h****i 发帖数: 41 | 1 乳腺癌预后一般比较好,如果发现早的话,术后很多病人不愿意放疗或化疗,觉得副反
应太大,比如下面这个例子:
患者女性,55岁左右,右侧乳房上12点位长有一包块,B超见多个实性低回声结节相互
融合,大约有1.2x0.8cm,边界清较规整。做了乳癌改良根治手术,术后病理是右侧乳
腺浸润性导管癌,腋窝自检淋巴结(0/10)、第二组淋巴结(0/3)、第3组淋巴结(0/
2)均未见癌转移。免疫组化只有ER是两个加号,别的p53等都是阴性。激素6项里孕酮
和催乳素高于正常值。
请问,像这种病例,术后需要常规放疗活化疗吗?如果病人对放化疗有顾虑的话,只激
素治疗可以吗?会不会增加复发的危险?
多谢! |
h*******l 发帖数: 1542 | |
R*******t 发帖数: 367 | 3 有一半以上的乳癌都是multicentric/multifocal disease,做了lumpectomy应该结合
chemoradiation,可以降低死亡率。有些做了mastectomy的,可以避免放疗。 |
h****i 发帖数: 41 | 4 多谢! 那做了mastectomy的,哪些情况可以避免放疗呢?是根据肿瘤分级吗?化疗是
必须的吗? |
I****a 发帖数: 407 | 5 In this case, I tend to use adjuvantonline.com which contains a set of
formula to calculate the potential benefit from the chemotherapy and
hormonal therapy. Almost all breast oncologist use this to see whether
chemotherapy is needed. We also send oncotypeDx to different patient who
might need chemotherapy in node negative early breast cancer.
She does not need radiation at this point. |
w********e 发帖数: 762 | 6 国内的oncotype Dx还是挺贵的吧,怀疑做不了。但是这个case 比较小。可以不用化疗
的说。。
用激素治疗应该可以。
【在 I****a 的大作中提到】 : In this case, I tend to use adjuvantonline.com which contains a set of : formula to calculate the potential benefit from the chemotherapy and : hormonal therapy. Almost all breast oncologist use this to see whether : chemotherapy is needed. We also send oncotypeDx to different patient who : might need chemotherapy in node negative early breast cancer. : She does not need radiation at this point.
|