain clear margins is required 尚无证据表明再次切除以获得阴性切缘是必要的
s108 Sentence In the intention-to-treat population, no benefit was found with the combination treatment 在意图治疗人群里发现,联合治疗并不增加获益
s109 Sentence For patients in this subset, surgery and/or radiation therapy may be curative 但少数患者可能仅有胸壁复发,对于此类患者,可通过手术与(或)放疗达到治愈目的
s110 Sentence These reviews are retrospective, noncontrolled, and are subject to substantial selection bias 这些研究均为回顾性非对照研究,易受大量选择偏倚的影响
s111 Sentence At this time, no data support the superiority of any particular regimen 目前尚无数据提示某一具体方案的有效性
s112 Sentence The use of adjuvant tamoxifen has been associated with certain toxic effects 他莫昔芬辅助治疗与特定的毒性作用相关
s113 Sentence Goals of treatment include improving quality of life and prolongation of life 治疗目的包括改善生活质量和延长寿命
s114 Sentence Bilateral disease is somewhat more common in patients with infiltrating lobular carcinoma 双侧病变更常见于浸润性小叶癌
s115 Sentence Pulmonary embolus relative risk (RR), 1.87 (95% CI, 1.13–3.07, P = .01) 肺栓塞相对风险(RR),1.87(95%CI,1.13-3.07,P=0.01)
s116 Sentence Docetaxel given weekly was not superior to paclitaxel given every 3 weeks 多西他赛每周一次给药不优于紫杉醇每三周一次给药
s117 Sentence At this time, cardiac mortality was also decreasing in the United States 与此同时,美国心脏相关死亡率也有所下降
s118 Sentence Caution should be used in interpreting pCR as a primary clinical outcome 以pCR作为主要临床结局时必须谨慎
s119 Sentence Other PDQ summaries containing information related to breast cancer include the following: 关于乳腺癌的其它PDQ总结如下:
s120 Sentence The FDA approved no more than 3 to 6 cycles of pertuzumab FDA批准帕妥珠单抗使用不超过3-6个疗程
s121 Sentence This was probably caused by the radiation received by the left myocardium 这可能是由于左侧心肌接受部分射线所致
s122 Sentence FEC alone (×3) followed by concurrent docetaxel plus trastuzumab plus pertuzumab (×)3 FEC单独治疗(3程)后行多西他赛、曲妥珠单抗、帕妥珠单抗同期治疗(3程)
s123 Sentence Metastases in 1–3 axillary lymph nodes, at least one metastasis >2.0 mm 1-3枚腋窝淋巴结转移,其中至少一枚超过2.0 mm
s124 Sentence (Refer to the PDQ summary on Breast Cancer Screening for more information.) (具体可参见乳腺癌的筛查PDQ总结)
s125 Sentence The HR for OS was 0.85 (95% CI, 0.7–1.02; P = .08) OS的HR为0.85(95%CI,0.7-1.02;P=0.08)
s126 Sentence (Refer to the PDQ summary on Breast Cancer Prevention for more information.) (具体可参见乳腺癌的预防​PDQ总结)
s127 Sentence Genetic testing is available to detect mutations in members of high-risk families 在高危家庭成员中进行基因检测可以明确这些突变是否存在
s128 Sentence Metastases in 4–9 axillary lymph nodes (at least 1 tumor deposit >2 mm) 4–9枚腋窝淋巴结转移(至少1枚肿瘤细胞团超过2 mm)
s129 Sentence Whether this increased detection rate will translate into improved treatment outcome is unknown 这一检出率的提高是否可以改善最终疗效尚不明确
s130 Sentence Radiation therapy and/or surgery may be indicated for patients with limited symptomatic metastases 症状局限的转移癌患者可考虑放疗和(或)手术
s131 Sentence Patients whose tumors have progressed on hormone therapy are candidates for cytotoxic chemotherapy 经过激素治疗后肿瘤进展的患者可考虑进行细胞毒性化疗
s132 Sentence In addition, mutation carriers may be at increased risk of other primary cancers 此外,存在这些基因突变的个体发生其他原发肿瘤的风险也可能增加
s133 Sentence However, this significance was lost at 5 years (RR, 1.00; 95% CI, 0.92–1.08) 但5年EFS无显著差异(RR,1.00;95%CI,0.92-1.08)
s134 Sentence In general, pathologic determination should take precedence over clinical determination of T size 一般来说,对T分期而言,病理诊断优于临床诊断
s135 Sentence Similar to estrogen, tamoxifen produces endometrial hyperplasia, which can be a premalignant change 与雌激素类似,他莫昔芬可以促进子宫内膜增生,进而发展为癌前病变
s136 Sentence Radiation therapy has a major role in the palliation of localized symptomatic metastases 放疗对缓解局部转移症状有重要作用
s137 Sentence –Posttreatment yp "N" should be evaluated as for clinical (pretreatment) "N" methods above   –治疗后yp "N" 应根据上述的临床(治疗前)"N"分期进行评估
s138 Sentence The pathologic complete response (pCR) rates were 29%, 46%, 17%, and 24%, respectively 四组的病理完全缓解率(pCR)分别为29%、46%、17%与24%
s139 Sentence Of note, OS and DFS outcomes were not reported in either clinical trial 需注意,这两项临床试验均未报道OS与DFS结果
s140 Sentence Patients with local-regional breast cancer recurrence may become long-term survivors with appropriate therapy 局部-区域性乳腺癌复发患者经过适当的治疗可长期生存
s141 Sentence There was no significant difference in DFS between the anastrozole and tamoxifen groups 阿那曲唑与他莫昔芬组患者的DFS无显著差异
s142 Sentence The combined local and distant recurrence rate following mastectomy is 1% to 2% 而行乳房单纯切除后局部及远处复发率仅为1%-2%
s143 Sentence Hormone therapy should be administered to patients whose tumors are ER-positive or unknown ER阳性或ER状态不明的患者应接受激素治疗
s144 Sentence Many breast surgeons, however, now consider this to be an overly aggressive approach 然而许多乳腺外科医生认为这种做法过于激进
s145 Sentence Metastases in ≥10 axillary lymph nodes (at least 1 tumor deposit >2.0 mm) 10枚及以上腋窝淋巴结转移(至少1个肿瘤细胞团超过2 mm)
s146 Sentence Single agents that have shown activity in metastatic breast cancer include the following: 对转移性乳腺癌有效的单药包括下列:
s147 Sentence No randomized controlled studies are available to guide patient care in this situation 尚无随机对照临床试验为这种情况下的患者治疗提供指南
s148 Sentence DCIS = ductal carcinoma in situ ; LCIS = lobular carcinoma in situ DCIS=导管原位癌,LCIS=小叶原位癌
s149 Sentence Adjuvant Chemotherapy 2000s to Present: The role of adding taxanes to adjuvant therapy 2000年至今的辅助化疗:向辅助化疗方案中增加紫杉烷的作用
s150 Sentence Patients with local-regional recurrence should be considered for further local treatment (e.g., mastectomy) 局部-区域性复发的患者应考虑进一步行局部治疗(例如乳房切除术)
s151 Sentence Additional pathologic characteristics, including grade and proliferative activity may also be of value 其他病理学特点,包括分级和增殖能力也可能具有重要意义
s152 Sentence Whether single-agent chemotherapy or combination chemotherapy is preferable for first-line treatment is unclear 尚不明确单药化疗与联合化疗哪种更适合一线治疗
s153 Sentence Randomized clinical trial data support the use of aromatase inhibitors in postmenopausal women 随机临床试验数据支持在绝经后女性乳腺癌患者中使用芳香酶抑制剂
s154 Sentence Another trial demonstrated the equivalence of 5 years and 10 years of therapy 另一项研究则显示他莫昔芬治疗5年和10年疗效等价
s155 Sentence No randomized comparisons of mastectomy versus breast-conserving surgery plus breast radiation are available 目前尚无关于乳房单纯切除术与保乳手术联合放疗疗效对比的随机研究数据
s156 Sentence At a median follow-up of 4.1 years, no difference in efficacy was seen 随访时间中位数为4.1年,发现二者的有效性无差别
s157 Sentence Male carriers of BRCA2 mutations are also at increased risk for breast cancer BRCA2基因突变的男性乳腺癌患病风险亦有所增加
s158 Sentence Results may have been different with these two contemporary modifications to the study 如果采用这两种当前的化疗方案结果可能有所不同
s159 Sentence No differences in DFS, distant DFS, and OS were observed between these two arms 两组的DFS、远处DFS和OS无差异
s160 Sentence PARPs are a family of enzymes involved in multiple cellular processes, including DNA repair PARP为参与包括DNA修复在内的多种细胞过程的一系列酶
s161 Sentence Toxicities associated with bevacizumab were similar to those seen in prior bevacizumab clinical trials 贝伐单抗相关毒性反应与既往贝伐单抗临床试验相似
s162 Sentence In addition, 14 women developed contralateral breast tumors (10 of the tumors were invasive) 此外,14例患者出现对侧乳腺癌(其中10例为浸润癌)
s163 Sentence Even when these tests permit earlier detection of recurrent disease, patient survival is unaffected 即使这些检查可以更早发现肿瘤复发,患者生存率也不受其影响
s164 Sentence Platinum agents have recently emerged as drugs of interest for the treatment of TNBC 铂类药物最近成为TNBC治疗领域的热点话题
s165 Sentence The axillary lymph nodes should be staged to aid in determining prognosis and therapy 应对腋窝淋巴结分组以协助判断预后和选择治疗方案
s166 Sentence The role of magnetic resonance imaging (MRI) in screening and follow-up continues to evolve 核磁共振成像(MRI)在乳腺癌筛查和随访中的地位还在不断发展中
s167 Sentence Cytologic or histologic documentation of recurrent or metastatic disease should be obtained whenever possible 应尽可能记录复发性或转移性乳腺癌的细胞学或组织学类型
s168 Sentence Sequential use of single agents or combinations can be used for patients who relapse 单药序贯治疗或联合治疗可以用于复发患者
s169 Sentence The group receiving AC-trastuzumab showed a small but not statistically significant benefit over TCH AC-T组患者人数较少,但与TCH组相比无统计学显著获益
s170 Sentence Cognitive impairment has been reported to occur after the administration of some chemotherapy regimens 一些患者接受化疗后出现认知损害
s171 Sentence The value of endometrial biopsy, hysteroscopy, and transvaginal ultrasound as screening tools is unclear 子宫内膜活检、宫腔镜和经阴道超声是否应作为筛查手段尚未明确
s172 Sentence Lymphedema consequent to cancer management remains a major quality-of-life concern for breast cancer patients 对乳腺癌患者而言继发于肿瘤治疗的淋巴水肿仍为影响生活质量的重要问题之一
s173 Sentence Specific mutations of BRCA1 and BRCA2 are more common in women of Jewish ancestry 在犹太裔的女性中BRCA1和BRCA2基因的特定突变更为常见
s174 Sentence Results of individual trials are generally in agreement with the conclusions of the meta-analysis 各项临床试验的结果基本与荟萃分析结论相符
s175 Sentence Clinical trials comparing multiagent chemotherapy plus trastuzumab versus single-agent chemotherapy have yielded conflicting results 一些临床试验对比了多药化疗联合曲妥珠单抗与单药化疗的有效性,结果并不一致
s176 Sentence However, the study was not powered to detect equivalence between the two trastuzumab-containing regimens 但该研究效力不足以检测出两个含曲妥珠单抗方案的等效性
s177 Sentence Toxicities, specifically alopecia, diarrhea, and rash were higher in the HER2/neu -positive lapatinib group HER2/neu阳性患者接受拉帕替尼治疗后毒性反应发生率较高,尤其是脱发、腹泻和皮疹
s178 Sentence This low-risk and uncertain-risk subset had a 96% 5-year survival rate without adjuvant therapy 这些低危患者与危险度不明的患者不接受辅助治疗的情况下,5年生存率为96%
s179 Sentence Proposals have been made to treat elderly patients with tamoxifen alone and without surgery 曾有人提出不行手术、单纯使用他莫昔芬治疗老龄患者
s180 Sentence In many cases, the diagnosis of breast carcinoma is made by core needle biopsy 在许多病例中,乳腺癌的诊断均由空心针活检完成
s181 Sentence HER2 overexpression is an indication for using adjuvant trastuzumab, usually in combination with chemotherapy HER2过表达患者应接受辅助曲妥珠单抗治疗,往往还需联合化疗
s182 Sentence AI= aromatase inhibitors; ER = estrogen receptor; GnRH = gonadotropin-releasing hormone; PR = progesterone receptor AI=芳香化酶抑制剂;ER=雌激素受体;GnRH=促性腺激素释放激素;PR=孕激素受体
s183 Sentence Rarely, the breast may be involved by other tumors such as lymphomas, sarcomas, or melanomas 但罕见情况下乳腺也可发生其他肿瘤,例如淋巴瘤、肉瘤或黑色素瘤等
s184 Sentence Patients without axillary dissection had fewer DFS events (hazard ratio [HR], 0.78; 95% CI, 0.55–1.11) 未接受全腋窝淋巴结清扫的患者DFS事件发生率更低(风险比[HR],0.78;95%CI,0.55-1.11)
s185 Sentence Metastases in ipsilateral level I, II axillary lymph nodes that are clinically fixed or matted ​同侧I、II 站腋窝淋巴结转移,淋巴结固定或融合
s186 Sentence Two randomized phase III clinical trials of chemotherapy with or without bevacizumab have reported results 两项化疗联合或不联合贝伐单抗的随机、III期临床试验结果已有报道
s187 Sentence The data for the benefit of dose escalation in breast cancer, however, are more controversial 但关于剂量递增对乳腺癌的益处数据则更具争议
s188 Sentence The treatment options presented below should be modified based upon both patient and tumor characteristics 下表所列的一些治疗选择应根据患者和肿瘤特征个体化裁量
s189 Sentence Strontium 89, a systemically administered radionuclide, can be administered for palliation of diffuse bony metastases 锶89是一种全身用的放射性核素,可用于缓解弥漫性骨转移
s190 Sentence However, further study of bevacizumab for the treatment of operable breast cancer may be warranted 但关于贝伐单抗用于治疗可手术乳腺癌的进一步研究可能是很有道理的
s191 Sentence Classification is based on axillary lymph node dissection with or without sentinel lymph node biopsy 分级基于伴或不伴前哨淋巴结活检的腋窝淋巴结清扫结果
s192 Sentence As an adjuvant strategy, ovarian ablation has also been compared with chemotherapy in premenopausal women 作为一项辅助治疗,研究人员还在绝经前女性中进行了卵巢去势和化疗的疗效对比
s193 Sentence Regional lymph nodes cannot be assessed (e.g., previously removed or not removed for pathologic study) 区域淋巴结无法评估(例如已切除或未因病理检查切除)
s194 Sentence Molecular profiling has led to classification of breast cancer into the following five distinct subtypes: 根据基因表达谱将乳腺癌分为以下五个亚型:
s195 Sentence Positive molecular findings (RT-PCR), but no regional lymph node metastases detected by histology or IHC 分子学检测阴性(RT-PCR),但组织学或IHC未发现区域淋巴结转移
s196 Sentence Premenopausal women should undergo oophorectomy (surgically, with external-beam radiation therapy or with an LHRH agonist) 绝经前女性应行卵巢去势治疗(手术,外部照射,或LHRH拮抗剂)
s197 Sentence The modifier "SN" is used only if a sentinel node evaluation was performed after treatment 如果治疗后行前哨淋巴结评估则标明"SN"
s198 Sentence Malignant cells in regional lymph node(s) ≤0.2 mm (detected by H&E or IHC including ITC) 区域淋巴结中恶性细胞局限于0.2 mm内(H&E染色或IHC发现,包括ITC)
s199 Sentence No difference was shown in OS (HR, 0.97; 95% CI, 0.85–1.12; P = .7 ) 两组的OS无明显差异(HR,0.97;95%CI,0.85-1.12;P=0.7)
s200 Sentence These rates are higher than those observed when SLN biopsy is done before adjuvant chemotherapy 这些假阴性率均高于辅助化疗前的SLN活检
s201 Sentence Further results of research studies prospectively evaluating the role of adjuvant ovarian ablation are awaited 关于卵巢去势辅助治疗的作用仍待进一步前瞻性研究以明确
s202 Sentence A prospectively controlled trial ( UCLA-9810046 ) has been completed but is not yet analyzed 一项前瞻性对照试验(UCLA-9810046​)已经结束,但数据分析尚未完成
s203 Sentence Several other studies, however, have failed to support this finding or have found opposite results 但也有一些研究未得出类似结果,或得到相反结果
s204 Sentence Estimated new cases and deaths from breast cancer (women only) in the United States in 2014: 美国2014年所有新发乳腺癌病例数和乳腺癌死亡病例数(仅统计女性)如下:
s205 Sentence Very few cases of DCIS present as a palpable mass; 80% are diagnosed by mammography alone DCIS临床上很少表现为可触及的包块;80%DCIS由钼靶检查首次发现
s206 Sentence AI = aromatase inhibitor; ER = estrogen receptor; GnRH = gonadotropin-releasing hormone; PR = progesterone receptor AI=芳香化酶抑制剂;ER=雌激素受体;GnRH=促性腺激素释放激素;PR=孕激素受体
s207 Sentence The administration of radiation therapy may be associated with short-term morbidity, inconvenience, and potential long-term complications 接受放疗可能与短期死亡率、操作不便和潜在的长期并发症相关
s208 Sentence Mutations in either the BRCA1 or BRCA2 gene also confer an increased risk of ovarian cancer BRCA1或BRCA2基因突变同时也造成卵巢癌患病风险增加
s209 Sentence Preclinical models and clinical studies suggest that mTOR inhibitors might enhance the efficacy of endocrine therapies 临床前模型和临床研究均提示此时可用mTOR抑制剂增强激素治疗的有效性
s210 Sentence All histologic types of invasive breast cancer may be treated with breast-conserving surgery plus radiation therapy 所有组织学类型的浸润癌均可采用保乳手术联合放疗的治疗方案
s211 Sentence Women taking tamoxifen should be evaluated by a gynecologist if they experience any abnormal uterine bleeding 接受他莫昔芬治疗的患者如果出现任何异常的子宫出血均应接受妇科医生的评估
s212 Sentence The main goal of adjuvant radiation therapy is to eradicate residual disease thus reducing local recurrence 辅助放疗的主要目的在于根除残余病灶从而降低局部复发率
s213 Sentence These trials will help to define the role of platinum agents for the treatment of TNBC 这些试验将有助于确定铂类在TNBC治疗中的角色
s214 Sentence If no subscript is attached, it is assumed that the axillary nodal evaluation was by AND 如果无任何标注,则默认根据腋窝淋巴结清扫结果评估淋巴结
s215 Sentence Ovarian ablation alone should not be routinely used as an alternative to any other systemic therapy 单纯卵巢去势也不能作为任何其它全身治疗的替代治疗
s216 Sentence The CLB-8541 trial compared three dose intensities of CAF in 1,550 patients with node-positive breast cancer CLB-8541​试验在1,550例淋巴结阳性乳腺癌女性患者中比较了三种剂量CAF的作用
s217 Sentence Comedo-type DCIS appears to be more aggressive, with a higher probability of associated invasive ductal carcinoma 粉刺型DCIS在几种亚型中最具侵袭性,其进展为浸润性导管癌的概率更大
s218 Sentence Tamoxifen use is also associated with an increased incidence of deep venous thrombosis and pulmonary emboli 他莫昔芬治疗还与深静脉血栓和肺栓塞的发生率增加相关
s219 Sentence DCIS can progress to become invasive cancer, but estimates of the likelihood of this vary widely DCIS可以进展为浸润癌,但无确定概率
s220 Sentence Metastases in ipsilateral supraclavicular lymph node(s) with or without axillary or internal mammary lymph node involvement ​同侧锁骨上淋巴结转移,伴或不伴腋窝或内乳淋巴结转移
s221 Sentence Treatment of metastatic breast cancer will usually involve hormone therapy and/or chemotherapy with or without trastuzumab 转移性乳腺癌的治疗通常包括激素治疗和(或)化疗加或不加曲妥珠单抗
s222 Sentence The role of bisphosphonates as part of adjuvant therapy for early stage breast cancer is unclear 辅助治疗中增加双磷酸盐对早期乳腺癌的作用尚不明确
s223 Sentence The poly (ADP-ribose) polymerase (PARP) inhibitors are emerging as promising therapeutics for the treatment of TNBC 多(ADP核糖)聚合酶(PARP)抑制剂涌现成为TNBC治疗被看好的新型药物
s224 Sentence Stage I, II, IIIA, and operable IIIC breast cancer often requires a multimodality approach to treatment I、II、IIIA及可手术的IIIC期乳腺癌往往需要综合性治疗
s225 Sentence The control group had a 5-year DFS rate of 75% and an OS rate of 87% 对照组的5年DFS率为75%,OS率为87%
s226 Sentence In the NSABP Breast Cancer Prevention Trial ( NSABP-P-1 ), this increase was not statistically significant 在NSABP乳腺癌预防试验(NSABP-P-1)中,这一风险增加不具有统计学意义
s227 Sentence Based on these results, bevacizumab should not be used in the treatment of operable breast cancer 根据这些结果,贝伐单抗不应用于可手术乳腺癌的治疗
s228 Sentence None of the trials identified a statistically significant benefit in OS or DFS from ovarian suppression 这些临床试验中卵巢抑制对于OS和DFS均未显示出具有统计学意义的获益
s229 Sentence In the FINHER trial, none of the patients who received trastuzumab experienced clinically significant cardiac events FINHER试验中,所有接受曲妥珠单抗治疗的患者均未发生临床上显著的心脏事件
s230 Sentence Patients with localized breast or chest wall recurrences, however, may be long-term survivors with appropriate therapy 但局部乳腺或胸壁复发的患者通过适当的治疗可能达到长期生存
s231 Sentence All patients with metastatic or recurrent breast cancer should be considered candidates for ongoing clinical trials 所有转移性或复发性乳腺癌患者均应考虑进入目前正在进行的临床试验
s232 Sentence Metastases in clinically detected internal mammary lymph nodes in the absence of axillary lymph node metastases 临床检测到内乳淋巴结转移,不伴腋窝淋巴结转移
s233 Sentence Breast cancer is commonly treated by various combinations of surgery, radiation therapy, chemotherapy, and hormone therapy 乳腺癌的常规治疗是以手术、放疗、化疗和内分泌治疗为基础的综合治疗
s234 Sentence An International Consensus Panel proposed a three-tiered risk classification for patients with negative axillary lymph nodes 国际共识专家组建议对腋窝淋巴结阴性的患者进行三层危险度分级
s235 Sentence Because only 25% of MRI-positive findings represent malignancy, pathologic confirmation prior to treatment action is recommended 由于仅有25%的MRI阳性结果最终确诊是乳腺癌,因此专家推荐在治疗前进行病理学确诊
s236 Sentence This difference in the pattern of recurrence was of borderline statistical significance ( P = .07) 复发率上的差异仅具边缘统计学意义(P=0.07)
s237 Sentence Gene profile testing by microarray assay or reverse transcription-polymerase chain reaction (e.g., MammaPrint, Onco type DX) 通过基因芯片技术或逆转录-聚合酶链式反应技术(例如MammaPrint、Oncotype DX)进行基因表达谱检测
s238 Sentence Patients with hormone receptor–negative tumors and those with visceral metastases are also candidates for cytotoxic agents 激素受体阴性肿瘤和脏器转移肿瘤患者也可考虑细胞毒性化疗
s239 Sentence Most women with LCIS have disease that can be managed without additional local therapy after biopsy 大多数LCIS患者在经过活检后无需进一步局部治疗
s240 Sentence Pertuzumab, in combination with trastuzumab with or without chemotherapy, has been evaluated in two clinical trials 两项临床试验评估了帕妥珠单抗联合曲妥珠单抗加或不加化疗的效果
s241 Sentence Breast cancer is classified into a variety of histologic types, some of which have prognostic importance 乳腺癌可分为多种组织学类型,其中一些类型对于预后具有重要意义
s242 Sentence Prior to treatment for recurrent or metastatic cancer, restaging to evaluate extent of disease is indicated 在治疗复发性或转移性乳腺癌患者之前需重新对疾病分期,评估侵犯程度
s243 Sentence Symptomatic CHF occurred in 1.7% and 0.06% of patients in the trastuzumab and observation arms, respectively 曲妥珠单抗组与观察组发生CHF症状的患者比例分别为1.7%与0.06%
s244 Sentence (Refer to the Letrozole section in the Aromatase inhibitors section of this summary for more information.) (具体可参见本总结芳香酶抑制剂部分来曲唑​一节)
s245 Sentence The development of a contralateral breast cancer is associated with an increased risk of distant recurrence 对侧乳腺癌复发意味着远处复发风险亦增加
s246 Sentence Breast cancer prevention trials, including the National Cancer Institute of Canada's trial ( CAN-NCIC-MAP3 [NCT00083174]), for example ​参与乳腺癌预防临床试验,例如加拿大国家乳腺癌研究所组织的临床试验 (CAN-NCIC-MAP3 [NCT00083174])
s247 Sentence A greater benefit was seen in hormone receptor-positive patients (HR, 0.83; 95% CI, .73–0.94; P = .05) 而在肿瘤激素受体阳性的患者中这一获益则较大(HR,0.83;95%CI,.73-0.94;P=0.05)
s248 Sentence Lapatinib is an orally administered tyrosine kinase inhibitor of both HER2/neu and the epidermal growth factor receptor 拉帕替尼是一种口服酪氨酸激酶抑制剂,能够抑制EGFR与HER2/neu两种受体
s249 Sentence Upfront AI or tamoxifen followed by AI plus chemotherapy, upfront AI or tamoxifen followed by AI alone AI起始方案,或他莫昔芬加AI加化疗,AI起始方案或他莫昔芬加AI
s250 Sentence For women with germ-line mutations in BRCA1 and BRCA2 , further study of breast-conserving treatment is needed 而对于具有BRCA1和BRCA2种系突变的女性来说,是否可行保乳手术仍需进一步研究
s251 Sentence The risks of cardiac toxicity may also be reduced by administering doxorubicin as a continuous intravenous infusion 阿霉素通过持续静脉输注给药可能降低心脏毒性风险
s252 Sentence Single-modality treatment of the axilla (surgery or radiation) is associated with a low incidence of arm edema 腋窝淋巴结单一治疗(手术或放疗)后上肢水肿发生率很低
s253 Sentence The high-dose arm had twice the dose intensity and twice the drug dose as the low-dose arm 大剂量组的剂量强度和药物剂量是小剂量组的2倍
s254 Sentence Patients on anastrozole, however, had a significantly longer DFS (hazard ratio [HR], 0.83) than those on tamoxifen 但与单纯他莫昔芬治疗相比,阿那曲唑的使用显著延长了患者的DFS(HR,0.83)
s255 Sentence All patients underwent lumpectomy, tangential whole-breast irradiation, and appropriate systemic therapy, and OS was the primary endpoint 所有患者均接受局部病灶切除、切向全乳照射和恰当的全身治疗,以OS为主要终点
s256 Sentence Breast-conserving therapy can be considered in patients with a good partial or complete response to neoadjuvant chemotherapy 对新辅助化疗有良好的部分缓解或完全缓解反应的患者可考虑行保乳术
s257 Sentence The MA27 (NCT00066573) trial randomly assigned 7,576 postmenopausal women to receive 5 years of anastrozole versus exemestane MA27​(NCT00066573)试验将7,576例绝经后女性随机分为2组,分别接受5年阿那曲唑或5年依西美坦治疗
s258 Sentence Although median survival has been reported to be 18 to 24 months, some patients experience long-term survival 虽然据报道中位生存期为18-24个月,但也有一些患者可长期生存
s259 Sentence Retrospective and some prospective data support the view that physicians should avoid arbitrary reductions in dose intensity 回顾性数据和一些前瞻性数据支持医师不应强制减少剂量强度
s260 Sentence Stage and molecular features determine the need for adjuvant systemic therapy and the choice of modalities used 乳腺癌分期和肿瘤分子学特征决定了是否有必要行全身辅助治疗以及应该选择何种治疗方案
s261 Sentence Bilateral prophylactic mastectomy is sometimes considered an alternative approach for women at high risk for breast cancer 对乳腺癌患病高危人群,有时可考虑行预防性双侧乳房单纯切除术
s262 Sentence Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1) 更新了2014年新发病例数和死亡病例数估计值统计信息(引用美国癌症协会数据,见参考文献1)
s263 Sentence In September 2011, the ALTTO trial was amended to discontinue the lapatinib alone arm of the trial 2011年9月,ALTTO试验停止了拉帕替尼单药治疗
s264 Sentence The optimal treatment duration for patients with responsive or stable disease has been studied by several groups 一些组织研究了肿瘤缓解或病情稳定患者的最佳治疗持续时间
s265 Sentence In the NCCTG-N9831 trial, 39 cardiac events were reported in the three arms over a 3-year period NCCTG-N9831​试验中,三组在3年时间内共发生39例心脏事件
s266 Sentence Another trial, entitled the Triple Negative Trial (NCT00532727), is evaluating carboplatin against docetaxel in the metastatic setting 另一项试验三阴性试验​(NCT00532727)正在进行之中,目的是评估卡铂联合多西他赛对转移癌的作用
s267 Sentence PARP inhibitors are currently being evaluated in clinical trials for patients with BRCA mutations and in TNBC PARP抑制剂正在接受多项临床试验的研究,评估其对BRCA突变型乳腺癌和TNBC患者的作用
s268 Sentence These reports demonstrate a 97.5% to 100% concordance between SLN biopsy and complete axillary lymph node dissection (ALND) 这些报告显示SLN活检和全腋窝淋巴结清扫(ALND)结果的一致性高达97.5%-100%
s269 Sentence A subsequent analysis of these data was performed to determine the influence of margin width on local control 研究人员对这些数据进行了进一步研究以确定切缘大小对于局部复发率的影响
s270 Sentence The optimal sequence of adjuvant chemotherapy and radiation therapy after breast-conserving surgery was studied in a randomized trial 一项随机临床试验评估了保乳术后辅助化疗与放疗的最优次序
s271 Sentence The year 2000 overview analysis (published in 2005) summarized the results of randomized adjuvant trials initiated by 1995 2000年综述分析(发表于2005年)总结了1995年之前启动的所有随机辅助治疗试验的结果
s272 Sentence Multimodality therapy delivered with curative intent is the standard of care for patients with clinical stage IIIB disease 对于临床分期为IIIB期乳腺癌的患者,根治性的综合治疗是标准治疗
s273 Sentence Concurrent 5-fluorouracil, epirubicin, cyclophosphamide (FEC) plus trastuzumab plus pertuzumab (×3) followed by concurrent docetaxel plus trastuzumab plus pertuzumab 5-氟尿嘧啶、表柔比星、环磷酰胺(FEC)加曲妥珠单抗加帕妥珠单抗同期治疗(3程)后行多西他赛、曲妥珠单抗、帕妥珠单抗同期治疗
s274 Sentence Modified radical mastectomy (removal of the entire breast with level I–II axillary dissection) with or without breast reconstruction 改良根治性乳房切除术(切除全乳,行I-II级腋窝淋巴结清扫)伴或不伴乳房重建
s275 Sentence Recurrent breast cancer is often responsive to therapy, though treatment is rarely curative at this stage of disease 复发性乳腺癌通常对治疗的反应较佳,尽管这一期别的患者很少达到治愈效果
s276 Sentence The diagnosis of such injury was made clinically with computerized tomography to distinguish radiation injury from tumor recurrence 该疾病依靠临床确诊,同时采用计算机断层扫描技术以除外肿瘤复发
s277 Sentence Although response rate and time-to-progression were both better for the combination, survival was the same in both groups 尽管联合组的缓解率和进展时间优于序贯组,但两组的生存率相同
s278 Sentence Early failure (e.g., <6 months) on hormone therapy suggests that cytotoxic chemotherapy should be the next modality employed 激素治疗早期失败(<6个月)提示下一种治疗方法应考虑细胞毒性化疗
s279 Sentence Metastases in ipsilateral level I, II axillary lymph nodes fixed to one another (matted) or to other structures ​同侧I、II站腋窝淋巴结转移,彼此融合或与其他结构粘连
s280 Sentence Short-term toxic effects of tamoxifen use may include vasomotor symptoms and gynecologic symptoms (e.g., vaginal discharge or irritation) 他莫昔芬治疗的短期毒性作用包括血管舒缩综合征和妇科综合征(如阴道溢液或刺激症状)
s281 Sentence In both trials, there was a trend toward a worse outcome associated with a longer duration of treatment 同时两项研究均表明,随着治疗时间延长,不良事件的发生率增加
s282 Sentence An American Society of Clinical Oncology (ASCO) Technology Assessment panel has commented on the implications of these results 一项美国临床肿瘤学会(ASCO)技术评估表详述了这些事件的意义
s283 Sentence At 2.5 years after randomization, 3.3% fewer patients on exemestane had developed a DFS event (95% CI, 1.6–4.9) 在随机分配2.5年后,依西美坦组DFS事件发生率较安慰剂组降低3.3%
s284 Sentence T0 and T1 tumors with nodal micrometastases only are excluded from Stage IIA and are classified Stage IB 仅伴淋巴结微转移的T0和T1肿瘤不再划分为IIA期,而应划分为IB期
s285 Sentence The 5-year DFS rate in one series of such patients was 25%, with a 10-year rate of 15% 一项病例分析提示此类患者的5年DFS率为25%,10年DFS率为15%
s286 Sentence The authors stated that there was no significant difference in DFS or OS between the two trastuzumab-containing regimens 作者认为两个含曲妥珠单抗方案的DFS与OS无显著差异
s287 Sentence The risk of recurrence in the conserved breast is substantial (>20%) even in confirmed axillary lymph node-negative women 如果保乳术后不行放疗,即使腋窝淋巴结阴性,保留的乳腺复发风险也很高(>20%)
s288 Sentence The study did not have tamoxifen as an adjuvant arm and also did not use taxanes or anthracyclines 该研究未将他莫昔芬作为辅助治疗方式,也未使用紫杉烷或蒽环类化疗药
s289 Sentence Additionally, initiating chemotherapy soon after breast-conserving therapy may be preferable for patients at high risk of distant dissemination 此外,对于远处播散风险较高的患者,保乳术后早期行化疗为首选
s290 Sentence Metastases in clinically detected ipsilateral internal mammary nodes in the absence of clinically evident axillary lymph node metastases 临床检测到同侧内乳淋巴结转移,无临床明显的腋窝淋巴结转移
s291 Sentence With a median follow-up of 33.3 months, no benefit was observed for the combination arm relative to tamoxifen 中位随访时间33.3个月,与单纯他莫昔芬治疗相比,阿那曲唑联合他莫昔芬治疗无显著获益
s292 Sentence Similarly, of the 1,010 patients enrolled in the EORTC-10853 trial, mammography detected lesions in 71% of the women 与之类似, EORTC-10853研究纳入了1,010例女性乳腺癌患者,其中71%为钼靶诊断
s293 Sentence Therefore, the highest pCR rate was seen in the preoperative treatment arm with dual HER2 blockade plus chemotherapy 即术前双重HER2阻断加化疗组的pCR率最高
s294 Sentence Sentinel lymph node (SLN) biopsy is the initial standard axillary staging procedure performed in women with invasive breast cancer 对浸润癌患者而言,前哨淋巴结(SLN)活检是首要标准的腋窝淋巴结分期操作
s295 Sentence "Not clinically detected" is defined as not detected by imaging studies (excluding lymphoscintigraphy) or not detected by clinical examination “临床未检测出”定义为影像学检查(不包括淋巴显像)或查体未发现
s296 Sentence This study, however, was not double blinded, and it is possible that patients on HRT were monitored more closely 然而遗憾的是该研究不是双盲试验,因此这一结果可能是由于HRT组患者监测更为密切所致
s297 Sentence This risk remains elevated even beyond 2 decades, and most of the subsequent cancers are ductal rather than lobular 这一风险可持续长达20年之久,并且大部分进展的浸润癌为导管性而非小叶性
s298 Sentence Patients who have breast cancer should have bilateral mammography at the time of diagnosis to rule out synchronous disease 乳腺癌患者在确诊时即应行双侧乳腺钼靶检查以除外同时存在的其它部位病变
s299 Sentence Patients with vertebral body involvement should be evaluated for impending cord compression even in the absence of neurologic symptoms 对于椎体受累的患者,即便无神经系统症状,也需评估脊髓压迫情况
s300 Sentence Such toxic effects can be minimized with current radiation delivery techniques and with careful delineation of the target volume 通过现有的放疗技术和谨慎的目标锚定,这类毒性作用可以最大程度降低
s301 Sentence In both of the studies reported here, the effect of radiation therapy was consistent across all assessed risk factors 上述两项研究中,放疗在所有评估的危险因素中影响相同
s302 Sentence The following are tumor subtypes that occur in the breast but are not considered to be typical breast cancers: 以下为发生于乳腺但为非典型乳腺癌的肿瘤亚型:
s303 Sentence Whether young women with germ-line mutations or strong family histories are good candidates for breast-conserving therapy is not certain 关于具有种系突变或明确家族史的女性患者是否是行保乳手术的合适候选者仍有争议
s304 Sentence Metastases in ipsilateral infraclavicular (level III axillary) lymph node(s) with or without level I, II axillary lymph node involvement ​同侧锁骨下淋巴结(III站腋窝淋巴结)转移,伴或不伴I、II站腋窝淋巴结转移
s305 Sentence In view of the lack of a standard approach, patients requiring second-line regimens are good candidates for clinical trials 因缺乏标准治疗方法上,故需二线化疗的患者是临床试验的良好备选受试者
s306 Sentence Less common, but serious, toxic effects include heart failure (if an anthracycline is used), thromboembolic events, and premature menopause 较为罕见但严重的毒性反应包括心力衰竭(如果使用了蒽环类药物)、血栓栓塞事件和提前绝经
s307 Sentence However, there was a significant interaction between the drug administered and schedule for both DFS (0.003) and OS (0.01) 但药物与方案之间存在显著的相互作用,DFS(0.003)和OS(0.01)评估中均可见此相互作用
s308 Sentence This risk for contralateral tumors may be even greater in women who are positive for BRCA1 and BRCA2 mutations 对于BRCA1和BRCA2基因突变的女性来说这一风险甚至更高
s309 Sentence Combinations of chemotherapy and hormone therapy have not shown an OS advantage over the sequential use of these agents 化疗联合激素治疗的OS获益可能不及细胞毒性化疗药序贯治疗
s310 Sentence Systemic therapy should be considered in patients with local regional recurrence because of the high risk of subsequent metastases 局部区域复发的患者应考虑接受全身治疗,因继续转移的风险较高
s311 Sentence Whether the optimal duration of adjuvant tamoxifen therapy in premenopausal women is 5 years or 10 years is controversial 绝经前女性乳腺癌患者他莫昔芬辅助治疗的最佳疗程是5年还是10年尚有争议
s312 Sentence The moderate-dose arm had 66% of the dose intensity as the high-dose arm but the same total drug dose 中等剂量组的剂量强度是大剂量组的66%,但两组总剂量相等
s313 Sentence Expert-reviewed information summary about the treatment of ductal carcinoma in situ, lobular carcinoma in situ, and invasive breast cancer 关于导管原位癌、小叶原位癌和浸润性乳腺癌治疗的专家审核信息
s314 Sentence Lapatinib is a small molecule tyrosine kinase inhibitor that is capable of dual-receptor inhibition of both EGFR and HER2 拉帕替尼是一种小分子酪氨酸激酶抑制剂,能够抑制EGFR与HER2两种受体
s315 Sentence In total, 26 women in the HRT group and 7 in the non-HRT group developed recurrences or new primaries 总体而言,HRT组26例患者和非HRT组7例患者出现复发或新发原发性乳腺癌
s316 Sentence The estimated lifetime risk of developing breast cancer for women with BRCA1 and BRCA2 mutations is 40% to 85% 存在BRCA1和BRCA2基因突变的女性终生乳腺癌患病风险为40%-85%
s317 Sentence The age of the patient should not be a determining factor in the selection of breast-conserving treatment versus mastectomy 在选择保乳手术或乳房单纯切除术时年龄并非决定因素
s318 Sentence A small, DFS advantage was conferred by the addition of early CMF to tamoxifen in women with ER-positive disease 对ER+乳腺癌患者,他莫昔芬早期联合CMF治疗可较小程度地改善DFS
s319 Sentence Metastases in clinically detected ipsilateral internal mammary lymph node(s) with clinically evident level I, II axillary lymph node metastases 临床检测到同侧锁骨上淋巴结转移,伴临床明显的I、II站腋窝淋巴结转移
s320 Sentence The American Joint Committee on Cancer (AJCC) staging system provides a strategy for grouping patients with respect to prognosis 美国肿瘤联合委员会(AJCC)分期系统根据预后对患者进行分期
s321 Sentence Clinical trials have established that screening with mammography, with or without clinical breast examination, may decrease breast cancer mortality 临床试验证实行乳腺钼靶检查同时结合或不结合乳腺查体可能会降低乳腺癌死亡率
s322 Sentence This study has also shown no difference in survival rates between four cycles of AC and six cycles of CMF 该研究也显示4程AC与6程CMF治疗后复发率无差异
s323 Sentence The open-label, randomized, phase II TRYPHAENA trial (NCT00976989) sought to evaluate the tolerability and activity associated with trastuzumab and pertuzumab TRYPHAENA试验(NCT00976989)为一项开放、随机的II期临床试验,力图评估曲妥珠单抗与帕妥珠单抗的耐受性和有效性
s324 Sentence In these single-institution case series, the prevalence of positive nodes in patients with T1a tumors ranged from 9% to 16% 在这些单机构病例研究中,T1a期乳腺癌患者淋巴结转移阳性率约为9-16%
s325 Sentence Every trial demonstrated a lower in-breast recurrence rate with radiation therapy, and this effect was present in all patient subgroups 每项研究均表明联合放疗乳内肿瘤复发率更低,并且在所有患者亚组中结果类似
s326 Sentence Elsewhere, margins of less than 1 mm have been associated with an unacceptable local recurrence rate, even with radiation therapy 此外,切缘小于1mm与局部复发率绝对相关,放疗亦无法改变其预后
s327 Sentence Patients with structural compromise of weight-bearing bones should be considered for surgical intervention and/or radiation in addition to systemic therapy 承重骨结构受损的患者除全身治疗之外,还应考虑接受手术和(或)放疗
s328 Sentence The cardioprotective drug, dexrazoxane, has been shown to decrease the risk of doxorubicin-induced cardiac toxicity in patients in controlled studies 一些对照研究发现心脏保护药右雷佐生降低阿霉素诱导的心脏毒性
s329 Sentence For one to three nodes: unclear role for regional radiation (infra/supraclavicular nodes, internal mammary nodes, axillary nodes, and chest wall) 1-3枚阳性淋巴结:区域治疗(锁骨上、锁骨下淋巴结、内乳淋巴结、腋窝淋巴结和胸壁)的作用不明
s330 Sentence Controlled studies have associated long-term tamoxifen use with preservation of bone mineral density of the lumbar spine in postmenopausal women 对照研究表明长期使用他莫昔芬与绝经后女性腰椎棘突骨密度的维持相关
s331 Sentence At present, there is no established role for the use of bevacizumab as part of neoadjuvant chemotherapy for breast cancer 目前关于将贝伐单抗纳入新辅助化疗方案对乳腺癌患者的作用尚无定论
s332 Sentence In 1998, DCIS accounted for about 18% of all newly diagnosed invasive plus noninvasive breast tumors in the United States 据统计,1998年美国全部新发乳腺浸润癌与非浸润癌中DCIS约占18%
s333 Sentence In one series of 178 patients with inflammatory breast cancer, DFS was 28% at 15 years with a combined-modality approach 一项病例分析纳入178例炎性乳腺癌患者,发现经联合治疗,15年DFS达到28%
s334 Sentence Adjuvant chemotherapy is associated with several well-characterized toxic effects that vary according to the individual drugs used in each regimen 辅助化疗与一些重度毒性反应相关,每种方案所用药物不同,产生的毒性反应也不同
s335 Sentence For women who are treated with breast-conserving surgery, the most common site of local recurrence is the conserved breast itself 对于接受保乳手术的女性,最常见的局部复发部位为保留的乳腺本身
s336 Sentence Radiation injury to the brachial plexus following adjuvant nodal radiation therapy is a rare clinical entity for breast cancer patients 臂丛神经的放射性损伤是一类罕见的乳腺癌放疗并发症
s337 Sentence Of note, the long-term ATLAS data are really applicable for women who remain premenopausal after 5 years of tamoxifen therapy 值得注意的是,长期ATLAS为我们提供了在接受5年他莫昔芬治疗后仍未绝经的女性乳腺癌患者相关数据
s338 Sentence Among patients treated with systemic chemotherapy at a single institution between 1973 and 1982, 263 patients (16.6%) achieved complete responses 一家医院1973-1982年间接受全身化疗的患者中,263例患者(16.6%)完全缓解
s339 Sentence These trial findings raise the question of whether anthracyclines are needed for the adjuvant treatment of HER2- overexpressing breast cancer 这些试验结果不禁让人产生疑问,即HER2过度表达型乳腺癌的辅助治疗是否必须含蒽环类药物
s340 Sentence Options for surgical management of the primary tumor include breast-conserving surgery plus radiation therapy, mastectomy plus reconstruction, and mastectomy alone 原发肿瘤的手术治疗包括保乳手术联合放疗、乳房单纯切除术+乳房再造术、乳房单纯切除术
s341 Sentence Nine percent to 25% of these patients will have distant metastases or locally extensive disease at the time of recurrence 其中9%-25%的患者在复发时合并远处转移或局部扩散
s342 Sentence Of all women with breast cancer, 5% to 10% may have a germ-line mutation of the genes BRCA1 and BRCA2 在所有乳腺癌女性患者中,有5%-10%的人存在BRCA1和BRCA2基因种系突变
s343 Sentence At the time the tumor tissue is surgically removed, estrogen receptor (ER) and progesterone receptor (PR) status should be determined 在切除肿瘤组织后,应评估雌激素受体(ER)和孕激素受体(PR)表达情况
s344 Sentence Pathologic classification (pN) is used for excision or sentinel lymph node biopsy only in conjunction with a pathologic T assignment 病理分期(pN)仅与病理T分期联合用于切除或前哨淋巴结活检分期
s345 Sentence Whether this group of patients would derive long-term benefit from tamoxifen for either its adjuvant or preventive effects remains uncertain 从他莫昔芬的辅助作用或预防作用来看,此类患者是否可得益于他莫昔芬长期治疗尚不明确
s346 Sentence The group with a positive family history, however, does appear more likely to develop contralateral breast cancer within 5 years 然而,具有阳性家族史的患者5年内发生对侧乳腺癌的风险似乎较高
s347 Sentence The potential for doxorubicin-induced cardiac toxic effects should be considered in the selection of chemotherapeutic regimens for an individual patient 在针对患者个体化选择化疗方案时需考虑阿霉素诱导心脏毒性反应的风险
s348 Sentence Patients whose tumors have these characteristics may benefit from a more generous initial excision to avoid the need for a re-excision 拥有以上特点的患者应于首次即行较为广泛的切除以避免二次手术
s349 Sentence Patients with extensive bony disease are at risk for the development of symptomatic hypercalcemia early in the course of hormone therapy 有广泛骨转移的患者在激素治疗早期发生高钙血症症状的风险较高
s350 Sentence The frequency of the diagnosis of DCIS has increased markedly in the United States since the widespread use of screening mammography 自从广泛采用钼靶筛查,美国DCIS的诊断率明显提高
s351 Sentence When this system was modified in 2002, some nodal categories that were previously considered stage II were reclassified as stage III 2002年该分期系统经过修订以后,一些原本划分为II期的淋巴结分期被重新划分为III期
s352 Sentence The presence of multifocal disease in the breast or a history of collagen vascular disease are relative contraindications to breast-conserving therapy 多灶性病变或胶原血管病病史是保乳手术的相对禁忌症
s353 Sentence Clinical trials (including the completed Radiation Therapy Oncology Group's (RTOG) trial [ RTOG-9714 ]) are exploring the optimal radiation fractionation schedule 一些临床试验(包括已经完成的放疗肿瘤组(RTOG)试验[RTOG-9714])探索了最优的分次放疗方案
s354 Sentence Outside of a clinical trial, standard first-line treatment for metastatic HER2 -overexpressing breast cancer should consist of single-agent chemotherapy plus trastuzumab 非临床试验情况下,转移性HER2过度表达型乳腺癌的标准一线治疗应包括单药化疗加曲妥珠单抗
s355 Sentence The International Breast Cancer Study Group trials VI and VII also varied the timing of radiation therapy with CMF adjuvant chemotherapy 国际乳腺癌研究组试验VI和VII也评估了CMF辅助化疗联合不同时间的放疗
s356 Sentence Increasing bone pain and increasing alkaline phosphatase within the first several weeks of hormone therapy does not necessarily imply disease progression 激素治疗后数周内出现骨痛加重和碱性磷酸酶升高并不一定意味着疾病进展
s357 Sentence In another study of postmenopausal women with node-positive disease, tamoxifen alone was compared with tamoxifen plus three different schedules of CMF 另一项针对淋巴结转移阳性的绝经后女性乳腺癌患者进行的研究比较了单纯他莫昔芬治疗与他莫昔芬联合三种不同方案的CMF化疗的有效性
s358 Sentence These patients then underwent a second randomization to receive zoledronic acid (4 mg intravenously every 6 months) versus no zoledronic acid 这些患者随后经二次随机分组,接受唑来膦酸(4mg静脉用,每6个月一次)和无唑来膦酸治疗
s359 Sentence Currently, there is no established role for adding platinum agents to the treatment of early-stage TNBC outside of a clinical trial 目前尚不明确在非临床试验情况下,加入铂类药物是否有益于早期TNBC的治疗
s360 Sentence If a patient was designated to have detectable distant metastases (M1) before chemotherapy, the patient will be designated as M1 throughout 如果患者在化疗前被划分为可见远处转移(M1),则该患者将终生划分为M1期
s361 Sentence Of note, no stage group is assigned if there is a complete pathologic response (CR) to neoadjuvant therapy, for example, ypT0ypN0cM0 注意,如果患者经新辅助治疗获得病理学完全缓解,则不将患者划分为任何一期,例如ypT0ypN0cM0
s362 Sentence Based on the conflicting results of these trials, the exact role for bisphosphonates in adjuvant therapy for breast cancer is controversial 基于这些不一致的试验结果,双磷酸盐作为乳腺癌辅助治疗的确切作用仍有争议
s363 Sentence Infiltrating or invasive ductal cancer is the most common breast cancer histologic type and comprises 70% to 80% of all cases 其中浸润性导管癌是最常见的乳腺癌组织学类型,占全部乳腺癌的70-80%
s364 Sentence Another potential problem is the development of benign ovarian cysts, which occurred in about 10% of women in a single study 另一个与他莫昔芬治疗相关的问题是良性卵巢囊肿的发生,在一项研究中其发生率约为10%
s365 Sentence T-DM1 allows specific intracellular drug delivery to HER2 -overexpressing cells, potentially improving the therapeutic index and minimizing exposure of normal tissue T-DM1能够将特定的细胞内药物传送至HER2过量表达型细胞中,可能提高治疗指数,减少正常组织的暴露
s366 Sentence The median time to progression was 8.4 months in the combination-therapy group as compared with 4.4 months in the monotherapy group 联合治疗组的进展时间中位数为8.4个月,单药治疗组为4.4个月
s367 Sentence A trial of 599 premenopausal node-positive patients found leuprorelin acetate to be similar to CMF with respect to DFS and OS 一项纳入599名绝经前淋巴结转移阳性患者的研究发现醋酸高丙瑞林与CMF对DFS和OS的影响相当
s368 Sentence Comedo-type DCIS consists of cells that appear cytologically malignant, with the presence of high-grade nuclei, pleomorphism, and abundant central luminal necrosis 粉刺型DCIS细胞异型性明显,有高级别核、多形性、中央腔坏死多见
s369 Sentence Age-specific risk estimates are available to help counsel and design screening strategies for women with a family history of breast cancer 以年龄为标准的危险因素评估有利于具有阳性家族史的女性患者进行咨询并设计筛查方案
s370 Sentence Prognosis and selection of therapy may be influenced by the following clinical and pathology features (based on conventional histology and immunohistochemistry): 预后及治疗方案的选择主要受到以下临床和病理特点(基于常规组织学和免疫组化结果)影响:
s371 Sentence There were 48 noncancer-related deaths on the high dose arm and four on the conventional dose arm (RR, 7.74; 95% CI, 3.43–17.50) 大剂量组有48例非癌症相关死亡病例,传统剂量组为4例(RR,7.74;95%CI,3.43-17.50)
s372 Sentence Identification of distant metastases after the start of therapy in cases where pretherapy evaluation showed no metastases is considered progression of disease 治疗前未发现转移而治疗开始后发现远处转移视为肿瘤进展
s373 Sentence After the presence of a malignancy is confirmed, treatment options should be discussed with the patient before a therapeutic procedure is selected 一旦确诊乳腺癌,应在选择治疗方案前与患者积极沟通
s374 Sentence If a boost is used, it can be delivered either by EBRT, generally with electrons, or by using an interstitial radioactive implant 加量照射既可采用EBRT(一般使用电子)也可采用组织间植入放射性粒子实现
s375 Sentence In the ER-positive subgroup, a longer time to relapse was associated with continued tamoxifen use, but no improvement in OS was observed 在ER+亚组中,继续他莫昔芬治疗与更长时间的疾病缓解相关,但OS无明显改善
s376 Sentence Patients with lymphangitic pulmonary metastases, major liver involvement, and/or central nervous system involvement should not receive hormone therapy as a single modality 淋巴管炎性肺转移、大部肝转移和(或)中枢神经系统受累的患者不应仅接受激素治疗
s377 Sentence This approach should allow clinicians to help individuals to determine if the gains anticipated from treatment are reasonable for their particular situation 临床医师经过这种权衡考量,将能够帮助患者判断当下最优治疗的预期获益
s378 Sentence Retrospective studies have shown the following examples of tumor characteristics to correlate with a greater likelihood of finding persistent tumor on re-excision: 回顾性研究表明以下肿瘤特点与再切除时肿瘤持续存在可能性增高相关:
s379 Sentence In the absence of data suggesting a benefit from high-dose chemotherapy with stem cell support, this remains an area of clinical evaluation 无数据支持大剂量化疗联合干细胞支持的益处,这一领域仍需进行更多的临床评估
s380 Sentence Ulceration and/or ipsilateral satellite nodules and/or edema (including peau d'orange) of the skin, which do not meet the criteria for inflammatory carcinoma 皮肤溃疡和/或同侧卫星结节和/或水肿(包括桔皮样变),不满足炎性癌的诊断标准
s381 Sentence In summary, the weight of evidence suggests that ovarian ablation should not be routinely added to systemic therapy with chemotherapy and/or tamoxifen 简言之,现有证据表明卵巢去势不应常规用于化疗和/或他莫昔芬治疗的辅助治疗中
s382 Sentence Paget disease of the nipple NOT associated with invasive carcinoma and/or carcinoma in situ (DCIS and/or LCIS) in the underlying breast parenchyma ​乳头Paget病,与下方乳腺实质的浸润癌和/或原位癌(DCIS和/或LCIS)无关
s383 Sentence The best study design compared buserelin (an LHRH agonist) versus tamoxifen versus the combination in 161 premenopausal women with hormone receptor–positive tumors 最佳的研究设计对比了布舍瑞林(一种LHRH拮抗剂)、他莫昔芬或二者联合对161例激素受体阳性的绝经前乳腺癌患者的作用
s384 Sentence Although these results have not been replicated in another series, this result suggests such patients should be treated with the same intent 尽管其他病例分析未能重复这一结果,但这一结果仍提示此类患者应同样接受以治愈为目的的治疗
s385 Sentence Radiation therapy should also be given following surgery for decompression of intracranial or spinal cord metastases and following fixation of pathologic fractures 应在手术解除颅内或脊髓转移的压迫症状和病理性骨折固定之后,再行放疗
s386 Sentence The NSABP-B-13 study demonstrated a benefit for chemotherapy with sequential methotrexate and 5-FU versus surgery alone in patients with node-negative, ER-negative tumors NSABP-B-13试验发现甲氨蝶呤与5-FU序贯治疗和单独手术相比,前者对淋巴结阴性、ER阴性肿瘤患者更有益
s387 Sentence Of concern is an increased risk of gastrointestinal malignancy after tamoxifen therapy, but these findings are tentative, and further study is needed 另一点值得注意的是他莫昔芬治疗后胃肠道肿瘤发病风险增加,但这些发现均为试验性的研究结论,尚待进一步明确
s388 Sentence Because of the available evidence indicating no difference in outcome, women with strong family histories should be considered candidates for breast-conserving treatment 鉴于目前可用的数据表明结局无显著差异,有明确家族史的女性可以考虑作为保乳手术的候选者
s389 Sentence Although preoperative chemotherapy affects the results of SLN biopsy, one small study indicated that SLN biopsy technique was feasible in this setting 虽然术前化疗影响SLN活检结果,但一项小规模研究发现这种情况下仍然可以进行SLN活检操作
s390 Sentence Confirmation of clinically detected metastatic disease by fine needle aspiration without excision biopsy is designated with an (f) suffix, for example, cN3a(f) 通过细针抽吸穿刺而非切除活检确诊的临床可见的转移癌需在最后加标(f)后缀,例如cN3a(f)
s391 Sentence Two additional randomized trials, though not specifically designed to address the timing of radiation therapy and adjuvant chemotherapy, do add useful information 另有2项随机试验虽然并未专门研究放疗和辅助化疗的时机,仍提供了一些有效信息
s392 Sentence Although adjuvant whole-breast radiation is standard treatment, no trials have addressed the role of regional lymph node radiation therapy in this setting 虽然辅助全乳放疗是标准疗法,但目前尚无试验评估这种情况下区域淋巴结放疗的作用
s393 Sentence In the HERA ( BIG-01-01 ) trial, severe congestive heart failure (CHF NYHA class III–IV) occurred in 0.6% of patients treated with trastuzumab 在HERA试验(BIG-01-01)中,曲妥珠单抗治疗后0.6%患者出现重度充血性心力衰竭(CHFNYHA分级III-IV级)
s394 Sentence A multicenter, randomized clinical trial sought to determine whether ALND is required after an SLN biopsy reveals an SLN metastasis of breast cancer 一项多中心随机临床试验试图确定在SLN活检显示存在乳腺癌的SLN转移后是否需行ALND
s395 Sentence OS was also similar, at 85.4% in the zoledronic acid group and 83.1% in the control group (adjusted HR, 0.85; P = .07) OS结果也类似,唑来膦酸组为85.4%,对照组为83.1%(校正后HR,0.85;P=0.07)
s396 Sentence Metastases in clinically detected ipsilateral internal mammary lymph nodes in the presence of one or more positive level I, II axillary lymph nodes 临床检测到的同侧内乳淋巴结转移,伴有1枚或更多I、II站腋窝淋巴结转移
s397 Sentence Since criteria for menopausal status vary widely, some studies have substituted age older than 50 years as a surrogate for the postmenopausal state 鉴于绝经的判定标准千差万别,一些研究已经将年龄大于50岁作为绝经后的替代指标
s398 Sentence Recognized risk factors for cardiac toxicity include advanced age, prior chest-wall radiation therapy, prior anthracycline exposure, hypertension, diabetes, and known underlying heart disease 已知的心脏毒性危险因素包括:高龄、既往胸壁放疗史、既往蒽环类药物用药史、高血压、糖尿病和已知有基础心脏病
s399 Sentence An randomized clinical trial, CALGB-40603 (NCT00861705), evaluated the benefit of carboplatin added to paclitaxel and adriamycin plus cyclophosphamide chemotherapy in the neoadjuvant setting 一项随机临床试验CALGB-40603(NCT00861705)评估了向紫杉醇、阿霉素、环磷酰胺新辅助化疗中增加卡铂的益处
s400 Sentence After a median follow-up of 55.7 months, the HR for DFS was 0.76 (95% CI, 0.66–0.88; P = .001) in favor of exemestane 中位随访55.7个月后,DFS的HR为0.76(95%CI,0.66-0.88;P=0.001),结果提示依西美坦治疗较佳
s401 Sentence Standard chemotherapy regimens for the adjuvant treatment of operable breast cancer that is given in the modern era are described in Table 6 目前可手术的乳腺癌辅助治疗中标准化疗方案见表6​所述
s402 Sentence In total 1,758 women were randomly assigned to receive high-dose chemotherapy with autograft, and 1,767 women were randomly assigned to receive conventional chemotherapy 共1,758例女性被随机分组接受大剂量化疗联合自体移植,1,767例女性接受传统化疗
s403 Sentence There was no stated a priori basis for expecting that varying the schedule of administration would have opposite effects for the two drugs 该试验并未预先设想到两种药物不同的给药方案可能会产生相反效果
s404 Sentence Patient management following initial suspicion of breast cancer generally includes confirmation of the diagnosis, evaluation of stage of disease, and selection of therapy 初筛可疑乳腺患者应进行一系列评估,包括确诊、肿瘤分期和治疗方案选择
s405 Sentence A double-blind, randomized phase III study compared paclitaxel and lapatinib with paclitaxel plus placebo as first-line therapy in patients with metastatic breast cancer 一项双盲、随机、III期临床研究比较了紫杉醇、拉帕替尼和紫杉醇联合拉帕替尼作为转移性乳腺癌患者一线治疗的作用
s406 Sentence The T classification of the primary tumor is the same regardless of whether it is based on clinical or pathologic criteria, or both 无论基于临床还是病理标准或者同时兼顾两者原发肿瘤的T分期都是相同的
s407 Sentence There was a statistically significant benefit in EFS at 3 years for the group who received high-dose chemotherapy (RR, 1.11; 95% CI, 1.05–1.18) 大剂量化疗组的3年EFS在统计学上显著优于传统化疗组(RR,1.11;95%CI,1.05-1.18)
s408 Sentence Traditionally, certain uncommon histologies (e.g., tubular, medullary, and mucinous) have also been associated with favorable prognosis and may be considered as low-risk factors 通常一些罕见的组织学(例如,管状、髓样和粘液性癌)预后较好,可视为低危因素
s409 Sentence The M category for patients treated with neoadjuvant therapy is the category assigned in the clinical stage, prior to initiation of neoadjuvant therapy 接受新辅助治疗的患者其M分期以治疗前临床分期为准
s410 Sentence In fact, LVEF was preserved in all of the women receiving trastuzumab, but the number of patients receiving adjuvant trastuzumab was very low 实际上,所有接受曲妥珠单抗治疗的女性LVEF均未降低,但接受曲妥珠单抗辅助治疗的患者人数很少
s411 Sentence Metastases only in clinically detected ipsilateral internal mammary nodes and in the absence of clinically evident level I, II axillary lymph node metastases 临床仅检测到同侧内乳淋巴结转移,无临床明显的I、II站腋窝淋巴结转移
s412 Sentence (Refer to the PDQ summaries on Adult Hodgkin Lymphoma Treatment , Adult Soft Tissue Sarcoma Treatment , and Melanoma Treatment for more information.) (更多信息请参考PDQ总结成人霍奇金淋巴瘤的治疗、成人软组织肉瘤的治疗和黑色素瘤的治​疗​)
s413 Sentence Carriers with a history of breast cancer have an increased risk of contralateral disease that may be as great as 5% per year 有乳腺癌病史且存在BRCA1和BRCA2基因突变的女性同侧复发乳腺癌的风险每年增加5%
s414 Sentence Classification based solely on sentinel lymph node biopsy without subsequent axillary lymph node dissection is designated (SN) for "sentinel node," for example, pN0(SN) 仅根据前哨淋巴结活检结果而未行之后的淋巴结清扫进行分级需标明“SN”,例如pN0(SN)
s415 Sentence With a median follow-up of 5 years, OS was 73% for the radiation-first group and 81% for the chemotherapy-first group ( P = .11) 经过中位时间为5年的随访期,先放疗组的OS为73%,先化疗组的OS为81%(P=0.11)
s416 Sentence These studies showed that delays from 2 to 7 months in radiation therapy after surgery had no effect on the rate of local recurrence 这些研究发现术后放疗延迟2-7个月不影响局部复发率
s417 Sentence In the EST-5181 trial, node-positive women who had already received 5 years of tamoxifen following chemotherapy were randomly assigned to continue therapy or observation 在EST-5181研究中,淋巴结转移阳性的乳腺癌患者在化疗后完成5年的他莫昔芬治疗,这些患者被随机分入继续他莫昔芬治疗组和观察组
s418 Sentence (Refer to the PDQ summaries on Genetics of Breast and Ovarian Cancer ; Breast Cancer Prevention ; and Breast Cancer Screening for more information.) (具体可参见乳腺癌和卵巢癌的遗传学、乳腺癌的预防、乳腺癌的筛查​等PDQ总结)
s419 Sentence An Eastern Cooperative Oncology Intergroup study ( E-1193 ) randomly assigned patients to receive paclitaxel and doxorubicin given both as a combination and sequentially 东部肿瘤协作组组间研究(E-1193)将患者随机分组接受紫杉醇联合阿霉素或紫杉醇、阿霉素序贯治疗
s420 Sentence Several phase III, clinical trials have addressed the role of the anti- HER2/neu antibody, trastuzumab, as adjuvant therapy for patients with HER2 -overexpressing cancers 一些III期临床试验评估了抗HER2/neu抗体曲妥珠单抗辅助治疗对HER2过度表达型肿瘤患者的作用
s421 Sentence Similarly, the RIBBON 1 (NCT00262067) trial randomly assigned 1,237 patients in a 2:1 fashion to standard chemotherapy plus bevacizumab or standard chemotherapy plus placebo 类似地,RIBBON1(NCT00262067)试验将1,237例患者以2:1随机分组,接受标准化疗联合贝伐单抗或标准化疗联合安慰剂
s422 Sentence In view of the success of breast-conserving surgery combined with breast radiation for invasive carcinoma, this conservative approach was extended to the noninvasive entity 鉴于保乳手术联合放疗在浸润癌治疗中取得的成功,这一保守方案正逐步转向非浸润癌的治疗
s423 Sentence The 3-year cumulative incidence of cardiac events for trastuzumab-treated patients was 4.1%, compared with 0.8% of patients in the control arm (95% CI, 1.7%–4.9%) 曲妥珠单抗组患者的3年累计心脏事件发生率为4.1%,对照组为0.8%(95%CI,1.7%-4.9%)
s424 Sentence This risk increases to more than 4% in patients receiving high cumulative doses of both epirubicin (>720 mg/m2 ) and cyclophosphamide (>6,300 mg/m2 ) 接受较大累积剂量表柔比星(>720 mg/m2)联合环磷酰胺(>6,300mg/m2)治疗的患者相应风险上升至超过4%
s425 Sentence An ongoing phase III trial ( NCT01077154 ) is examining the activity of the bone-modifying agent, denosumab, in stage II and III breast cancer 一项正在进行之中的III期临床试验(NCT01077154)评估了骨调节剂地诺单抗对II期和III期乳腺癌患者的作用
s426 Sentence Bevacizumab is a monoclonal antibody that works against vascular endothelial growth factor A and has shown some degree of efficacy in the metastatic setting 贝伐单抗是一种单克隆抗体,拮抗血管内皮生长因子A,在一定程度上对转移癌有效
s427 Sentence In one series, the 5-year actuarial rate of relapse for patients treated for invasive recurrence after initial breast conservation and radiation therapy was 52% 一项病例分析发现,保乳术联合化疗后出现浸润性复发患者五年精确复发率为52%
s428 Sentence The addition of pertuzumab to the docetaxel plus trastuzumab combination did not appear to increase toxic effects, including the risk of cardiac adverse events 多西他赛联合曲妥珠单抗方案中增加帕妥珠单抗没有表现出增加毒性反应风险,包括心脏不良事件风险
s429 Sentence Modern radiation therapy techniques introduced in the 1990s minimized deep radiation to the underlying myocardium when left-sided chest wall or left-breast radiation was used 20世纪90年代兴起的现代放疗技术最大程度地降低了左侧胸壁或左侧乳腺放疗对深部心肌组织的辐射量
s430 Sentence In comparison to megestrol acetate, all three currently available aromatase inhibitors have demonstrated, in prospective randomized trials, at least equal efficacy and better tolerability 所有现在市售的三种芳香化酶抑制剂均有前瞻性随机临床试验证实,与醋酸甲地孕酮相比,有效性至少相等,而耐受性更佳
s431 Sentence In each case, the absolute difference in outcomes between anthracycline-based and CMF-type chemotherapy was about 3% at 5 years and 4% at 10 years 无论是复发率还是死亡率,含蒽环类药物方案和CMF类化疗方案的5年结局绝对差异约为3%,10年结局绝对差异约为4%
s432 Sentence For example, a reported size of 1.1 mm is reported as 1 mm, or a size of 2.01 cm is reported as 2.0 cm 例如,大小为1.1mm记录为1mm,2.01cm记录为2.0cm
s433 Sentence The ER levels and PR levels, HER2/neu positivity at the time of recurrence, and previous treatment should be considered, if known, when selecting therapy 选择适当的治疗时注意复发时的ER水平、PR水平、HER2/neu阳性率和既往治疗史
s434 Sentence In this small trial, which did not meet its target accrual, the combination of tamoxifen and ovarian ablation provided comparable DFS and OS rates 该小型研究未获得目标获益,结果表明他莫昔芬联合卵巢去势与CMF相比对DFS和OS的影响相当
s435 Sentence Late toxic effects of radiation therapy, though uncommon, can include radiation pneumonitis, cardiac events, arm edema, brachial plexopathy, and the risk of second malignancies 放疗的迟发毒性作用少见,包括放射性肺炎、心脏事件、上肢水肿、臂丛神经病和继发肿瘤风险
s436 Sentence The secondary endpoint of 5-year disease-free survival (DFS) was 82.2% (95% CI, 78.3%–86.3%) with ALND and 83.9% (95% CI, 80.2%–87.9%) with SLN biopsy alone ALND组和仅接受SLN活检组的次要终点-5年无病生存率(DFS)分别为82.2%(95%CI,78.3%-86.3%)和83.9%(95%CI,80.2%-87.9%)
s437 Sentence Several groups have attempted to define a population of women in whom the probability of nodal metastasis is low enough to preclude axillary node biopsy 若干组织试图找出淋巴结转移可能性较低而无需行腋窝淋巴结活检的患者亚群
s438 Sentence Indications include painful bony metastases, unresectable central nervous system metastases (i.e., brain, meningeal, and spinal cord), bronchial obstruction, and fungating/painful breast or chest wall lesions 适应证包括骨转移疼痛、无法切除的中枢神经系统转移(例如脑、脑膜和脊髓)、支气管梗阻、乳腺或胸壁病变真菌感染或疼痛
s439 Sentence One trial that treated 28 women with stage II or stage III TNBC with four cycles of neoadjuvant cisplatin resulted in a 22% pCR rate 一项试验对28例II期或III期TNBC女性患者用4程新辅助铂类化疗,发现pCR率为22%
s440 Sentence The rate of disease progression, the presence or absence of comorbid medical conditions, and physician/patient preference will influence the choice of therapy in individual patients 疾病进展率、是否存在合并症和医师/患者的偏好影响了个例患者的治疗选择
s441 Sentence The ongoing APHINITY trial (NCT01358877), a randomized, phase III, adjuvant study for women with HER2-positive breast cancer, is the confirmatory trial for this accelerated approval 目前正在进行的APHINITY试验(NCT01358877)是针对HER2阳性的女性乳腺癌患者进行的一项随机、III期辅助研究,是为了此次加速审批的验证性试验
s442 Sentence The use of this agent has permitted patients to receive greater cumulative doses of doxorubicin and allowed patients with cardiac risk factors to receive doxorubicin 右雷佐生的应用使得患者能够有机会接受更大累积剂量的阿霉素治疗,同时一些有心脏危险因素的患者也可以接受阿霉素治疗
s443 Sentence For these two subgroups, sequence assignment made little difference in local or distant recurrence rates, though the statistical power of these subgroup analyses was low 这两组患者接受不同的放疗与化疗顺序后,局部或远处复发率几乎无差异,但这两项亚组分析的统计学效力较低
s444 Sentence All patients should be considered candidates for clinical trials to evaluate the most appropriate fashion in which to administer the various components of multimodality regimens 所有患者均应考虑参与临床试验,以评估综合治疗的最佳方式
s445 Sentence Immediate administration of zoledronic acid resulted in a 34% improvement in DFS (HR, 0.66; 95% CI, 0.44–0.97, P = .035) but did not affect OS 即刻唑来膦酸用药组的DFS提高了34%(HR,0.66;95%CI,0.44-0.97;P=0.035),但OS不受影响
s446 Sentence In a direct comparison of surgical or radiation ablation and CMF, DFS and OS rates were identical in 332 premenopausal women with stage II disease 在一项直接对比手术或放疗卵巢去势与CMF疗效的研究中,332名绝经前II期乳腺癌患者的DFS和OS均无差异
s447 Sentence Estrogen-receptor (ER) and progesterone-receptor (PR) protein status and human epidermal growth factor receptor 2 ( HER2/neu ) status should be determined for the primary tumor 应确定原发肿瘤的雌激素受体(ER)、孕激素受体(PR)及人类表皮生长因子受体2(HER2/neu)的表达情况
s448 Sentence AND = axillary node dissection; H&E = hematoxylin and eosin stain; IHC = immunohistochemical; ITC = isolated tumor cells; RT-PCR = reverse transcriptase/polymerase chain reaction AND=腋窝淋巴结清扫,H&E=苏木素伊红染色法,IHC=免疫组化,ITC=孤立的肿瘤细胞,RT-PCR=逆转录酶聚合酶链反应
s449 Sentence Following breast reconstruction, radiation therapy can be delivered to the chest wall and regional nodes either in the adjuvant setting or if local disease recurs 完成乳房再造后,可以行胸壁和区域淋巴结放疗以行辅助治疗或消除局部复发病灶
s450 Sentence To identify such a favorable group of patients, several pathologic staging systems have been developed and tested retrospectively, but consensus recommendations have not been achieved 为解决这一问题,研究人员提出了若干病理分级系统并进行了回顾性研究,但尚未达成共识
s451 Sentence Ado-trastuzumab emtansine (T-DM1) is an antibody-drug conjugate that incorporates the HER2 –targeted antitumor properties of trastuzumab with the cytotoxic activity of the microtubule-inhibitory agent DM1 Ado-trastuzumabemtansine(T-DM1)是一种抗体药物结合物,具有曲妥珠单抗的HER2靶向抗肿瘤活性和微球抑制剂DM1的细胞毒性活性
s452 Sentence For patients receiving TCH, the 5-year DFS rate was 81% (HR, 0.75; P = .04), and the OS rate was 91% (HR, 0.77; P = .04) TCH组5年DFS率为81%(HR,0.75;P=0.04),OS率为91%(HR,0.77;P=0.04)
s453 Sentence DCIS comprises a heterogeneous group of histopathologic lesions that have been classified into several subtypes based primarily on architectural pattern: micropapillary, papillary, solid, cribriform, and comedo DCIS在组织病理学上极富异质性,根据其结构特点可分为多种亚型:微乳头型、乳头型、实性型、筛状型和粉刺型
s454 Sentence Irrespective of the eventual procedure selected, the diagnostic biopsy and surgical procedure that will be used as primary treatment should be performed as two separate procedures 无论最终选择哪种治疗措施,诊断性活检和手术治疗作为主要治疗应分两次进行
s455 Sentence (Refer to the PDQ summary on Gastrointestinal Complications for information on diarrhea and for information on insomnia, refer to the PDQ summary on Sleep Disorders .) (具体可参见胃肠道并发症和睡眠障碍​的PDQ总结以更多了解关于腹泻和失眠的信息)
s456 Sentence Metastases in 1–3 axillary lymph nodes and in internal mammary lymph nodes with micrometastases or macrometastases detected by sentinel lymph node biopsy but not clinically detected 临床未检测出、仅由前哨淋巴结活检发现的1-3枚腋窝淋巴结转移和伴有微转移或广泛转移的内乳淋巴结转移
s457 Sentence These four studies indicate that different combination regimens of additional chemotherapy immediately following a patient’s best response to an induction chemotherapy regimen does not improve OS 这四项研究说明,患者对诱导化疗产生最佳反应之后,立即开始其他化疗的不同组合方案并不改善OS
s458 Sentence Two randomized trials (including Regional Oncologic Center-Hormonal Replacement Therapy After Breast Cancer--Is It Safe [ ROC-HABITS ]) comparing HRT with no hormonal supplementation have been reported 两项随机研究(包括地方癌症中心-乳腺癌后激素替代治疗-是否安全研究[ROC-HABITS])比较了HRT和无激素补充治疗
s459 Sentence Information regarding the confirmation of the nodal status will be designated in site-specific factors as clinical, fine needle aspiration, core biopsy, or sentinel lymph node biopsy 淋巴结转移的确诊信息根据部位特异性分别指定为临床、细针抽吸穿刺、空心针穿刺活检或前哨淋巴结活检
s460 Sentence Preoperative chemotherapy may be beneficial in women who desire breast conservation surgery but who would otherwise not be considered candidates because of the size of their tumor 术前化疗对有保乳意愿但因肿瘤大小原本无法行保乳手术的患者有益
s461 Sentence The selection of therapy is most appropriately based upon knowledge of an individual’s risk of tumor recurrence balanced against the short-term and long-term risks of adjuvant treatment 如何选择治疗还需取决于对肿瘤复发的个体化风险评估和辅助治疗的短期与长期风险的权衡
s462 Sentence Hormone therapy should generally be considered as initial treatment for a postmenopausal patient with newly diagnosed metastatic disease if the patient’s tumor is ER-positive, PR-positive, or ER/PR-unknown 对新诊断癌症转移的ER阳性、PR阳性或ER/PR状态不明的绝经后女性,初步治疗应考虑激素治疗
s463 Sentence While bisphosphonates appear to improve DFS in a population with low-to-intermediate-risk breast cancer, this benefit does not appear to be seen in all patients with breast cancer 虽然双磷酸盐似乎能够提高低-中危乳腺癌患者的DFS,但该获益并不见于所有乳腺癌患者
s464 Sentence The risk of a primary breast cancer in the contralateral breast ranges from 3% to 10% at 10 years after diagnosis, although endocrine therapy decreases that risk 确诊乳腺癌10年后对侧出现原发性乳腺癌的风险为3%-10%,内分泌治疗可以降低这一风险
s465 Sentence In some groups, for example, women with receptor-positive small tumors and those older than 70 years, the absolute reduction in the rate of recurrence was small (<5%) 例如在一些亚组中,患者肿瘤较小、受体阳性或患者年龄超过70岁,复发率降低的绝对值本身即偏低(<5%)
s466 Sentence When BRCA1 / BRCA2 mutation carriers were diagnosed at a young age, the risk of a contralateral breast cancer reached nearly 50% in the ensuing 25 years 如果存在BRCA1/BRCA2基因突变的患者在年轻时即确诊患有乳腺癌,其在未来25年内同侧复发乳腺癌的概率接近50%
s467 Sentence Examples of second-line hormone therapy in postmenopausal women include selective aromatase inhibitors, such as anastrozole, letrozole, or exemestane; megestrol acetate; estrogens; androgens; and the ER down-regulator, fulvestrant 适用于绝经后女性的二线激素治疗包括:选择性芳香化酶抑制剂,例如阿那曲唑、来曲唑或依西美坦;醋酸甲地孕酮;雌激素;雄激素;和下调ER的药物氟维司群
s468 Sentence Radiation therapy following reconstruction with a breast prosthesis may affect cosmesis, and the incidence of capsular fibrosis, pain, or the need for implant removal may be increased 乳房假体植入的乳房再造术后行放疗可能会影响整形的效果,同时发生囊性纤维化、疼痛或需要去除假体的风险也可能增加
s469 Sentence –If a patient presents with M1 prior to neoadjuvant systemic therapy, the stage is considered Stage IV and remains Stage IV regardless of response to neoadjuvant therapy –如果患者在接受新辅助系统治疗前被分为M1期,则无论疗效如何该患者始终为IV期
s470 Sentence Note : ITCs are defined as small clusters of cells ≤0.2 mm, or single tumor cells, or a cluster of &lt;200 cells in a single histologic cross-section 注意:ITC指癌细胞团局限于0.2 mm内或单个肿瘤细胞或单个组织学切面细胞数<200
s471 Sentence There was also a statistically significant higher incidence of asymptomatic and persistent decrease in LVEF in the AC-DH arm than with either the AC-D or DCbH arms AC-DH组无症状性LVEF持续下降事件的发生率显著高于AC-D组或DCbH组
s472 Sentence In addition, the analysis showed no statistically significant increase in deaths attributed to other cancers or to vascular causes among all women randomly assigned to receive chemotherapy 此外,分析显示所有接受化疗的女性死于其他癌症或血管源性死亡的风险并不显著升高
s473 Sentence The NSABP-P-1 trial of 13,388 high-risk women comparing tamoxifen to placebo demonstrated an overall 49% decrease in invasive breast cancer, with a mean follow-up of 47.7 months NSABP-P-1研究纳入了13,388例高危患者,与安慰剂相比,他莫昔芬在平均随访47.7个月后降低了49%的浸润癌发生率
s474 Sentence In women older than 50 years, this benefit was accompanied by an annual incidence of 1 to 2 per 1,000 women of endometrial cancer and thrombotic events 但在超过50岁的患者中,他莫昔芬的使用增加了子宫内膜癌和血栓事件的发生率,每年约为1-2‰
s475 Sentence At a median follow-up of 6.3 years, 5-year OS was 91.8% (95% confidence interval [CI], 89.1%–94.5%) with ALND and 92.5% (95% CI, 90.0–95.1%) with SLN biopsy alone 中位随访时间6.3年,ALND组和仅接受SLN活检组5年OS分别为91.8%(95%置信区间[CI],89.1%-94.5%)和92.5%(95%CI,90.0-95.1%)
s476 Sentence Some additional tumor characteristics that may eventually prove helpful in the prognosis of node-negative disease include the tumor proliferative fraction (S-phase) and the level of HER2/neu expression 其他肿瘤特征也有助于对淋巴结阴性患者的预后进行评估,包括肿瘤增殖分数(S-期)和HER2/neu表达情况
s477 Sentence The SLN is defined as any node that receives drainage directly from the primary tumor, therefore, allowing for more than one SLN, which is often the case SLN定义为任何接受原发肿瘤淋巴回流的淋巴结;因此,SLN数量往往多于1枚
s478 Sentence Because of enrollment challenges, a total of 891 women out of a target enrollment of 1,900 women were randomly assigned to one of the two treatment arms 由于纳入标准过于严格,该研究最终仅筛选出891例患者参与试验
s479 Sentence The use of tamoxifen has decreased the risk of developing breast cancer in women with LCIS and should be considered in the routine management of these women 他莫昔芬可以降低LCIS患者进展为乳腺癌的风险,因此推荐常规使用
s480 Sentence Chemotherapy plus tamoxifen, chemotherapy plus ovarian ablation/GnRH analog, chemotherapy plus tamoxifen plus ovarian ablation/GnRH analog, ovarian ablation alone or with tamoxifen or GnRH alone or with tamoxifen 化疗联合他莫昔芬,化疗联合卵巢趋势/GnRH类似物,化疗联合他莫昔芬联合卵巢趋势/GnRH类似物,单纯卵巢趋势,或卵巢趋势联合他莫昔芬,或单纯GnRH,或GnRH联合他莫昔芬
s481 Sentence Using this prognostic index, patients with favorable lesions, who received surgical excision alone, had a low recurrence rate (i.e., 2% with a median follow-up of 79 months) 根据这一预后指数,病变偏良性的患者即使仅接受手术治疗复发率也很低(2%,中位随访时间79个月)
s482 Sentence Very few women in this trial received adjuvant tamoxifen, which makes it difficult to assess whether these results are applicable to women who relapse after adjuvant tamoxifen 该试验中几乎没有女性接受过他莫昔芬辅助治疗,因此很难评估这些结果是否适用于他莫昔芬辅助治疗后复发的女性
s483 Sentence At a median follow-up of 59 months, there was no significant benefit in the DFS in both groups (77% in each group; HR, 0.98; P = .79) 经过中位时间为59个月的随访之后,两组的DFS均无显著获益(分别各为77%;HR,0.98;P=0.79)
s484 Sentence Retrospective studies indicate no difference in local failure rates or overall survival (OS) when women with strong family histories are compared with similarly treated women without such histories 回顾性研究表明保乳手术的局部失败率或总体生存率(OS)在有明确家族史和无明确家族史的患者间无显著差异
s485 Sentence The 3-year cumulative incidence of cardiac events in arm A was 0.35% (no trastuzumab), arm B, 3.5% (trastuzumab following paclitaxel) and arm C, 2.5% (trastuzumab concomitant with paclitaxel) A组(无曲妥珠单抗)、B组(先紫杉醇再曲妥珠单抗)和C组(紫杉醇与曲妥珠单抗同期给药)的心脏事件3年累计发生率分别为0.35%、3.5%与2.5%
s486 Sentence Nodes containing only ITCs are excluded from the total positive node count for purposes of N classification but should be included in the total number of nodes evaluated 仅有ITC的淋巴结不以转移名义计入N分期但要计入淋巴结评估总数中
s487 Sentence Whether tamoxifen or aromatase inhibitors add to ovarian ablation, and the elucidation of the optimal roles for endocrine manipulation and chemotherapy in receptor-positive premenopausal women, require further evaluation 他莫昔芬或芳香酶抑制剂是否可以增加卵巢去势的疗效、肿瘤受体阳性的绝经前乳腺癌患者内分泌治疗与化疗的最佳方案仍需进一步评估
s488 Sentence On the basis of these studies, the FDA granted accelerated approval for the use of pertuzumab as part of neoadjuvant treatment for women with early-stage, HER2-positive breast cancer 基于这些研究,FDA同意了加速审批帕妥珠单抗用于HER2阳性的早期女性乳腺癌患者的新辅助治疗
s489 Sentence This small proportional reduction translated into an absolute benefit that was only marginally statistically significant, but it indicates that chemotherapy does not increase the risk of contralateral disease 这一小比例下降转化为绝对获益仅有边界统计学意义,但提示化疗不增加对侧乳腺癌风险
s490 Sentence As a result of the stage migration phenomenon, survival by stage for case series classified by the new system will appear superior to those using the old system 由于分期的改动,根据新分期系统进行病例分析的分期生存评估似乎要优于旧分期系统
s491 Sentence Survival is equivalent with any of these options as documented in randomized prospective trials (including the European Organization for Research and Treatment of Cancer's trial [ EORTC-10801 ]) 随机前瞻性临床研究(包括欧洲癌症研究及治疗组织发起的临床试验[EORTC-10801])表明不同术式的生存率相似
s492 Sentence The rate of local recurrence in the breast with conservative treatment is low and varies slightly with the surgical technique used (e.g., lumpectomy, quadrantectomy, segmental mastectomy, and others) 保守治疗的局部复发率低,可能由于手术方式(例如局部病灶切除、四分之一切除、区段切除及其他)的选择而略有不同
s493 Sentence The hazard ratio for time to progression was 0.49 (95% CI, 0.34–0.71; P &lt; .001), with 49 events in the combination-therapy group and 72 events in the monotherapy group 疾病进展风险比为0.49(95%CI,0.34-0.71;P<0.001),联合治疗组有49例进展,单药治疗组有72例进展
s494 Sentence The EBCTCG meta-analysis revealed that women who received adjuvant combination chemotherapy did have a 20% (standard deviation = 10) reduction in the annual odds of developing contralateral breast cancer EBCTCG荟萃分析显示接受辅助联合化疗的女性患者对侧乳腺癌年发生率降低20%(标准差=10)
s495 Sentence Some of the most important data on the benefit of adjuvant chemotherapy came from the EBCTCG, which meets every 5 years to review data from global breast cancer trials 一些非常重要的辅助化疗获益证据来自于EBCTCG,该组织每5年对全球乳腺癌试验数据进行一次综述
s496 Sentence Because the teratogenic potential of tamoxifen is unknown, contraception should be discussed with patients who are premenopausal or of childbearing age and are candidates for treatment with this drug 鉴于他莫昔芬的致畸作用尚不明确,应与绝经前或育龄期乳腺癌并可能会接受他莫昔芬治疗的患者进入深入沟通
s497 Sentence The use of hormone replacement therapy (HRT) poses a dilemma for the rising numbers of breast cancer survivors, many of whom enter menopause prematurely as a result of therapy 激素替代治疗(HRT)的施行对于日益增多的乳腺癌存活者来说是一个两难的选择,因为许多患者在接受HRT后会过早绝经
s498 Sentence Because of the inconsistent findings of these studies, it would be premature to mandate a modification in the scheduling of breast cancer operations according to the patient’s menstrual cycle 因这些研究的结果不一致,现在根据患者的月经周期调整乳腺癌手术时机仍为时尚早
s499 Sentence Excisional biopsy of a lymph node or biopsy of a sentinel node, in the absence of assignment of a pT, is classified as a clinical N, for example, cN1 未指定pT的淋巴结切除活检或前哨淋巴结活检被划分为临床N,例如cN1
s500 Sentence The EBCTCG meta-analysis analyzed 11 trials that began in 1976 through 1989 in which women were randomized to receive regimens containing anthracyclines (e.g., doxorubicin or epirubicin) versus CMF alone EBCTCG荟萃分析总结了1976-1989年之间启动的11项临床试验,其中女性患者被随机分组接受含蒽环类药物(例如阿霉素或表柔比星)化疗或单行CMF治疗
s501 Sentence In the NSABP B-31 (NCT00004067) trial, 31 of 850 patients in the trastuzumab arm had confirmed symptomatic cardiac events, compared with 5 of 814 patients in the control arm NSABPB-31(NCT00004067)试验中,曲妥珠单抗组850例患者汇总31例出现心脏事件症状,而对照组814例患者中仅5例出现此类症状
s502 Sentence A trial of CMF versus tamoxifen plus ovarian ablation (e.g., by surgery, radiation therapy, or gonadotropin-releasing hormone [GnRH]) in premenopausal or perimenopausal women with receptor-positive tumors has been reported 一项针对绝经前和围绝经期肿瘤受体阳性的乳腺癌患者进行的研究对比了CMF与他莫昔芬联合卵巢去势(例如手术、放疗或使用促性腺激素释放激素)治疗的疗效
s503 Sentence Strictly speaking, it is not known to be a premalignant lesion, but rather a marker that identifies women at an increased risk for subsequent development of invasive breast cancer 严格来说,LCIS并非癌前病变,而是表明患者进展为浸润癌的风险增加
s504 Sentence If ER and PR status is unknown, then the site(s) of recurrence, disease-free interval, response to previous treatment, and menopausal status are useful in selecting chemotherapy or hormone therapy 如果ER与PR状态不明,复发部位、无病间期、对既往治疗的反应和绝经情况则有助于选择化疗还是激素治疗
s505 Sentence This trial supports the use of TCH as an alternative adjuvant regimen for women with early-stage HER2 -overexpressing breast cancer, particularly in those with concerns about cardiac toxic effects 该试验支持以TCH作为早期HER2过度表达型乳腺癌女性患者的辅助治疗替代方案,尤其可用于有心脏毒性反应顾虑的患者
s506 Sentence Several randomized but underpowered trials have tried to determine if combined hormone therapy (luteinizing hormone-releasing hormone [LHRH] agonists + tamoxifen) is superior to either approach alone in premenopausal women 一些效力欠佳的随机临床试验曾尝试评估对于绝经前女性,激素联合治疗(促黄体激素释放激素[LHRH]拮抗剂+他莫昔芬)是否优于单药治疗
s507 Sentence When used in HER2/neu -positive patients, treatment with paclitaxel and lapatinib showed improvement in time to progression, event-free survival, response rate, and clinical benefit rate; OS did not increase 紫杉醇联合拉帕替尼治疗HER2/neu阳性患者时改善进展时间、无事件生存率、缓解率和临床获益率,但并不改善OS
s508 Sentence Women whose tumors are ER-positive or unknown, with bone or soft tissue metastases only, who have received an antiestrogen within the past year, should be given second-line hormone therapy ER阳性或状态不明、仅有骨转移或软组织转移、过去1年内曾接受抗雌激素治疗的女性患者应采用二线激素治疗
s509 Sentence Designation should be made with the subscript "c" or "p" modifier to indicate whether the T classification was determined by clinical (physical examination or radiologic) or pathologic measurements, respectively 应在下标注明“c”或“p”以表明该T分期是依据临床(查体或影像学)还是病理
s510 Sentence The use of anthracycline-containing regimens, however—particularly those containing an increased dose of cyclophosphamide—has been associated with a cumulative risk of developing acute leukemia of 0.2% to 1.7% at 5 years 但含蒽环类药物方案,尤其是接受大剂量环磷酰胺治疗的患者,发生急性白血病的5年累计风险从0.2%上升到1.7%
s511 Sentence Also, a systematic review of nine randomized, controlled trials comparing the effectiveness of high-dose chemotherapy and autograft with conventional chemotherapy for women with early poor prognosis breast cancer was performed 将比较大剂量化疗联合自体移植与传统化疗对早期预后较差女性乳腺癌患者作用的9项随机对照临床试验进行系统性回顾
s512 Sentence Two randomized trials that enrolled 400 and 451 patients who had progressed after receiving tamoxifen demonstrated that fulvestrant yielded similar results to anastrozole in terms of its impact on PFS 两项随机临床试验分别招募了400例与451例他莫昔芬治疗后疾病进展的患者,研究发现氟维司群对PFS的影响与阿那曲唑相当
s513 Sentence A clinical trial indicated that between 10% and 20% of patients will have locally recurrent disease in the breast between 1 and 9 years after breast-conservation surgery plus radiation therapy 一项临床试验指出10%-20%的患者在保乳术联合放疗后的1-9年之间出现局部复发
s514 Sentence Chemotherapy plus tamoxifen, chemotherapy plus ablation or GnRH analog*, chemotherapy plus tamoxifen plus ovarian ablation or GnRH*, or ovarian ablation alone or with tamoxifen or GnRH alone or with tamoxifen 化疗联合他莫昔芬,化疗联合卵巢去势或GnRH类似物*,化疗联合他莫昔芬加卵巢趋势或GnHR*,或单纯卵巢趋势,或卵巢趋势联合他莫昔芬,或单纯GnRH,或GnRH联合他莫昔芬
s515 Sentence Of those, 49 patients (3.1% of the total group) remained in complete remission for more than 5 years, and 26 patients (1.5%) were still in complete remission at 16 years 其中49例患者(占总数的3.1%)完全缓解超过5年,26例患者(1.5%)完全缓解超过16年
s516 Sentence Initial surgery is generally limited to biopsy to permit the determination of histology, estrogen-receptor (ER) and progesterone-receptor (PR) levels, and human epidermal growth factor receptor 2 ( HER2/neu ) overexpression 初次手术通常仅限于进行活检,以评估组织学、雌激素受体(ER)和孕激素受体(PR)水平及人类表皮生长因子受体2(HER2/neu)是否过表达
s517 Sentence Further analyses revealed that differences in recurrence patterns persisted for most subgroups with the exception of those that had either negative tumor margins or one to three positive lymph nodes 进一步的分析发现多数亚组均有这种复发率差异,但肿瘤切缘阴性患者或1-3枚阳性淋巴结患者除外
s518 Sentence Controversy existed as to whether adjuvant radiation therapy to the left chest wall or breast, with or without inclusion of the regional lymphatics, had an association with increased cardiac mortality 关于在左侧胸壁或乳腺及局部淋巴结行辅助放疗是否会增加心脏相关死亡率仍有争议
s519 Sentence Regardless of how one chooses to characterize node-negative tumors, evidence from clinical trials suggests that various types of adjuvant therapies benefit certain subgroups of patients with these kinds of tumors 无论如何确定淋巴结阴性患者的预后,来自临床试验的证据表明多种辅助治疗可以使得某些肿瘤特征的患者获益
s520 Sentence In women treated with radiation therapy before 1980, an increased cardiac death rate was noted after 10 to 15 years, compared with women with nonradiated or right-side-only radiated breast cancer 1980年以前接受放疗的乳腺癌患者与未接受放疗或仅接受右侧放疗的乳腺癌患者相比,其10-15年心脏相关死亡率有所增加
s521 Sentence By contrast, no subset of patients was identified in the prospective NSABP trial that did not benefit from the addition of radiation therapy to lumpectomy in the management of DCIS 相反,在NSABP前瞻性研究中所有DCIS患者均获益于手术治疗后的放疗
s522 Sentence Because of the results of the first trial, the second trial, which was conducted under a joint steering committee with the first, closed prematurely after the enrollment of 378 patients 鉴于第一项研究的结果,在与该研究组成的联合指导委员会带领下完成的第二项研究在纳入378例患者后提前结束
s523 Sentence In a meta-analysis including all trials that compared the use of the same chemotherapy preoperatively and postoperatively, the use of preoperative chemotherapy was associated with a higher rate of local recurrence 一项荟萃分析总结了所有比较相同术前、术后化疗方案的研究,发现术前化疗的局部复发率较高
s524 Sentence Carcinomas in the breast parenchyma associated with Paget disease are categorized based on the size and characteristics of the parenchymal disease, although the presence of Paget disease should still be noted Paget病相关的乳腺实质肿瘤根据肿瘤大小和实质疾病的性质进行分类,同时应注意有Paget病
s525 Sentence A study has shown that treatment with lumpectomy and radiation therapy in women 65 years and older produces survival and freedom-from-recurrence rates similar to those of women younger than 65 years 一项研究表明局部病灶切除联合放疗的生存率和无复发率在年龄≥65岁和&lt;65岁组间无显著差异
s526 Sentence A single study of more than 300 patients that compared cyclophosphamide, methotrexate, 5-FU, and prednisone (CMFP) with the same chemotherapy regimen plus surgical oophorectomy showed no additional survival benefit from oophorectomy 一项共纳入300例患者的单中心研究比较了环磷酰胺、甲氨蝶呤、5-FU、泼尼松(CMFP)化疗组和CMFP+卵巢切除治疗组疗效,结果表明卵巢切除并未使患者生存获益增加
s527 Sentence For patients who respond to neoadjuvant chemotherapy, local therapy may consist of total mastectomy with axillary lymph node dissection followed by postoperative radiation therapy to the chest wall and regional lymphatics 对于新辅助化疗有效的患者,局部治疗包括全乳房切除术加腋窝淋巴结清扫术和术后胸壁及区域淋巴放疗
s528 Sentence Having demonstrated an increased detection rate of mammographically occult disease, the selective use of MRI for additional screening is being used with increased frequency despite the absence of randomized, controlled data MRI在检出钼靶阴性的乳腺癌中显示出一定优势,尽管缺乏随机对照研究数据,选择性加做MRI进行筛查得到越来越多的应用
s529 Sentence While there is a biologic rationale for combining fulvestrant with a third-generation aromatase inhibitor for patients with recurrent or metastatic disease, the benefits of such combination therapy have not been established 虽然氟维司群联合第三代芳香化酶抑制剂治疗复发性或转移性乳腺癌存在生物学合理性,但这种联合治疗的获益未经临床试验证实
s530 Sentence Neither of these studies, however, showed an improvement in OS for patients who received immediate treatment, and in one of these studies, survival was actually worse in the immediately treated group 但这些研究均显示患者立即接受下一种治疗并不改善OS,其中一项研究显示,立即治疗组的生存率实际上低于对组
s531 Sentence Axillary radiation therapy can increase the risk of arm edema in patients who received axillary dissection from 2% to 10% with dissection alone to 13% to 18% with adjuvant radiation therapy 相比于单纯腋窝淋巴结清扫,术后辅助放疗可使患者上肢水肿发生率由2-10%增加至13-18%
s532 Sentence Based on the above studies, delaying radiation therapy for several months after breast-conserving surgery until the completion of adjuvant chemotherapy does not appear to have a negative impact on overall outcome 基于上述研究,保乳术后推迟放疗,直至完成辅助化疗后再行放疗似乎对总结局无负面影响
s533 Sentence The AZURE trial was a randomized, phase III trial that assigned 3,660 patients with stage II or III breast cancer to receive chemotherapy and/or hormone therapy with or without zoledronic acid AZURE试验为一项随机、III期临床试验,共纳入3,660例II或III期乳腺癌患者,接受化疗联合(或)激素治疗加或不加唑来膦酸
s534 Sentence While tamoxifen has been used in this setting for many years, several randomized trials suggest equivalent or superior response rates and progression-free survival (PFS) for the aromatase inhibitors compared to tamoxifen 他莫昔芬被应用于治疗此类患者已有多年,一些随机临床试验提示芳香化酶抑制剂与他莫昔芬相比,缓解率和无进展生存率(PFS)等效或优于后者
s535 Sentence With a median follow-up of 4.1 years, there were 11 recurrences in the hormone replacement group and 13 recurrences in the patients assigned to no hormone replacement (HR, 0.82; 95% CI, 0.35–1.9) 该研究中位随访时间为4.1年,激素替代治疗组和非激素替代治疗组分别有11例和13例患者复发(HR,0.82;95%CI,0.35-1.9)
s536 Sentence Thus, compared with paclitaxel given every 3 weeks, paclitaxel given weekly improved both DFS (OR, 1.27; 95% CI, 1.01–1.57; P = .006) and OS (OR, 1.32; 95% CI, 1.02–1.72; P = .01) 紫杉醇每周一次给药的DFS(OR,1.27;95%CI,1.01-1.57;P=0.006)与OS(OR,1.32;95%CI,1.02-1.72;P=0.01)大于紫杉醇每三周一次给药
s537 Sentence Intergroup study ( SWOG-8897 ) observed patients off treatment with tumors of low-risk (tumors too small for biochemical ER/PR assay) and uncertain-risk (tumors &lt;2 cm, ER-positive and PR-positive, and low S-phase fractions) 一项美国组间研究(SWOG-8897​)观察到低危患者(肿瘤过小,无法进行ER/PR生化分析)和危险度不明的患者(肿瘤<2cm,ER阳性与PR阳性,S期分数低)不接受治疗的情况
s538 Sentence Patients receiving buserelin and tamoxifen had a significantly improved median survival of 3.7 years compared with those receiving tamoxifen or buserelin who survived 2.9 and 2.5 years, respectively ( P = .01) 接受布舍瑞林联合他莫昔芬治疗的患者生存时间中位数为3.7年,而仅接受他莫昔芬或布舍瑞林治疗的患者生存时间中位数分别为2.9和2.5年(P=0.01)
s539 Sentence A phase III, randomized study showed that local control of cutaneous metastases could be achieved with the application of topical miltefosine; however, the drug is not currently available in the United States 一项III期、随机研究发现可外用米替福新局部控制皮肤转移灶,但该药未在美国上市
s540 Sentence Studies comparing high-dose chemotherapy with stem cell support to conventional chemotherapy in patients with metastatic disease indicate no OS or relapse-free survival benefit for patients receiving high-dose chemotherapy with stem cell support 一些临床研究对比了大剂量化疗联合干细胞支持与传统化疗对转移癌患者的应用,发现接受大剂量化疗联合干细胞支持的患者并无OS或无复发生存获益
s541 Sentence An EORTC randomized trial ( EORTC-10902 ) likewise demonstrated no improvement in DFS or OS, but showed an increased frequency of conservative surgery with the use of preoperative versus postoperative FEC chemotherapy EORTC随机试验(EORTC-10902)也证实术前FEC化疗与术后FEC化疗相比,DFS或OS没有改善,但保乳手术率增加
s542 Sentence In a retrospective series, approximately 32% of patients with ipsilateral supraclavicular node involvement and no evidence of distant metastases (pN3c) had prolonged disease-free survival (DFS) at 10 years with combined modality therapy 一项回顾性病例发现,同侧锁骨上淋巴结受累但无远处转移证据的患者(pN3c期)中,约有32%的患者经过综合治疗,长期无病生存时间可达10年
s543 Sentence In one randomized study of patients with metastatic breast cancer treated with trastuzumab, paclitaxel, and carboplatin, patients tolerated the combination well and had a longer time-to-progression, compared to trastuzumab and paclitaxel alone 一项随机研究对转移性乳腺癌患者采用曲妥珠单抗、紫杉醇联合卡铂治疗或单纯曲妥珠单抗联合紫杉醇治疗,前组患者对联合方案的耐受性良好,至进展时间延长
s544 Sentence In this analysis, parameters associated with an increased risk of in-breast recurrence included age 40 years or younger, palpable disease, intermediate or poorly differentiated DCIS, cribriform or solid growth pattern, and indeterminate margins 在该研究中,与乳内乳腺癌复发相关的危险因素包括年龄≤40岁、肿瘤可触及、中或低分化DCIS、筛状或实性生长方式以及边界不清
s545 Sentence For patients who attain a complete response to initial therapy, two randomized trials have shown a prolonged DFS from immediate treatment with a different chemotherapy regimen compared to observation with treatment upon relapse 两项随机临床试验发现,对于初步治疗后完全缓解的患者,立即换用一种化疗方案治疗和仅观察直至肿瘤复发相比,前者的DFS延长
s546 Sentence Compared to CMF, anthracycline-based regimens were associated with a modest but statistically significant 11% proportional reduction in the annual risk of disease recurrence, and a 16% reduction in the annual risk of death 与CMF相比,以蒽环类药物为基础的化疗方案组乳腺癌年复发率约降低11%,幅度不大但具有统计学显著性,死亡年风险降低16%
s547 Sentence The limited impact of radiation therapy in this group of women was also reported in a confirmatory observational study looking at in-breast control rates using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database 在一项利用监控、流行病学和终点事件(SEER)-医疗保健数据库进行的确证观察研究中这些亚组的患者乳内复发率在接受放疗后仍有降低
s548 Sentence For patients receiving AC-T plus trastuzumab, the 5-year DFS rate was 84% (HR for the comparison with AC-T, 0.64; P &lt; .001), and the OS rate was 92% (HR, 0.63; P &lt; .001) AC-T加曲妥珠单抗组的5年DFS率为84%(与AC-T组相比的HR为0.64;P<0.001),OS率为92%(HR,0.63;P<0.001)
s549 Sentence Clearly, this group has a risk of developing a new breast cancer that would meet the eligibility criteria that were used in the Breast Cancer Prevention Trial that demonstrated a benefit with tamoxifen 但此类患者存在新发乳腺癌的风险,可能符合乳腺癌预防试验的入选标准,该试验证实了他莫昔芬治疗的益处
s550 Sentence The EBCTCG overview analysis directly compared anthracycline-containing regimens (mostly 6 months of FEC or FAC) with CMF (either oral or IV) in approximately 14,000 women, 64% of whom were younger than 50 years EBCTCG概况分析直接比较了含蒽环类药物化疗方案(多数为6月FEC方案或FAC方案)与CMF(口服或静脉用)对约14,000例女性的作用,其中64%女性年龄小于50岁
s551 Sentence Patients whose excised lesions had margin widths 10 mm or larger in every direction had an extremely low probability of local recurrence with surgery alone (4% with a mean follow-up of 8 years) 各方向切缘均在10 mm及以上的患者即使仅接受手术治疗复发率也极低(4%,中位随访时间8年)
s552 Sentence Clotting factor changes have been observed in controlled studies of prolonged tamoxifen use at standard doses; antithrombin III, fibrinogen, and platelet counts have been reported to be minimally reduced in patients receiving tamoxifen 在持续他莫昔芬标准剂量治疗对照研究中,研究人员发现了凝血因子的改变;接受他莫昔芬治疗的患者抗凝血酶III、纤维蛋白原和血小板计数均轻度降低
s553 Sentence Several well-established factors have been associated with an increased risk of breast cancer, including family history, nulliparity, early menarche, advanced age, and a personal history of breast cancer ( in situ or invasive) 目前明确可造成乳腺癌患病风险增加的因素包括阳性家族史、未产、初潮时间早、老年、乳腺癌病史(原位癌或浸润癌)
s554 Sentence Although all trials assessing the role of radiation therapy in breast-conserving therapy have shown highly statistically significant reductions in local recurrence rate, no single trial has demonstrated a statistically significant reduction in mortality 尽管所有评估放疗对保乳术作用的试验均发现放疗后局部复发率在统计学上极为显著地降低了,但其中任何一项试验均未证实死亡率显著降低
s555 Sentence In a second, similarly designed trial, 929 women with breast tumors smaller than 5 cm and SLN involvement smaller than 2 mm were randomly assigned to receive or not receive axillary lymph node dissection 另一项设计类似的临床试验共纳入929例肿瘤小于5cm、SLN转移灶小于2mm的乳腺癌患者,随机将其分为接受与不接受全腋窝淋巴结清扫两组
s556 Sentence All 225 women with tumors that were larger than 2 cm or node-positive, and who had operable, locally advanced, or inflammatory HER2 -positive breast cancer, were randomly assigned to one of three preoperative regimens: 纳入的患者为225例肿瘤大于50px或淋巴结阳性且可行手术、局部晚期或HER2阳性炎性乳腺癌患者,被随机分到三个术前治疗组中:
s557 Sentence A large national clinical trial by the Radiation Therapy Oncology Group ( RTOG-9804 ) comparing breast-conserving surgery and tamoxifen with or without radiation therapy was closed due to poor accrual, and results are pending 由美国放射治疗协作组组织的一项大型全国性临床研究(RTOG-9804)比较了保乳手术+他莫昔芬联合或不联合放疗的疗效,该研究最终因招募速度过慢而终止,结果待定
s558 Sentence (Refer to the PDQ summary on Sexuality and Reproductive Issues for more information.) Ophthalmologic toxic effects have also been reported in patients receiving tamoxifen; patients who complain of visual problems should be assessed carefully (具体可参见性功能和生殖问题​PDQ总结)另有报道接受他莫昔芬治疗的患者出现眼毒性;主诉视力异常的患者应仔细评估
s559 Sentence The ABCSG-12 (NCT00295646) trial was a 2 × 2 factorial-design randomized trial that assigned 1,803 premenopausal patients with ER+ breast cancer to receive ovarian function suppression with goserelin and tamoxifen versus goserelin and anastrozole ABCSG-12(NCT00295646)试验为2×2因素随机对照试验,将1,803例ER+绝经前乳腺癌女性患者随机分组,接受戈舍瑞林抑制卵巢功能加他莫昔芬治疗或戈舍瑞林加阿那曲唑治疗
s560 Sentence The 5-year crude rates of first recurrence by site in the radiation-first and chemotherapy-first groups, respectively, were 5% and 14% for local recurrence and 32% and 20% for distant or regional recurrence or both 先放疗组和先化疗组5年首次复发率粗略估值为:局部复发分别为5%和14%,远处或区域复发或二者兼有分别为32%和20%
s561 Sentence When 54 Gy in 30 fractions was delivered to the regional nodes, the incidence of symptomatic brachial plexus injury was 1.0% compared with 5.9% when increased fraction sizes (45 Gy in 15 fractions) were used 区域淋巴结总剂量54Gy(分30次)放疗组与总剂量45Gy(分15次)放疗组的症状性臂丛神经损伤发生率分别为1.0%和5.9%
s562 Sentence What has become clear after reviewing results from multiple breast cancer treatment trials is that hormone therapy and chemotherapy regimens generally offer the same proportional benefit to women irrespective of their axillary lymph node status 根据多项乳腺癌治疗试验的结果,人们逐渐认可激素治疗与化疗对女性患者的获益程度相当,而无论有无阳性淋巴结
s563 Sentence Evidence from randomized trials indicates that periodic follow-up with bone scans, liver sonography, chest x-rays, and blood tests of liver function does not improve survival or quality of life when compared with routine physical examinations 来自随机临床试验的证据表明,与常规查体相比较,定期随访时行骨扫描、肝脏超声、胸部X线和肝功检查并不改善患者生存率或生活质量
s564 Sentence Patients should continue to have regular breast physical examinations and mammography to detect either recurrence in the ipsilateral breast in those patients treated with breast-conserving surgery or a second primary cancer in the contralateral breast 接受保乳手术治疗或对侧原发性乳腺癌的患者应坚持长期规律接受乳腺查体和钼靶检查以及早发现同侧复发病变
s565 Sentence The Independent Data Monitoring Committee of the trial determined that the patients assigned to the lapatinib alone arm were not likely to do as well as the patients assigned to the trastuzumab alone control arm 该试验的独立数据审核委员会认为拉帕替尼单药治疗组患者的结局不如曲妥珠单抗单药治疗对照组
s566 Sentence The phase III EMILIA or TDM4370g (NCT00829166) study was a randomized, open-label trial enrolling 991 patients with HER2 -overexpressing, unresectable, locally advanced or metastatic breast cancer who were previously treated with trastuzumab and a taxane III期临床试验EMILIA,也称为TDM4370g(NCT00829166)是一项随机、开放临床试验,共招募了991例HER2过量表达型、不可切除、局部高分期或转移性乳腺癌患者,这些患者既往接受过曲妥珠单抗和紫杉醇治疗
s567 Sentence "Clinically detected" is defined as detected by imaging studies (excluding lymphoscintigraphy) or by clinical examination and having characteristics highly suspicious for malignancy or a presumed pathologic macrometastasis based on fine-needle aspiration biopsy with cytologic examination “临床检测出”定义为影像学检查(不包括淋巴显像)或查体发现,同时根据细针抽吸穿刺活检细胞学检查显示高度可疑恶性或病理上推定存在广泛转移
s568 Sentence In a single small study by the Cancer and Leukemia Group B ( MDA-MBDT-8081 ), 36% of hormone receptor–positive tumors were found to be receptor negative in biopsy specimens isolated at the time of recurrence 癌症与白血病B组进行的一项小规模研究(MDA-MBDT-8081)发现36%的激素受体阳性肿瘤在复发之后,活检标本提示受体阴性
s569 Sentence In the AVENTIS-TAX-GMA-302 (BCIRG 006) trial, clinically symptomatic cardiac events were detected in 0.38% of patients in the AC-D arm, 1.87% of patients in the AC-DH arm, and 0.37% of patients in the DCbH arm AVENTIS-TAX-GMA-302​(BCIRG006)试验中,AC-D组有临床症状性心脏事件的发生率为0.38%,AC-DH组为1.87%,DCbH组为0.37%
s570 Sentence Risk was reduced by 56% in the subset of 826 women with a history of LCIS, and the average annual hazard rate for invasive cancer fell from 12.99 per 1,000 women to 5.69 per 1,000 women 在826例既往有LCIS病史的患者中其浸润癌发生风险降低了56%,浸润癌平均年危险率由12.99‰降至5.69‰
s571 Sentence Clinically detected is defined as detected by imaging studies (excluding lymphoscintigraphy) or by clinical examination and having characteristics highly suspicious for malignancy or a presumed pathologic macrometastasis based on fine needle aspiration biopsy with cytologic examination 临床发现定义为影像学检查(不包括淋巴显像)或查体发现,同时根据细针抽吸穿刺活检细胞学检查显示高度可疑恶性或病理上推定存在广泛转移
s572 Sentence In a single-institution study using current radiation techniques, 449 breast cancer patients treated with postoperative radiation therapy to the breast and regional lymphatics were followed for 5.5 years to assess the rate of brachial plexus injury 一项单中心研究共纳入449例乳腺癌患者,这些患者均接受术后乳腺及区域淋巴结放疗,研究采用现有放疗技术,随访5.5年以评估臂丛神经损伤的发生率
s573 Sentence Hormone therapy is especially indicated if the patient’s disease involves only bone and soft tissue and the patient has either not received adjuvant antiestrogen therapy or has been off such therapy for more than 1 year 如果肿瘤仅累及骨和软组织,且患者未接受过辅助性抗雌激素治疗或停用此类治疗已超过1年,则更应考虑激素治疗
s574 Sentence Given that lumpectomy and radiation therapy are generally applicable for most patients with DCIS, can a subset of patients be identified with such a low risk of local recurrence that postoperative radiation therapy can be omitted 鉴于大部分DCIS患者可以接受局部病灶切除术联合术后放疗,是否可以进一步筛选出无需行术后放疗的局部复发率较低的患者亚群呢
s575 Sentence The rates of congestive heart failure and cardiac dysfunction were significantly higher in the group receiving AC-T plus trastuzumab than in the docetaxel and carboplatin plus 52 weeks of trastuzumab (TCH) group ( P &lt; .001) AC-T加曲妥珠单抗组的充血性心力衰竭与心功能不全发生率显著高于多西他赛、卡铂加52周曲妥珠单抗(TCH)治疗组(P<0.001)
s576 Sentence If the tumor size is slightly less than or greater than a cutoff for a given T classification, it is recommended that the size be rounded to the millimeter reading that is closest to the cutoff 如果肿瘤大小稍高于或低于某一特定分期的截点,建议按照最接近截点的读数四舍五入
s577 Sentence Because the axillary node status remains the most important predictor of outcome in breast cancer patients, insufficient evidence is available to recommend that lymph node staging can be omitted in most patients with invasive breast cancer 鉴于腋窝淋巴结转移情况仍为乳腺癌最重要的预后指标,目前尚无足够证据表明浸润癌患者可以不行淋巴结分期
s578 Sentence Patients received either chemotherapy first (n = 122), consisting of CMFP plus doxorubicin repeated every 21 days for four cycles, followed by breast radiation, or breast radiation first (n = 122), followed by the same chemotherapy 该试验中患者先接受化疗再行乳腺放疗(n=122),或先行乳腺放疗再行化疗(n=122),所用化疗方案为CMFP联合阿霉素,每21天为一程,共4程
s579 Sentence Patients received either CAF (300/30/300 mg/m2 every 4 weeks for four cycles; low-dose arm), CAF (400/40/400 mg/m2 every 4 weeks for six cycles; moderate-dose arm), or CAF (600/60/600 mg/m2 every 4 weeks for four cycles; high-dose arm) 该试验中患者被分入CAF小剂量组(300/30/300mg/m2,每4周一次,共4程)、CAF中等剂量组(400/40/400mg/m2,每4周一次,共6程)或CAF大剂量组(600/60/600mg/m2,每4周一次,共4程)
s580 Sentence In the open-label, randomized, phase II NeoSPHERE trial (NCT00545688), 417 women with tumors that were larger than 2 cm or node-positive, and who had HER2 -positive breast cancer, were randomly assigned to one of four preoperative regimens: NeoSPHERE试验(NCT00545688)为一项开放、随机的II期试验,417例肿瘤大于50px或淋巴结阳性的HER2阳性女性乳腺癌患者被随机分到下列四个术前治疗组中:
s581 Sentence A large, randomized trial of 9,366 patients has compared the use of the aromatase inhibitor anastrozole and the combination of anastrozole and tamoxifen with tamoxifen alone as adjuvant therapy for postmenopausal patients with node-negative and node-positive disease 一项大型随机临床试验共纳入9366例乳腺癌患者,对比了芳香酶抑制剂阿那曲唑联合他莫昔芬治疗与他莫昔芬单药治疗对于淋巴结转移阴性和淋巴结转移阳性绝经后乳腺癌患者的疗效
s582 Sentence The original Consensus Panel classification also required that women be 35 years or older to be included in the low-risk group and included women 35 years and younger in the high-risk group, based admittedly on indirect evidence 最初的共识专家组分类要求低危组女性年龄应大于等于35岁,高危组女性年龄小于等于35岁,此要求显然是根据间接证据作出
s583 Sentence (Refer to the Aromatase Inhibitors section of this summary for more information.) For women who remain premenopausal after 5 years of tamoxifen, discussion with the patient about the risks and benefits of extending tamoxifen therapy should occur (具体可参见本总结芳香酶抑制剂​部分)对于接受5年他莫昔芬治疗后仍未绝经的女性乳腺癌患者,应就延长他莫昔芬治疗的风险与获益与其深入沟通
s584 Sentence A large double-blinded randomized trial ( EORTC-10967 [ICCG-96OEXE031-C1396-BIG9702]) of 4,742 patients compared continuing tamoxifen with switching to exemestane for a total of 5 years of therapy in women who had received 2 to 3 years of tamoxifen 一项大型双盲随机临床试验(EORTC-10967[ICCG-96OEXE031-C1396-BIG9702])共纳入4742名患者,对比了连续5年他莫昔芬治疗和他莫昔芬治疗2-3年后改为依西美坦治疗的疗效
s585 Sentence A systematic review of 17 randomized trials found that the addition of one or more chemotherapy drugs to a chemotherapy regimen in the attempt to intensify the treatment improved tumor response but had no effect on OS 对17项随机临床试验进行系统性回顾,发现向化疗方案中增加一种或多种化疗药以强化治疗可能提高肿瘤缓解率,但并不改善OS
s586 Sentence The Van Nuys Prognostic Index, which combines three predictors of local recurrence (i.e., tumor size, margin width, and pathologic classification), was used to retrospectively analyze 333 patients treated with either excision alone or excision and radiation therapy Van Nuys预后指数包含三大局部复发预测指标(肿瘤大小、切缘及病理分级),一项纳入了333例患者的回顾性研究运用该指数比较了仅接受手术治疗与接受手术联合放疗的效果
s587 Sentence For patients who require an ALND, the standard evaluation usually involves only a level I and II dissection, thereby removing a satisfactory number of nodes for evaluation (i.e., 6–10 at least), while reducing morbidity from the procedure 对于需要行ALND的患者,标准评估通常只需清扫I、II站淋巴结,即切除满足要求的一定数目的淋巴结(即至少6-10枚)同时降低因手术操作可能带来的致残率
s588 Sentence The most important effect is the development of endometrial cancer which, in large clinical trials, has been reported to occur at a rate that is two times to seven times greater than that observed in untreated women 大型临床试验报道的最常见的毒性作用为子宫内膜癌的发生,与未接受他莫昔芬治疗的患者相比其发病率增加了2-7倍
s589 Sentence In the Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization trial ( ALTTO [NCT00553358]), the role of lapatinib (in combination with, in sequence to, in comparison to, or as an alternative to trastuzumab) in the adjuvant setting is being investigated 拉帕替尼和(或)曲妥珠单抗优化辅助治疗(ALTTO[NCT00553358])评估了拉帕替尼(联合、序贯、对比或替代曲妥珠单抗)在辅助治疗中的作用
s590 Sentence A single study that addressed the use of perioperative adjuvant chemotherapy in node-positive patients showed no advantage in DFS when a single cycle of perioperative chemotherapy was given in addition to standard therapy initiated 4 weeks after surgery 一项研究在淋巴结阳性患者中评估了术前辅助化疗的作用,显示在术后4周开始的标准治疗基础上增加1程术前化疗并不改善DFS
s591 Sentence On the basis of the results of these trials, the medical necessity of ALND after a positive SLN biopsy in patients with limited SLN-positive breast cancer treated with breast conservation, radiation, and systemic therapy is called into question 根据这些研究结果,在仅存在有限SLN阳性转移的乳腺癌患者中行保乳、放疗和全身治疗后是否有必要进一步行全腋窝淋巴结清扫值得商榷
s592 Sentence The mild androgen activity of exemestane prompted a randomized trial to evaluate whether exemestane might be preferable to anastrozole, in terms of its efficacy and toxicity, as upfront therapy for postmenopausal women diagnosed with hormone receptor-positive breast cancer 依西美坦有轻微的雄激素活性,因此一项随机临床试验评估了依西美坦作为激素受体阳性的绝经后乳腺癌女性患者一线治疗,在有效性和毒性上是否优于阿那曲唑
s593 Sentence However, a phase III trial ( BCIRG-007 [NCT00047255]) comparing carboplatin and docetaxel plus trastuzumab versus docetaxel plus trastuzumab as first-line chemotherapy for metastatic HER2 -overexpressing breast cancer showed no difference in OS, time to progression, or response rate )比较了卡铂联合多西他赛加曲妥珠单抗和多西他赛加曲妥珠单抗作为转移性HER2过量表达型乳腺癌患者一线化疗的作用,发现两组患者的OS、至进展时间或缓解率均无差异
s594 Sentence In November 2011, based on the consistent finding that bevacizumab only modestly improved PFS but not OS, and given bevacizumab’s considerable toxicity profile, the Food and Drug Administration revoked approval of bevacizumab for the treatment of metastatic breast cancer 2011年11月,基于现有的结果,贝伐单抗仅轻度改善PFS,但不改善OS,考虑到贝伐单抗的显著毒性,美国食品药品监督管理局(FDA)对贝伐单抗用于转移性乳腺癌撤销批准​
s595 Sentence Radiation therapy (as part of breast-conserving local therapy) consists of postoperative external-beam radiation therapy (EBRT) to the entire breast with doses of 45 Gy to 50 Gy, in 1.8 Gy to 2.0 Gy daily fractions over a 5-week period 放疗(保乳局部治疗的一部分)指总剂量45-50Gy的术后全乳体外放射治疗(EBRT),平均每日治疗剂量1.8-2.0Gy,共持续5周
s596 Sentence Potential explanations for the increase in distant recurrence noted in the radiation therapy-first group are that chemotherapy was delayed for a median of 17 weeks after surgery, and that this group received lower chemotherapy dosages due to increased myelosuppression 先放疗组的远处复发率较高的一个原因可能是化疗推迟到术后中位时间17周再进行,因骨髓抑制发生率增高,该组的化疗剂量也降低
s597 Sentence The first trial included 345 evaluable breast cancer patients with menopausal symptoms and was terminated early because of an increased incidence of recurrences and new primaries in the HRT group (hazard ratio [HR], 3.5; 95% confidence interval [CI], 1.5–7.4) 第一项研究纳入了345例有绝经期症状的可评价的乳腺癌患者,该研究最终提前结束,因为HRT组患者复发率和新发原发性乳腺癌的比例均增加(风险比[HR],3.5;95%置信区间[CI],1.5-7.4)
s598 Sentence Similarly, no difference in survival was noted when patients with partial response or stable disease after initial therapy were randomized to receive either a different chemotherapy versus observation or a different chemotherapy regimen given at higher versus lower doses 类似地,经过初步治疗后部分缓解或病情稳定的患者被随机分组,接受另一种化疗方案治疗,或仅观察,或接受另一种剂量更大或更小的化疗方案,患者的生存率并无差别
s599 Sentence In a phase III trial ( GSK-EGF100151 ), lapatinib plus capecitabine was superior to capecitabine alone in women with HER2 -positive advanced breast cancer that has progressed after treatment with regimens that included an anthracycline, a taxane, and trastuzumab 一项III期临床试验(GSK-EGF100151​)发现对于含蒽环类药物、紫杉烷和曲妥珠单抗方案治疗后进展的HER2阳性晚期乳腺癌患者,拉帕替尼联合卡培他滨的效果优于单用卡培他滨
s600 Sentence There was no statistically significant difference in OS between women who received high-dose chemotherapy with autograft and women who received conventional chemotherapy, either at 3 years (RR, 1.02; 95% CI, 0.98–1.06), or at 5 years (RR, 0.98; 95% CI, 0.93–1.05) 大剂量化疗联合自体移植组女性与传统化疗组女性的3年OS(RR,1.02;95%CI,0.98-1.06)和5年OS均无统计学显著差异(RR,0.98;95%CI,0.93-1.05)
s601 Sentence Results from the NSABP-B-14 study, which compared a 5-year regimen to a 10-year regimen of adjuvant tamoxifen for women with early-stage breast cancer, indicated no advantage for continuation of tamoxifen beyond 5 years in women with node-negative, ER-positive breast cancer NSABP-B-14研究比较了早期乳腺癌患者分别接受5年和10年他莫昔芬辅助治疗的疗效,结果表明对于淋巴结转移阴性、ER+的乳腺癌患者,他莫昔芬治疗5年后继续治疗没有额外获益
s602 Sentence There was an improvement in time to recurrence (HR, 0.79; 95% CI, 0.70–0.90; P = .005), distant DFS (HR, 0.86; 95% CI, 0.74–0.99; P = .04) and contralateral breast cancer (42% reduction; P = .01) in patients who received anastrozole 接受阿那曲唑治疗的患者在肿瘤复发间隔(HR,0.79;95%CI,0.70-0.90;P=0.005)、远处DFS(HR,0.86;95%CI,0.74-0.99;P=0.04)和对侧乳腺癌发生率(降低42%;P=0.01)方面有所改善
s603 Sentence This approach has unacceptably high local failure rates and, outside of a clinical trial setting, should be used only for patients who are not candidates for mastectomy or breast-conserving surgery plus radiation therapy, or for those who refuse these options 该方法因局部失败率较高而被弃置,除临床试验之外,仅可用于不适合行乳房切除术或保乳术加放疗的患者,或拒绝这些手术治疗的患者
s604 Sentence Arthralgia and fractures were reported significantly more often in patients who received anastrozole, whereas hot flushes, vaginal bleeding and discharge, endometrial cancer, ischemic cerebrovascular events, venous thromboembolic and deep venous thromboembolic events were more common in patients who received tamoxifen 阿那曲唑治疗组的患者更易出现关节痛和骨折,而他莫昔芬治疗组的患者则更易出现潮热、阴道流血和溢液、子宫内膜癌、缺血性心血管事件、静脉血栓栓塞和深静脉血栓栓塞事件
s605 Sentence AC = cyclophosphamide, doxorubicin; AC-T = cyclophosphamide, doxorubicin, taxol; CAF = cyclophosphamide, doxorubicin, fluorouracil; d = day; D = docetaxel; P = paclitaxel; T = taxol; TAC = docetaxel, doxorubicin and cyclophosphamide; TC = docetaxel and cyclophosphamide; 5-FU = fluorouracil AC=环磷酰胺,阿霉素;AC-T=环磷酰胺、阿霉素、紫杉酚;CAF=环磷酰胺、阿霉素、氟尿嘧啶;d=天;D=多西他赛;P=紫杉醇;T=紫杉酚;TAC=多西他赛、阿霉素与环磷酰胺;TC=多西他赛与环磷酰胺;5-FU=氟尿嘧啶
s606 Sentence The NSABP-B-15 trial randomized 2,194 patients with axillary node-positive breast cancer and tumors determined nonresponsive to tamoxifen to doxorubicin and cyclophosphamide (AC) (four cycles), CMF (six cycles), or AC (four cycles) followed after a 6-month delay by CMF (three cycles) NSABP-B-15试验将腋窝淋巴结阳性且对他莫西芬无反应的2,194例患者随机分为3组,一组接受阿霉素与环磷酰胺(AC)(4程)治疗,一组接受CMF(6程)治疗,一组接受先AC(4程)间隔6月后再CMF(3程)治疗
s607 Sentence An Eastern Cooperative Oncology Group–led intergroup trial ( E1199 [NCT00004125]) involving 4,950 patients compared, in a factorial design, two schedules (weekly and every 3 weeks) of the two drugs (docetaxel vs. paclitaxel) following standard-dose AC chemotherapy given every 3 weeks 东部肿瘤协作组主导的组间试验(E1199[NCT00004125])共纳入4,950例患者,以多因素设计、两药(多西他赛与紫杉醇)双方案(每周一次、每三周一次)开展,患者先行每三周一次标准剂量AC化疗,再行多西他赛或紫杉醇治疗
s608 Sentence This phase III noninferiority trial planned to randomly assign 1,900 women with clinical T1–T2 invasive breast cancer without palpable adenopathy and with one to two SLNs containing metastases identified by frozen section to undergo ALND versus no further axillary treatment 这一III期非劣效性临床试验计划将1900例无可触及肿块的腺病、由冰冻切片证实存在1-2枚SLN转移的临床T1-T2期乳腺癌患者分为接受ALND和不进行进一步腋窝淋巴结清扫治疗两组
s609 Sentence Patients with chest wall recurrences of less than 3 cm, axillary and internal mammary node recurrence (not supraclavicular, which has a poorer survival), and a greater than 2-year disease-free interval prior to recurrence have the best chance for prolonged survival 胸壁复发灶小于3cm、腋窝和内乳淋巴结复发(不包括预后较差的锁骨上淋巴结)、复发前无病生存时间超过2年的患者可有机会实现长期生存
s610 Sentence Docetaxel given every 3 weeks was also superior in DFS to paclitaxel given every 3 weeks (OR, 1.23; 95% CI, 1.00–1.52; P = .02), but the difference was not statistically significant for OS (OR, 1.13; 95% CI, 0.88–1.46; P = .25) 多西他赛每三周一次给药的DFS大于紫杉醇每三周一次给药(OR,1.23;95%CI,1.00-1.52;P=0.02),但这两种方案的OS无统计学显著差异(OR,1.13;95%CI,0.88-1.46;P=0.25)
s611 Sentence Women on exemestane had significantly more arthralgia, diarrhea, hypertension, fractures, arthritis, musculoskeletal pain, carpal tunnel syndrome, insomnia, and osteoporosis, but women on tamoxifen had significantly more gynecologic symptoms, muscle cramps, vaginal bleeding and discharge, thromboembolic disease, endometrial hyperplasia, and uterine polyps 依西美坦治疗组的患者出现关节痛、腹泻、高血压、骨折、关节炎、肌肉骨骼疼痛、腕管综合征、失眠和骨质疏松的情况更加多见,而他莫昔芬治疗组的患者出现妇科症状、肌肉痉挛、阴道流血和溢液、血栓栓塞疾病、子宫内膜增生、子宫脱垂的情况更加多见
s612 Sentence The analyses of adjuvant chemotherapy involved 28,764 women participating in 60 trials of combination chemotherapy (polychemotherapy) versus no chemotherapy, 14,470 women in 17 trials of anthracycline-containing versus CMF-type chemotherapy, and 6,125 women in 11 trials of longer versus shorter chemotherapy duration 该辅助化疗分析共纳入来自60项联合化疗(多药化疗)和非化疗对比性试验的28,764例女性、来自17项含蒽环类药物和CMF类化疗对比性试验的14,470例女性、及来自11项长期化疗与短期化疗对比性试验的6,125例女性
s613 Sentence HRT has generally not been used for women with a history of breast cancer because estrogen is a growth factor for most breast cancer cells in the laboratory; however, empiric data on the safety of HRT after breast cancer are limited HRT一般不用于有乳腺癌病史的女性,因为在实验室条件下雌激素是大多数乳腺癌细胞的生长因子;然而,关于乳腺癌患者接受HRT的安全性经验数据非常有限
s614 Sentence The higher dose levels used in this trial are currently considered standard, so it is unclear whether this trial is supportive of the value of dose intensity or, rather, supportive of the concept of a threshold level below which treatment becomes ineffective 本试验中所用的较大剂量实际上为标准剂量,因此无法明确该试验是支持较大剂量强度有益于治疗,还是证实了强度“阈值”概念,低于该强度阈值的治疗无效
s615 Sentence Asymptomatic decline in LVEF (defined by &gt;10% decline or to 55%) occurred in 17% of patients in the trastuzumab arm (95% CI, 15%–20%) and 34% of patients in the control arm (95%CI, 31%–38%), with a HR, 2.1 (95%CI, 1.7–2.6; P &lt; .001) 曲妥珠单抗组17%(95%CI,15%-20%)患者出现无症状的LVEF下降(定义为EF降低超过10%或低于55%),对照组的相应比例为34%(95%CI,31%-38%),HR为2.1(95%CI,1.7-2.6;P<0.001)
s616 Sentence Candidates for whom adjuvant therapy may not be necessary include individuals with small primary tumors (&lt;1 cm) and negative axillary nodes who have an excellent prognosis, with nearly 90% of patients alive and free of disease at 20 years in one series 不一定需行辅助治疗的患者包括肿瘤体积较小(<1cm)和腋窝淋巴结阴性、预后较佳的患者
s617 Sentence There was no difference observed in the overall comparison with regard to DFS of docetaxel to paclitaxel (odds ratio [OR], 1.03; 95% CI, 0.91–1.16; P = .61) or between the 1-week and 3-week schedules (OR, 1.06; 95% CI, 0.94–1.20; P = .33) ,1.03;95%CI,0.91-1.16;P=0.61),每周一次与每三周一次方案的DFS业务差异(OR,1.06;95%CI,0.94-1.20;P=0.33)
s618 Sentence Similar results were obtained in the trial ( NCT00171340 ) in which 1,065 postmenopausal women received letrozole and were randomly assigned to receive zoledronic acid (4 mg intravenously every 6 months) immediately or only after the development of bone loss or fractures 另一项试验(NCT00171340)观察到类似结果,该试验中1,065例绝经后女性接受来曲唑治疗后被随机分组,即刻接受唑来膦酸治疗(4mg静脉用,每6个月一次)或仅在发生骨质疏松或骨折后应用唑来膦酸治疗
s619 Sentence In phase I/II studies as a single agent, lapatinib has resulted in objective responses between 4.3% and 7.8% in ER2-positive patients who had progressed on multiple trastuzumab-containing regimens with a substantial number having stable disease at 4 months (34%–41%) and 6 months (18%–21%) 在I、II期研究中,多种含曲妥珠单抗方案治疗后疾病进展的ER2阳性患者经过拉帕替尼单药治疗的客观缓解率在4.3%-7.8%之间,疾病稳定至少4个月(34%-41%)和6个月(18%-21%)的患者不在少数
s620 Sentence Results of the 1 year versus 2 years of trastuzumab of the HERA trial are awaited, as are the results of the Protocol of Herceptin Adjuvant with Reduced Exposure ( INCA-PHARE [NCT00381901]) trial, which compared 1 year versus 6 months of adjuvant trastuzumab HERA试验中1年与2年曲妥珠单抗治疗的对比结果尚未公布,赫赛汀辅助治疗剂量减少方案(INCA-PHARE​[NCT00381901])试验比较了1年和6个月曲妥珠单抗治疗的效果,结果也尚未公布
s621 Sentence In an analysis conducted when all but 8% of the patients had completed protocol therapy at a follow-up of 68 months, the benefit of anastrozole relative to tamoxifen with respect to DFS was slightly less (HR, 0.87; 95% CI, 0.78–0.96; P = .01) 在一项分析中,除8%的患者外其余均完成预定方案治疗,随访时间68个月,与他莫昔芬治疗组相比阿那曲唑组在DFS的获益较小(HR,0.87;95%CI,0.78-0.96;P=0.01)
s622 Sentence –Stage designation may be changed if postsurgical imaging studies reveal the presence of distant metastases, provided that the studies are carried out within 4 months of diagnosis in the absence of disease progression and provided that the patient has not received neoadjuvant therapy –如果患者未接受新辅助治疗且在肿瘤未进展的4个月内行术后影像学检查显示有远处转移,则分期可能会更改
s623 Sentence Fifty-one patients experienced a confirmed left ventricular ejection fraction (LVEF) decrease (defined as an EF decrease of &gt;10 points from baseline to an LVEF &lt;50%) with trastuzumab, which recovered or stabilized within 3 to 6 weeks of initial treatment in 86% of cases 曲妥珠单抗治疗组51例患者左心室射血分数(LVEF)下降(EF与基线相比降低至少10点至LVEF<50%),其中86%的患者经过初步治疗后病情在3-6周后康复或稳定
s624 Sentence In the BCIRG-006 (NCT00021255) trial, 3,222 women with early stage HER2 -overexpressing breast cancer were randomly assigned to receive AC followed by docetaxel (AC-T) versus AC followed by docetaxel plus trastuzumab (AC-T plus trastuzumab) versus docetaxel, carboplatin, plus trastuzumab (TCH, a nonanthracycline-containing regimen) BCIRG-006(NCT00021255)试验将3,222例早期HER2过度表达型乳腺癌患者随机分组,接受先AC再多西他赛(AC-T)治疗或先AC再多西他赛加曲妥珠单抗(AC-T加曲妥珠单抗)或多西他赛、卡铂联合曲妥珠单抗(TCH,一种非蒽环类方案)治疗
s625 Sentence In a large, prospective series from the National Surgical Adjuvant Breast and Bowel Project (NSABP) with a 12-year follow-up of 182 women with LCIS that was managed with excisional biopsy alone, 26 women developed ipsilateral breast tumors (9 of the tumors were invasive) 一项由美国全国乳腺及肠道外科辅助治疗项目组(NSABP)组织的大型前瞻性研究纳入了 182例仅接受切除活检的LCIS女性患者,随访12年后,26例患者进展为同侧乳腺癌(其中9例为浸润癌)
s626 Sentence At a median follow-up of 9 years, DFS and OS on the high-dose and intermediate-dose arms were superior to the corresponding survival measures on the low-dose arm ( P = .001) with no difference in these measures between the high-dose and intermediate-dose arms 经过中位时间为9年的随访期之后,大剂量组与中等剂量组的DFS与OS优于小剂量组(P=0.001),而大剂量组和中等剂量组之间的测量指标无差异
s627 Sentence The NSABP-B-22 and NSABP-B-25 trials, for example, escalated the dose of cyclophosphamide to 1,200 mg/m2 (without granulocyte-colony stimulating factor [G-CSF]) and 2,400 mg/m2 (with G-CSF), respectively, with no significant advantage observed in DFS or OS compared with the standard dose of 600 mg/m2 例如,NSABP-B-22和NSABP-B-25试验中,环磷酰胺剂量增加到1,200mg/m2(不加粒细胞集落刺激因子[G-CSF])和2,400mg/m2(加G-CSF),发现这些剂量递增方案与标准剂量600mg/m2相比,DFS或OS均无显著提高
s628 Sentence Because TNBC shares multiple clinicopathologic features with BRCA -mutated breast cancers, which harbor dysfunctional DNA repair mechanisms, it is possible that PARP inhibition, in conjunction with the loss of DNA repair via BRCA-dependent mechanisms, would result in synthetic lethality and augmented cell death 因TNBC与BRCA-突变型乳腺癌共有多种临床病理特征,而BRCA-突变型乳腺癌有DNA修复功能失调机制,因此PARP抑制剂联合BRCA依赖性机制中的DNA修复失调,将导致DNA合成停止,细胞死亡
s629 Sentence However, the addition of zoledronic acid to endocrine therapy, as compared with endocrine therapy without zoledronic acid, resulted in a relative reduction of 36% in the risk of disease progression (HR, 0.64; P = .01) but did not significantly reduce the risk of death 但内分泌治疗加唑来膦酸与单纯内分泌治疗相比,疾病进展风险相对降低36%(HR,0.64;P=0.01),但死亡风险并不显著降低
s630 Sentence Although certain rare inherited mutations, such as those of BRCA1 and BRCA2, predispose women to develop breast cancer, prognostic data on BRCA1 / BRCA2 mutation carriers who have developed breast cancer are conflicting; these women are at greater risk of developing contralateral breast cancer 尽管特定罕见的遗传突变如BRCA1或BRCA2基因突变增加了女性乳腺癌患病风险,但关于BRCA1/BRCA2基因突变携带者发生乳腺癌的预后相关数据仍存在争议;这类女性患者同侧复发乳腺癌的风险增加
s631 Sentence In the NSABP-B-15 trial, patients who had undergone breast-conserving surgery received either one course of CMF (n = 194) followed by radiation therapy followed by five additional cycles of CMF, or they received four cycles of AC (n = 199) followed by radiation therapy NSABP-B-15试验中,保乳术后患者接受1程CMF治疗(n=194)后行放疗,再行5程CMF治疗,或接受4程AC治疗(n=199)后行放疗
s632 Sentence Breast-conserving surgery alone without radiation therapy has been compared with breast-conserving surgery followed by radiation therapy in six prospective randomized trials (including the National Surgical Adjuvant Breast and Bowel Project's trial [ NSABP-B-06 ] and the Cancer and Leukemia Group B's trial [ CLB-9343 ])  6项前瞻性研究(包括美国全国乳腺及肠道外科辅助治疗项目组的研究[NSABP-B-06]、癌症和白血病B组的研究[CLB-9343])对比了单纯保乳手术和保乳手术联合放疗的疗效
s633 Sentence The combination of lapatinib and trastuzumab in the ALTTO trial is further supported by a demonstration that lapatinib combined with trastuzumab confers a significantly improved progression-free survival in patients with metastatic breast cancer who experience progression on prior trastuzumab-containing treatment when compared to lapatinib alone ALTTO试验支持了拉帕替尼联合曲妥珠单抗治疗,该试验发现对于既往含曲妥珠单抗治疗后疾病进展的转移性乳腺癌患者,拉帕替尼联合曲妥珠单抗较曲妥珠单抗单药治疗相比,显著改善无进展生存期
s634 Sentence Median PFS was longer for each bevacizumab-containing combination (Cape cohort: increased from 5.7 mo. to 8.6 mo.; HR, 0.69; 95% CI, 0.56–0.84; log-rank, P &lt; .001; and Taxane/Anthracycline cohort: increased from 8.0 mo. to 9.2 mo.; HR, 0.64; 95% CI, 0.52–0.80; log-rank, P &lt; .001) 含贝伐单抗方案的中位PFS延长(卡培他滨队列:从5.7个月增加到8.6个月;HR,0.79;95%CI,0.56-0.84;秩和检验P<0.001;紫杉醇/蒽环类药物队列:从8.0个月增加到9.2个月;HR,0.64;95%CI,0.52-0.80;秩和检验,P<0.001)
s635 Sentence However, the results of two prospective studies ( NCT02031042 and NCT00881361 ) indicate that SLN biopsy is associated with false-negative rates of 14.2% and 12.6%, respectively, when undertaken after neoadjuvant chemotherapy in patients who convert from a clinically positive to a clinically negative axillary status 然而,两项前瞻性研究(NCT02031042与NCT00881361)发现新辅助化疗后淋巴结临床评估从阳性转为阴性的患者行SLN活检的假阴性率分别为14.2%与12.6%
s636 Sentence The rationale for mastectomy included a 30% incidence of multicentric disease, a 40% prevalence of residual tumor at mastectomy following wide excision alone, and a 25% to 50% incidence of breast recurrence following limited surgery for palpable tumor, with 50% of those recurrences being invasive carcinoma 采用这一治疗方案的理由如下:30%的DCIS为多灶性病变、仅行广泛切除后仍有40%的肿瘤残存、局限性切除可触及的肿瘤后25-50%会复发且其中50%为浸润癌
s637 Sentence Therapeutic decisions are formulated in part according to staging categories but primarily according to tumor size, lymph node status, estrogen-receptor and progesterone-receptor levels in the tumor tissue, human epidermal growth factor receptor 2 ( HER2/neu ) status, menopausal status, and the general health of the patient 治疗方案部分参考分期,但更主要依据肿瘤大小、淋巴结受累情况、肿瘤组织的雌激素受体和孕激素受体水平、人类表皮生长因子受体2(HER2/neu)表达情况、是否绝经和患者的一般情况
s638 Sentence Several retrospective reviews have indicated that statistically significantly better DFS is achieved for premenopausal women with breast cancer and positive axillary lymph nodes if breast surgery is performed during the luteal phase (days 15–36) as compared with the follicular phase (days 0–14) of the menstrual cycle 一些回顾性综述发现,淋巴结阳性的绝经前乳腺癌女性患者在黄体期(第15-36天)进行手术的DFS显著优于在卵泡期(第0-14天)进行手术
s639 Sentence (Refer to the PDQ summary on Nausea and Vomiting and for information on mucositis, refer to the PDQ summary on Oral Complications of Chemotherapy and Head/Neck Radiation ; for information on symptoms associated with premature menopause, refer to the PDQ summary on Sweats and Hot Flashes .) (请参考PDQ总结恶心与呕吐,黏膜炎相关信息请参考PDQ总结化疗与头颈部放疗的口腔并发症,提前绝经的症状信息请参考PDQ总结出汗与潮热​)
s640 Sentence At a median follow-up of 10.5 years, the overall rate of in-breast tumor recurrence was reduced from 26% to 15% ( P &lt; .001) with a similarly effective reduction of invasive (13% to 8%, P = .065) and noninvasive (14% to 7%, P = .001) recurrence rates 该研究中位随访时间10.5年,结果表明经过术后放疗,乳内乳腺癌整体复发率由26%降至15%(P&lt;0.001),其中浸润癌(13%-8%,P=0.065)与非浸润癌(14%-7%,P=0.001)结果类似
s641 Sentence Studies have shown that the injection of technetium-labeled sulfur colloid, vital blue dye, or both around the tumor or biopsy cavity, or in the subareolar area, and subsequent drainage of these compounds to the axilla results in the identification of the SLN in 92% to 98% of patients 研究表明通过在肿瘤或活检腔周围注射锝标记的硫胶体、活化蓝染料或同时使用两种试剂并观察这些试剂向腋窝淋巴结引流的情况,可以发现92%-98%患者的SLN
s642 Sentence In three larger trials in which medical ovarian ablation with goserelin was used, the impact of goserelin alone on DFS was found to be comparable to CMF in the subgroup of ER+ patients, whereas the combination of goserelin and tamoxifen was associated with prolonged DFS compared with CMF alone 在三项使用戈舍瑞林进行药物性卵巢去势的大型研究中,在ER+的亚组中戈舍瑞林与CMF治疗对DFS的影响相当,而与单纯CMF治疗相比,戈舍瑞林联合他莫昔芬治疗可延长DFS
s643 Sentence However, in the 2005 Early Breast Cancer Trialists' Collaborative Group's (EBCTCG) update, when all relevant trials were combined, 15-year breast-cancer mortality was reduced from 35.9% to 30.5% in women receiving radiation therapy (absolute difference of 5.4%; 95% CI, 2.1%–8.7%; breast cancer death rate ratio 0.83; 95% CI, 0.75–0.91; P = .002) 2005年早期乳腺癌试验者协作组(EBCTCG)将所有相关试验进行汇总,发现接受放疗的女性的乳腺癌相关死亡率从39.5%下降到30.5%(绝对降幅5.4%;95%CI,2.1%-8.7%;乳腺癌死亡率比值0.83;95%CI,0.75-0.91;P=0.002)
s644 Sentence The National Cancer Institute of Canada's study ( CAN-NCIC-MA20 [NCT00005957]) has closed, but until results are reported, decisions regarding the use of such therapy must rely on extrapolations from the postmastectomy setting and on knowledge of the local-regional recurrence rates following conservation therapy with axillary lymph node dissection for a given lesion 国家癌症研究所加拿大研究(CAN-NCIC-MA20[NCT00005957])已经完成,但在结果报道之前,关于某一病变是否应用此类治疗的决策必须依靠乳腺切除术后的情况推测,也必须对基于保乳加腋窝淋巴结清扫术后局部区域复发率的了解
s645 Sentence Although one retrospective study raised concern that endometrial cancers in women taking tamoxifen (40 mg/day) had a worse outcome and were characterized by higher-grade lesions and a more advanced stage than endometrial cancers in women not treated with tamoxifen, other larger studies using standard tamoxifen doses (20 mg/day) have not supported this finding 一项回顾性研究提出,与未接受他莫昔芬治疗的乳腺癌患者相比,接受治疗(每日40mg)的患者发生子宫内膜癌的预后更差、病变级别更高、分期更晚;其他使用标准他莫昔芬剂量治疗(每日20mg)的大型研究则无类似发现
s646 Sentence A retrospective study of 753 patients who were divided into three groups based on receptor status (ER- or PR-positive; ER- and PR-negative but HER2/neu -positive; and ER-, PR-, and HER2/neu -negative [triple-negative]) found no differences in disease control within the breast in patients treated with standard breast-conserving surgery; however, there are not yet substantive data to support this finding 一项回顾性研究纳入了753例患者,根据肿瘤受体表达情况将患者分为三组(即ER+或PR+;ER-、PR-、HER2/neu+;ER-、PR-、HER2/neu-[三阴性]),经过标准保乳手术治疗三组的预后未表现出显著差异;然而目前尚无充分数据支持这一结论
s647 Sentence In a cohort of women without a history of breast cancer who were randomly assigned to receive tamoxifen or placebo on the British Pilot Breast Cancer Prevention Trial, 16% of those on tamoxifen developed atypical hyperplasia at varying times from the start of treatment (range, 3 months–75 months; median, 24 months), while no cases occurred on the control arm 英国初步乳腺癌预防试验纳入了一批无乳腺癌病史的女性,将其随机分配到他莫昔芬治疗组与安慰剂组,自试验开始他莫昔芬治疗组有16%的人在不同的时间点出现子宫内膜的不典型增生(3-75个月不等,中位时间24个月),而对照组则无一例报道
s648 Sentence The impact of radiation therapy on local control was additionally clarified by showing that healthy women aged 70 to 79 years were most likely to benefit from radiation therapy (number needed to treat [NNT] to prevent one event = 21–22 patients) when compared with women aged 80 years or older or to those who have comorbidities (NNT = 61–125 patients) 研究进一步证实与80岁及以上的患者和存在合并症(需要治疗以预防乳腺癌事件的人数[NNT]=61-125例)的患者相比,70-79岁(NNT=21-22例)的患者从放疗中获益最大
s649 Sentence In a meta-analysis that included randomized trials of patients who were receiving an aromatase inhibitor as either their first or second hormonal therapy for metastatic disease, those who were randomly assigned to a third-generation drug (e.g., anastrozole, letrozole, exemestane, or vorozole) lived longer (HR death 0.87; 95% CI, 0.82–0.93) than those who received standard therapy (tamoxifen or a progestational agent) 一项荟萃分析纳入接受芳香化酶抑制剂作为一线或二线激素治疗的转移性乳腺癌患者,这些患者被随机分组接受第三代药物治疗(阿那曲唑、来曲唑、依西美坦或伏罗唑)或标准治疗(他莫昔芬或孕激素治疗),发现第三代药物治疗组患者生存时间长于标准治疗组(死亡风险比[HR],0.87;95%置信区间[CI],0.82-0.93)
s650 Sentence A meta-analysis of these three studies showed that patients who switched to anastrozole had significant improvements in DFS (HR, 0.59; 95% CI, 0.48–0.74; P &lt; .001), EFS (HR, 0.55; 95% CI, 0.42–0.71; P &lt; .001), distant DFS (HR, 0.61; 95% CI, 0.45–0.83; P = .002), and OS (HR, 0.71; 95% CI, 0.52–0.98; P = .04) compared with the patients who remained on tamoxifen 关于这三项研究的荟萃分析显示,与继续他莫昔芬治疗组相比,改为阿那曲唑治疗组的患者在DFS(HR,0.59;95%CI,0.48-0.74;P&lt;001)、无事件生存率(EFS)(HR,0.55;95%CI,0.42-0.71;P&lt;001)、远处DFS(HR,0.61;95%CI,0.45-0.83;P=0.002)和OS(HR,0.71;95%CI,0.52-0.98;P=0.04)方面均有改善
s651 Sentence To determine whether breast-conserving surgery plus radiation therapy was a reasonable approach to the management of DCIS, the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the European Organisation for Research and Treatment of Cancer (EORTC) have each completed prospective randomized trials in which women with localized DCIS and negative surgical margins following excisional biopsy were randomized to either breast radiation (50 Gy) or to no further therapy 为证实保乳手术联合放疗是否适用于DCIS的治疗,美国全国乳腺及肠道外科辅助治疗项目组(NSABP)和欧洲癌症研究及治疗组织(EORTC)分别就局部DCIS、切除活检切缘阴性的患者进行了术后放疗(50 Gy)与非放疗的前瞻性随机临床试验