腋淋巴结阳性乳腺癌系统治疗

浸润性乳腺癌Ⅰ、ⅡA、ⅡB或T3N1M0

Axillary Lymph Node-Positive Tumors

腋淋巴结阳性肿瘤

Patients with lymph node-positive disease are most often candidates for chemotherapy and, if the tumor is hormone receptor-positive, for the addition of endocrine therapy (category 1). When HER2 is amplified or over-expressed, HER2 targeted therapy should be incorporated into the adjuvant chemotherapy. The NCCN Panel has noted in a footnote that the 21-gene RT-PCR assay recurrence score can be considered in select patients with 1 to 3 involved ipsilateral ALNs to guide the addition of combination chemotherapy to standard hormone therapy based on the retrospective study by Albain et al.

淋巴结阳性患者是化疗的最常见候选者，而且如果肿瘤激素受体阳性，适合加入内分泌治疗(1类)。当HER2扩增或过表达时，HER2靶向治疗应该加入到辅助化疗中。NCCN小组已经在一个脚注中指出根据Albain等的回顾性研究在选择性的1-3个同侧腋淋巴结受累的患者中可考虑21-基因RT-PCR分析复发评分以指导标准激素疗法加入联合化疗。

Breast cancer NCCN 2015v3