最近审阅: 七月 2020
最近更新: 三月  2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在危险因素
  • 骨痛
  • 胸膜腔积液
  • 原发性肿瘤治疗后出现可触及的肿块

其他诊断因素

  • 呼吸短促
  • 厌食
  • 体重减轻
  • 神经性疼痛或无力、头痛、癫痫发作

危险因素

  • 女性
  • 50 岁以上
  • 乳腺癌和/或卵巢癌家族史
  • 父母任一方存在早发型 1 型乳腺癌(breast cancer type 1, BRCA1)或 2 型乳腺癌易感蛋白(breast cancer type 2, BRCA2)突变
  • PALB2 基因生殖细胞系突变
  • CDH1 生殖细胞系突变
  • 肿瘤直径>5 cm
  • 淋巴结阳性的数量多(例如>10)
  • 淋巴脉管侵犯
  • 预后不佳的70 项基因标记
  • 21 项高危型基因标记
  • 微小残留病变 (minimal residual disease, MRD)
  • 骨转移或肺转移基因标记
  • Lynch 家族综合征
  • CHEK2 突变
  • ATM 突变

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 肝功能检查 (LFT)
  • 胸部 X 线检查
  • (胸部及腹部)CT
  • 骨扫描
更多 首要检查

需考虑的检查

  • 磁共振(针对关注的部位,例如骨骼、脑部)
  • PET 扫描
  • 转移灶活检
  • 多门控采集 (MUGA) 扫描
  • 胸膜细胞学检查
  • 癌胚抗原
  • 癌抗原 15-3
  • 癌抗原 27-29
更多 需考虑的检查

治疗流程

撰稿人

Edward Sauter

Director

Breast Surgery Program

Hartford Healthcare

Hartford

Visiting Professor of Surgery

University of Connecticut School of Medicine

Farmington

CT

利益声明

ES declares that he has no competing interests.

Hematology and Oncology

Ellis Fischel Cancer Center

Margaret Proctor Mulligan Assistant Professor of Clinical Medicine

Medical Oncology - Breast Program Director

University of Missouri

Columbia

MO

利益声明

PN declares that she has no competing interests.

Professor

Clinical Medicine

University of Missouri

Columbia

MO

利益声明

Not disclosed.

Dr Edward Sauter, Dr Puja Nistala, and Dr Donald Doll would like to gratefully acknowledge Dr Carl E. Freter and Dr Michael Perry, previous contributors to this topic.

同行评议者展开全部内容

Professor

Assistant Dean

Undergraduate Program

McMaster University

Hamilton

Ontario

Canada

利益声明

AN declares that he has no competing interests.

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).

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.

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