შეჯამება
განსაზღვრება
ანამნეზი და გასინჯვა
ძირითადი დიაგნოსტიკური ფაქტორები
- bone pain
- pleural effusion
- palpable mass after treatment of the primary tumor
სხვა დიაგნოსტიკური ფაქტორები
- shortness of breath
- cough (nonproductive)
- anorexia
- weight loss
- neurologic symptoms (e.g., neuralgic pain, weakness, headaches, seizures)
რისკფაქტორები
- female sex
- age >50 years
- family history of breast and/or ovarian cancer
- breast cancer susceptibility genes (BRCA1, BRCA2, CDH1, PALB2, PTEN, STK11, and TP53)
- tumor >5 cm in diameter
- high number of positive axillary lymph nodes (e.g., >10)
- lymphovascular invasion
- high-risk 70-gene signature
- high-risk 21-gene signature
- high-risk PAM50 gene signature
- Lynch syndrome (hereditary nonpolyposis colorectal cancer)
- CHEK2 mutations
- ATM mutations
- minimal residual disease (MRD)
- bone metastasis and lung metastasis gene signatures
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- CBC
- LFTs
- calcium
- CT (of chest and abdomen)
- bone scan (scintigraphy)
გასათვალისწინებელი კვლევები
- MRI (focused on area of concern, e.g., brain, spinal cord, bone)
- FDG-PET/CT scan
- biopsy of metastatic lesion
- high-penetrance breast cancer susceptibility genes
- additional biomarker testing
- echocardiogram
- multigated acquisition (MUGA) scan
- pleural cytology
მკურნალობის ალგორითმი
hormone receptor-positive, HER2-negative, without visceral crisis: postmenopausal
hormone receptor-positive, HER2-negative, without visceral crisis: premenopausal
hormone receptor-positive, HER2-positive, without visceral crisis: postmenopausal
hormone receptor-positive, HER2-positive, without visceral crisis: premenopausal
hormone receptor-negative, HER2-positive, without visceral crisis
PD-L1-negative, triple-negative (hormone receptor-negative, HER2-negative), without visceral crisis
PD-L1-positive, triple-negative (hormone receptor-negative, HER2-negative), without visceral crisis
hormone receptor-positive or negative, HER2-negative, with visceral crisis
hormone receptor-positive or negative, HER2-positive, with visceral crisis
კონტრიბუტორები
ავტორები
Edward Sauter, MD, PhD
Medical and Program Officer
Division of Cancer Prevention
National Cancer Institute
Rockville
MD
გაფრთხილება:
ES declares that he has no competing interests.
Wajeeha Razaq, MD
Breast Cancer Site Chair
University Oklahoma School of Medicine
Oklahoma City
OK
გაფრთხილება:
WS declares that she has no competing interests.
მადლიერება
Dr Edward Sauter and Dr Wajeeha Razaq would like to gratefully acknowledge Dr Puja Nistala, Dr Donald Doll, Dr Carl E. Freter and Dr Michael Perry, previous contributors to this topic.
გაფრთხილება:
PN, DD, CEF and MP declare that they have no competing interests.
რეცენზენტები
Alan Neville, MD
Professor
Assistant Dean
Undergraduate Program
McMaster University
Hamilton
Ontario
Canada
利益声明
AN declares that he has no competing interests.
Gianfilippo Bertelli, MD, PhD, FRCP (Edin)
Consultant
Honorary Senior Lecturer in Medical Oncology
South West Wales Cancer Centre
Swansea
UK
利益声明
GB has received honoraria for participation in advisory boards (AstraZeneca, Novartis, Pfizer, Roche, GSK, Cephalon, Amgen, Sanofi, Aventis), speaker's fees (AstraZeneca, Novartis, Sanofi, Aventis), and hospitality at conferences (AstraZeneca, Novartis, Pfizer, Roche, Aventis).
Christos Vaklavas, MD
Assistant Professor
Division of Hematology/Oncology
Department of Medicine
University of Alabama at Birmingham
Birmingham
AL
利益声明
CV declares that University of Alabama at Birmingham has received research support from Pfizer, F. Hoffmann-La Roche, and Incyte.
鉴别诊断
- Lung cancer
- Osteosarcoma
- Breast sarcoma
更多 鉴别诊断指南
- NCCN clinical practice guidelines in oncology: breast cancer
- NCCN clinical practice guidelines in oncology: genetic/familial high-risk assessment: breast, ovarian, pancreatic, and prostate
更多 指南患者教育信息
Breast cancer, locally advanced: what is it?
Breast cancer, locally advanced: what treatments work?
更多 患者教育信息
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