小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 乳房肿块
- 乳头溢液
- 腋窝淋巴结病
其他诊断因素
- 皮肤增厚或发黑
- 乳头内陷或脱皮
危险因素
- 年龄增长
- 女性
- 种族本源
- 阳性家族史
- 基因突变
- 内源性雌激素暴露
- 外源性雌激素/孕酮暴露
- 饮酒
- 放射暴露
- 非典型乳腺疾病
- 乳房密度增高
- 乳腺 MRI 显示轻度、中度或显著背景实质强化（BPE）
- 缺乏体力活动
- 饮食不良
- 社会经济地位高
- 吸烟
- 肥胖
- 高水平邻苯二甲酸二丁酯暴露
诊断性检查
首要检查
- 乳房 X 线检查
需考虑的检查
- 乳腺超声检查
- 乳房 MRI
- 活检
- 激素受体测定
- HER2 检测
- 基因表达分析
- 计算机断层扫描
- 基因检测
- 全血细胞计数 (FBC）
- 肝功能检查 (LFT)
- 碱性磷酸酶
治疗流程
早期乳腺癌（I 至 IIB 期 [T2 N1 M0]）
局部晚期乳腺癌（IIB 期 [T3 N0 M0] 至 III 期）
疾病复发
撰稿人
作者
Krystal Cascetta, MD
Assistant Professor
Division of Hematology and Medical Oncology
Icahn School of Medicine at Mount Sinai
New York
NY
利益声明
KC declares that she has no competing interests.
Amy Tiersten, MD
Professor
Division of Hematology and Medical Oncology
Dubin Breast Center of the Tisch Cancer Institute
New York
NY
利益声明
AT is on the advisory board for Immunomedics, AstraZeneca, Novartis, Eisai, and Healthline. She receives research funding from Pfizer, Novartis, Genentech, Lilly, and AstraZeneca and does expert testimony work.
鸣谢
Dr Krystal Cascetta and Professor Amy Tiersten would like to gratefully acknowledge Dr Hope S. Rugo, Dr Amal Melhem-Bertrandt, Dr Gabriel N. Hortobagyi, and Dr Phuong Khanh H. Morrow, the previous contributors to this topic.
利益声明
AMB, GNH, and PKHM declare that they have no competing interests. HSR receives research funding through the University of California from Novartis, Pfizer, Genentech, Macrogenics, Plexxikon, Merck, Nektar, and GSK; has been reimbursed for travel by Novartis, Genentech, and Nektar; and has received speaker honorarium from Genomic Health.
同行评议者
Kandace P. McGuire, MD
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
利益声明
KPM declares that she has no competing interests.
Katherine H.R. Tkaczuk, MD, FACP
Professor of Medicine
University of Maryland School of Medicine
Baltimore
MD
利益声明
KHRT declares that she has no competing interests.
Susan Tannenbaum, MD
Associate Professor, Medicine
Chief, Division of Hematology/Oncology
Medical Director, Neag Comprehensive Cancer Center
University of Connecticut
Farmington
CT
利益声明
ST declares that she has no competing interests.
Emily Hsu, MD
Fellow
Division of Hematology/Oncology
University of Connecticut
Farmington
CT
利益声明
EH declares that she has no competing interests.
Anees Chagpar, MD
Assistant Professor
University of Louisville
Louisville
KY
利益声明
AC declares that she has no competing interests.
Gurhan Celik, MD
General Surgeon
General Surgery Department
Istanbul Training and Research Hospital
Istanbul
Turkey
利益声明
GC is an author of a number of references cited in this topic.
Edward R. Sauter, MD, PhD
Medical Officer
Breast and Gynecologic Cancer Working Group
Division of Cancer Prevention
National Cancer Institute
Bethesda
MD
利益声明
ERS declares that he has no competing interests.
鉴别诊断
- 纤维囊性变
- 纤维腺瘤
- 乳腺炎
更多 鉴别诊断指南
- 疑似癌症：识别和转诊
- 早期和局部晚期乳腺癌：诊断和管理
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