Russian Journal of OncologyRussian Journal of OncologyРоссийский онкологический журнал1028-99842412-9119Eco-Vector4005010.17816/onco40050ArticlesСтатьиReview ArticleCurrent approaches to the treatment of patients with primary resectable breast cancerСовременные подходы к лечению больных первично-операбельным раком молочной железыLetyaginV. PЛетягинВ. ПVysotskayaI. VВысоцкаяИ. ВGrigor’evaT. AГригорьеваТ. АФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» РАМНГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России15122013186NO6 (2013)№6 (2013)394722072020Copyright ©; 2013, Eco-VectorCopyright ©; 2013, ООО "Эко-Вектор"2013Eco-VectorООО "Эко-Вектор"https://rjonco.com/1028-9984/article/view/40050

The paper examines the main issues of integrated treatment of resectable breast cancer. Identifies underlying prognostic factors and the relation between the choice of systemic therapy on the molecular characteristics of tumours. In the evolutionary aspect different approaches, both local and systemic treatments of patients with resectable primary breast cancer are assessed.

В статье рассаматриваются основные вопросы комплесного лечения операбельного рака молочной железы. Определяются основополагающие прогностические факторы и зависимость выбора системной терапии от молекулярных особенностей опухолей. В эволюционном аспекте оцениваются различные подходы как локального, так и системного вида лечения больных первично-операбельным раком молочной железы.

breast cancermolecular subtypes of tumourssentinel lymph node biopsyintraoperative irradiation therapy molecular- directed actionрак молочной железымолекулярные подтипы опухолейбиопсия сигнальных лимфатических узловинтраоперационное облучениетерапия молекулярно-направленного действияGlobocan 2008. bttp: // globocan.iarc.fr/ factsbeets/cancers/ breast.aspДавыдов М.И., Аксель Е.М., ред. Статистика злокачественных новообразований в России и странах СНГ в 2010 г. М.; 2012.Autier P. et al. Breast cancer mortality in neigbbouring European countries with different levels of screening but similar access to treatment: treand analysis of WHO mortality database Br. Med. J. 2011; 343: d 4411.Давыдов М.И., Летягин В.П. Клиническая маммология (практическое руководство). М.: АБВ-пресс; 2010: 73—6.Вишнякова В.В. Эффективность экономных операций при раке молочной железы. Вопросы онколгии. 1990; 36(5): 540—5.Семиглазов В.Ф. Органосохраняющее лечение рака молочной железы. Вопросы онкологии. 1996; 42(3): 26—9.Veronesi U. Milan I—III. Eur. J. Cancer. 1995, 31(10): 1574—9.Fisher B., Anderson S., Redmond C.K. et al. NSABP-B-06. Reanalysis and results after 12 years of follow-up in a in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N. Engl. J. Med. 1995; 333: 1456—61.Vaidya J.S., Baum M., Tobias J.S. et al. Targeted intra-operative radiotherapy (Targit): an innovative method of treatment for early breast cancer. Ann. Oncol. 2001; 12(8):1075—80.Veronesi U., Paganelli G., Galimberti V. et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer. Lancet. 1997; 349: 1864—7.Rosen P.P., Groshen S., Kinne D.W. et al. Factors influencing prognosis in node-negative breast carcinoma: analysis of 767 T1N0M0/ T2N0M0 patients with long-term follow-up. J. Clin. Oncol. 1993; 11: 2090—100.Veronesi U., Paganelli G., Viale G. et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N. Engl. Jki Med. 2003; 349: 546—53.Veronesi U., Gatti G., Luini A. et al. Intraoperative radiotherapy for breast cancer: technical notes. Breast. J. 2003;9:106—12.Luini A., Gatti G., Ballardini B. et al. The development of axillary surgery in breast cancer. Ann. Oncol. 2005; 16(2): 259—62.Moffat F.L. Lymph node staging surgery and breast cancer: potholes in the fast lane from more to less. J. Surg. Oncol. 2005; 89: 53—60.Gianni L., Baselga J., Eiermann W. et al. Phase III trial evaluating the addition of paclitaxel to doxorubicin followed by cyclophosphamide, methotrexate, and fluorouracil, as adjuvant or primary systemic therapy: European Cooperative Trial in Operable Breast Cancer. J. Clin. Oncol. 2009; 27: 2474-81.Albert J.M., Buzdar A.U., Guzman R. et al. Prospective randomized trial of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) versus paclitaxel and FAC (TFAC) in patients with operable breast cancer: impact of taxane chemotherapy on locoregion-al control. Breast Cancer Res. Treat.2011 Jul; 128(2): 421-7.Sparano J.A., Wang M., Martino S. et al. Phase III study of doxorubicin cyclophosphamide followed by paclitaxel or docetaxel given every 3 weeks or weekly in patients with axillary nodepositive or high-risk nodenegative breast cancer: results of North American Breast Cancer Intergroup Trial E1199. San Antonio Breast Cancer Symposium, San Antonio, 2005.Martin M., Rodriguez-Lescure A., Ruiz A. et al. Randomized phase 3 trial of fluorouracil, epirubicin, and cyclophosphamide alone or followed by paclitaxel for early breast cancer. J. Natl. Cancer Inst.2008;100: 805-14.Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Lancet. 2005; 366: 2087—106.Joensuu H., Kellokumpu-Lehtinen P.-L., Bono P. et al. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med 2006; 354: 809—20.Aebi S., Sun Z., Braun D. et al. Differential efficacy of three cycles of CMF followed by tamoxifen in patients with ER-positive and ER-negative tumors: long-term follow up on IBCSG Trial IX. Ann. Oncol. 2011 [epub ahead of print 31 January 2011] doi:10.1093/annonc/mdq754.Albain K.S., Barlow W.E., Shak S. et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010; 11: 55-65.Борисов В.И. Адъювантная гормонотерапия у больных в менопаузе. Опухоли женской репродуктивной системы. 2010; (3): 26—9.Smith I., Procter M., Gelber R.D. et al. Survival and safety of exemestane versus tamoxifen after 2—3 years chemotherapy in HER2-positive breast cancer: a randomised controlled trial. Lancet. 2007; 369: 29—36.Perez E. Aromatase inhibitors and bone health. ASCO 2005; ab-str 1824.Berry D.A., Cirrincione C., Henderson C. et al. Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer. JAMA 2006; 295: 1658—67.Dowsett M., Cuzick J., Ingle J. et al. Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J.Clin. Oncol. 2010; 28(3): 509—18.Hortobagyi G.N. Trastuzumab in the treatment of breast cancer. N Engl J Med 2005; 353: 1734—6.Spielmann M., Roché H., Humblet Y. et al. Three-year follow-up of trastuzumab following adjuvant chemotherapy in node positive HER2-positive breast cancer patients: results of the PACS-04 trial. SABCS, 2007.Piccart-Gebhart M.J., Procter M., Leyland-Jones B. et al. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N. Engl. J. Med. 2005; 353: 1659—72.Romond E.H., Perez E.A., Bryant J. et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N. Engl. J. Med. 2005; 353: 1673—84.Стенина М.Б. Трастузумаб в лечении рака молочной железы: от теории к практике. Русский медицинский журнал.2006; 14(14): 1028—31.Артамонова Е.В., Королева И.А. НБК2-позитивный рак молочной железы: выбор режима адъювантной терапии с учетом проблемы кардиотоксичности. Эффективная фармакотерапия. 2011; (1): 26—9.Prat A., Perou C.M. Deconstructing the molecular portraits of breast cancer. Mol. Oncol. 2011; 5: 5-23.Nielsen T.O., Hsu F.D., Jensen K. et al. mmunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin. Cancer Res. 2004; 10: 5367-74.Goldhirsch A., Wood W.C., Coates A.S. et al. Strategies for sub-types-dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann. Oncol. 2011; 11(8): 1736—47.http://annonc.oxfordjournals.org/content/24/9/2206.full. pdf+htmlPaik S., Tang G., Shak S. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. N. Engl. J. Med. 2004; 351(27): 2817—26.Parker J.S., Mullins M., Cheang M.C. et al. Supervised risk predictor of breast cancer based on intrinsic subtypes. J. Clin. Oncol. 2009; 27: 1160-7.Blows FM., Driver K.E., Schmidt M.K. et al. Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS Med 2010; 7:e1000279.Hugh J., Hanson J., Cheang M.C. et al. Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 Trial. J. Clin. Oncol. 2009; 27: 1168-76.Cheang M.C., Chia S.K, Voduc D. et al. Ki-67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl. Cancer Inst. 2009; 101: 736-50.Millikan R.C., Newman B., Tse C.K. et al. Epidemiology of basal-like breast cancer. Breast Cancer Res. Treat. 2008; 109:123-39.Phipps A.I., Buist D.S., Malone K.E. et al. Reproductive history and risk of three breast cancer subtypes defined by three biomarkers. Cancer Causes Control. 2011; 22: 399-405.Liedtke C., Mazouni C., Hess K.R. et al. Response to neoadjuvant therapy and longterm survival in patients with triple-negative breast cancer. J. Clin. Oncol. 2008; 26: 1275-81.Nguyen P.L., Taghian A.G., Katz M.S. et al. Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy. J. Clin. Oncol. 2008; 26: 2373-8.Tang G., Shak S., Paik S. et al. Comparison of the prognostic and predictive utilities of the 21-gene recurrence score assay and Adjuvant for women with node-negative, ER-positive breast cancer: results from NSABP B-14 and NSABP B-20. Breast Cancer Res. Treat.2011; 127: 133-42.