关键词: 乳腺癌, 保乳手术, 前哨淋巴结活检, 新辅助治疗, 辅助治疗

Abstract:

Breast cancer is the most common malignant tumor in women. Early breast cancer refers to primary lesion localized in the breast and regional lymph nodes, and without distant metastasis. Treatment strategies include preoperative neoadjuvant therapy, local treatment (surgery and/or radiotherapy), and postoperative adjuvant therapy. Early breast cancer is highly heterogeneous, hence currently treatment strategies need to be formulated according to different molecular subtypes and pathology stages. At present, breast cancer is further divided into hormone receptor positive, triple negative breast cancer (TNBC), human epidermal growth factor receptor 2 (HER2) positive and other undefined subtypes. With the in-depth exploration of the biological characteristics of different molecular types, a series of new drugs have been developed, such as CDK4/6 inhibitors for hormone receptor positive, anti HER2 targeted therapy for HER2 positive, immunotherapy for TNBC, poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA mutations, and new generation of antibody-drug conjugates (ADCs) drug have entered clinical practice. Combined with the implementation of precision individualized treatment strategy, the prognosis of early breast cancer is also constantly improving, and local treatment is also updated from the "most tolerable" mode to the "least effective" mode, also known as “less is more”. Breast conserving surgery and sentinel lymph node biopsy have become the standard surgical methods for early breast cancer. The neo-adjuvant treatment has promoted the tumor down-staging, and it has also provided the possibility of surgical step-down for patients who could not have breast conserving surgery or sentinel lymph node biopsy. In recent years, the concept of reducing the scope and trauma of surgery, ensuring treatment effectiveness while reducing the physical, psychological, and economic burden on patients through local treatment, has been increasingly popular. This article reviewed the updated research progress and future prospects of local and systematic treatment of early breast cancer aimed to provide reference for clinical workers.

Key words: Breast cancer, Breast conserving surgery, Sentinel lymph node biopsy, Neoadjuvant therapy, Adjuvant therapy