Preview

Войти

Регистрация нового пользователя Забыли Ваш пароль?

Опухоли женской репродуктивной системы

Расширенный поиск

Общие рекомендации по лечению раннего рака молочной железы St. Gallen-2015, адаптированные экспертами Российского общества онкомаммологов

https://doi.org/10.17650/1994-4098-2015-11-3-43-60

Полный текст:

PDF (Rus)

Аннотация

В марте 2015 г. завершила работу 14-я Международная конференция по раку молочной железы St. Gallen-2015, проведенная в Вене впервые. 

Как и прежде, конференция закончилась принятием консенсус-документа о рекомендациях по местному и системному лечению ранних (операбельных) стадий рака молочной железы. Не все страны, включая Европу и Северную Америку, безоговорочно принимают отдельные положения рекомендаций. В частности, эксперты Российского общества онкомаммологов (РООМ) подходят с осторожностью к оценке «чистых» хирургических краев при выполнении органосохраняющего лечения, а также к планированию лечения минимальных опухолей pT1b–cN0M0. Впервые в практике работы конференции St. Gallen были рассмотрены и учтены в общих рекомендациях отдельные предложения экспертов РООМ по планированию адъювантного лечения в зависимости от биологических и клинико-анатомических характеристик заболевания. Многие положения наших рекомендаций 2012–2013 гг. нашли свое отражение в итоговой резолюции международного консенсуса St. Gallen. Это касается как лечебно-ориентированной классификации подгрупп рака молочной железы в целом, так и проблем стандартизации оценки маркера активности опухоли Ki-67 в различных лабораториях и вопроса об улучшении прогностической эффективности использования маркеров ER и PR. 

Основные положения рекомендаций St. Gallen учитываются при разработке ESMO. 

Список литературы

1. Ferlay J., Soerjomataram I., Ervik M. et al. GLOBOCAN 2012 v 1.0, Cancer Incidence and Mortality Worldwide. IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer, 2013.

2. Coates A.S. Evolution of the St. Gallen Consensus process for the optimal treatment of women with breast cancer. The Breast 2015;24(Suppl 1):PG 0.1.

3. Francis P.A., Regan M.M., Fleming G.F. et al. Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med 2015;372:436–46.

4. Moore H.C.F., Unger J.M., Phillips K.A. et al. Goserelin for Ovarian Protection during Breast-Cancer Adjuvant Chemotherapy. N Engl J Med 2015;372:923–32.

5. Pagani О., Regan M.M., Walley B.A. et al. Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med 2014;371:107–18.

6. Moran M.S., Schnitt S.J., Giuliano A.E. et al. Society of Surgical Oncology – American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. J Clin Oncol 2014;32:1507–15.

7. Budach W., Kammers K., Boelke E. et al. Adjuvant radiotherapy of regional lymph nodes in breast cancer – a meta-analysis of randomized trials. Radiat Oncol 2013;8:267.

8. Nordenskjold A.E., Fohlin H.I., Albertsson P. et al. No clear effect of postoperative radiotherapy on survival of breast cancer patients with 1–3 positive nodes: а population-based study. Ann Oncol 2015;26(6):1149–54.

9. Haviland J.S., Owen J.R., Dewar J.A. et al. The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol 2013;14:1086–94.

10. Whelan T.J., Pignol J.P., Levine M.N. et al. Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med 2010;362:513–20.

11. Dowsett M. Neoadjuvant endocrine therapy: patient selection, treatment duration and surrogate endpoints. Breast 2015; 24(Suppl 1):PG 8.02.

12. Regan M. Predicting benefit of endocrine therapy. Breast 2015;24(Suppl 1):PG 11.03.

13. Viale G., Regan M.M., Dell'Orto P. et al. Which patients benefit most from adjuvant aromatase inhibitors? Results using a composite measure of prognostic risk in the BIG 1-98 randomized trial. Ann Oncol 2011;22:2201–7.

14. Regan M.M., Neven P., Giobbie-Hurder A. et al. Assessment of letrozole and tamoxifen alone and in sequence for postmenopausal women with steroid hormone receptor-positive breast cancer: the BIG 1-98 randomised clinical trial at 8.1 years median follow-up. Lancet Oncol 2011;12:1101–8.

15. The Cancer Genome Atlas Network. Comprehensive molecular portraits of human breast tumours. Nature 2012;490:61–70.

16. Sorlie T., Perou C.M., Tibshirani R. et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 2001;98:10869–74.

17. Bayraktar S., Royce M., Stork-Sloots L. et al. Molecular subtyping predict pathologic tumor response in early-stage breast cancer treated with neoadjuvant docetaxel plus capecitabine with or without trastuzumab. Med Oncol 2014;31:163–73.

18. Dowsett M., Sestak I., Lopez-Knowles E. et al. Comparison of PAM50 risk of recurrence score with oncotype DX and IHC4 for predicting risk of distant recurrence after endocrine therapy. J Clin Oncol 2013;31:2783–90.

19. Eiermann W., Rezai M., Kummel S. et al. The 21-gene recurrence score assay impacts adjuvant therapy recommendations for ERpositive, node-negative and node-positive early breast cancer resulting in a risk-adapted change in chemotherapy use. Ann Oncol 2013;24: 618–24.

20. Nielsen T.O., Parker J.S., Leung S. et al. A comparison of PAM50 intrinsic subtyping with immunohistochemistry and clinical prognostic factors in tamoxifen-treated estrogen receptor-positive breast cancer. Clin Cancer Res 2010;16:5222–32.

21. Prat A., Adamo B., Cheang M.C. et al. non-basal-like triple-negative breast cancer. Oncologist 2013;18:123–33.

22. Coates A.S., Millar E.K., O'Toole S.A. et al. Prognostic interaction between expression of p53 and estrogen receptor in patients with node-negative breast cancer: results from IBCSG Trials VIII and IX. Breast Cancer Res 2012;14:143.

23. Regan M.M., Pagani О., Walley В. et al. Premenopausal endocrine-responsive early breast cancer: who receives chemotherapy? Ann Oncol 2008;19:1231–41.

24. Wirapati P., Sotiriou C., Kunkel S. et al. Meta-analysis of gene expression profiles in breast cancer: toward a unified understanding of breast cancer subtyping and prognosis signatures. Breast Cancer Res 2008;10:R65.

25. de Azambuja E., Cardoso F., de Castro G. Jr et al. Ki-67 as prognostic marker in early breast cancer: a meta-analysis of published studies involving 12 155 patients. Br J Cancer 2007;96:1504–13.

26. Denkert C., von M.G. Reply to Ki-67 in breast cancer: a useful prognostic marker! Ann Oncol 2014;25:542–3.

27. Polley M.Y., Leung S.C., McShane L.M. et al. An international Ki-67 reproducibility study. J Natl Cancer Inst 2013;105:1897–906.

28. Bastien R.R., Rodriguez-Lescure A., Ebbert M.T. et al. PAM50 breast cancer subtyping by RT-qPCR and concordance with standard clinical molecular markers. BMC Med Genomics 2012;5:44.

29. Houssami N., Morrow M. Margins in breast conservation: a clinician's perspective and what the literature tells us. J Surg Oncol 2014;110:2–7.

30. Donker M., van Tienhoven G., Straver M.E. et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 2014;15:1303–10.

31. Giuliano A.E., Hunt K.K., Ballman K.V. et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis. JAMA 2011;305:569–75.

32. Dengel L.T., van Zee K.J., King Т.А. et al. Axillary dissection can be avoided in the majority of clinically node-negative patients undergoing breast-conserving therapy. Ann Surg Oncol 2014;21:22–7.

33. Yao K., Winchester D.J., Czechura T. et al. Contralateral prophylactic mastectomy and survival: report from the National Cancer Data Base, 1998–2002. Breast Cancer Res Treat 2013;142:465–76.

34. Narod S.A. The impact of contralateral mastectomy on mortality in BRCA1 and BRCA2 mutation carriers with breast cancer. Breast Cancer Res Treat 2011;128:581–3.

35. Kurian A.W., Lichtensztajn D.Y., Keegan T.H. et al. Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998–2011. JAMA 2014;312:902–14.

36. Guth U., Myrick M.E., Viehl C.T. et al. Increasing rates of contralateral prophylactic mastectomy – a trend made in USA? Eur J Surg Oncol 2012;38:296–301.

37. Partridge A.H., Gelber S., PiccartGebhart M.J. et al. Effect of age on breast cancer outcomes in women with human epidermal growth factor receptor 2-positive breast cancer: results from a herceptin adjuvant trial. J Clin Oncol 2013;31:2692–8.

38. Boileau J.F., Poirier B., Basik M. et al. Sentinel node biopsy after neoadjuvant chemotherapy in biopsy-proven node-positive breast cancer: the SN FNAC Study. J Clin Oncol 2015;33:258–64.

39. Boughey J.C., Suman V.J., Mittendorf E.A. et al. Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071 (Alliance). Ann Surg 2015;261:547–52.

40. Galimberti V. Feasibility of sentinel node biopsy in breast cancer after neoadjuvant treatment. Breast 2015;24(Suppl 1):PG 9.02.

41. Kuehn T., Bauerfeind I., Fehm T. et al. Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol 2013;14:609–18.

42. Ataseven B., Lederer B., Blohmer J.U. et al. Impact of multifocal or multicentric disease on surgery and locoregional, distant and overall survival of 6,134 breast cancer patients treated with neoadjuvant chemotherapy. Ann Surg Oncol 2015;22: 1118–27.

43. Wolmark N., Mamounas E.P., Baehner F.L. et al. Recurence score and quantitative ER expression to predict in late distant recurrence risk in ER+ BC after 5 years of tamoxifen. J Clin Oncol 2014;32(Suppl):Abstr 11024.

44. Sestak I., Cuzick J., Dowsett M. et al. Prediction of late distant recurrence after 5 years of endocrine treatment: a combined analysis of patients from the Austrian Breast and Colorectal Cancer Study Group 8 and Arimidex, Tamoxifen Alone or in Combination randomized trials using the PAM50 risk of recurrence score. J Clin Oncol 2015;33: 916–22.

45. Sestak I., Dowsett M., Zabaglo L. et al. Factors predicting late recurrence for estrogen receptor positive breast cancer. J Natl Cancer Inst 2013;105:1504–11.

46. Dubsky P., Brase J.C., Jakesz R. et al. The EndoPredict score provides prognostic information on late distant metastases in ER+/ HER-2– breast cancer patients. Br J Cancer 2013;109:2959–64.

47. Zhang Y., Schnabel C.A., Schroeder B.E. et al. Breast cancer index identifies early-stage estrogen receptor-positive breast cancer patients at risk for earlyand late-distant recurrence. Clin Cancer Res 2013;19: 4196–205.

48. Sledge G.W., Hudis C.A., Swain S.M. et al. ASCO's approach to a learning health care system in oncology. J Oncol Pract 2013;9(3):145–8.

49. Campbell P. Interpreting genomics data at a functional level: What are we learning from large molecular screening projects? Breast 2015;24(Suppl 1):G 2.01.

50. Reis-Filho J., Weigelt B. Discrepancies between genetic tools and immunohistochemistry: bad pathology and good signature, and vice-versa. Breast 2015;24(Suppl 1):PG 2.03.

51. Viale G., Slaets L., Bogaerts J. et al. High concordance of protein (by IHC), gene (by FISH; HER2 only), and microarray readout (by TargetPrint) of ER, PgR, and HER2: results from the EORTC 10041/BIG 03-04 MINDACT trial. Ann Oncol 2014;25:816–23.

52. Maisonneuve P., Disalvatore D., Rotmensz N. et al. Proposed new clinicopathological surrogate definitions of luminal A and luminal В (HER-2-negative) intrinsic breast cancer subtypes. Breast Cancer Res 2014;16:R65.

53. Prat A., Cheang M.C., Martin M. et al. Prognostic significance of progesterone receptor-positive tumor cells within immunohistochemically defined luminal a breast cancer. J Clin Oncol 2013;31: 203–9.

54. Viale G. A bad tumor biomarker is as bad as a bad drug: the gap between genomics data and phenotype to predict response. Breast 2015;24(Suppl 1):PG 2.04.

55. Prat A., Bianchini G., Thomas M. et al. Research-based PAM50 subtype predictor identifies higher responses and improved survival outcomes in HER2-positive breast cancer in the NOAH study. Clin Cancer Res 2014;20:511–21.

56. Schneeweiss A., Chia S., Hickish T. et al. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracyclinecontaining and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRVPHAENA). Ann Oncol 2013;24: 2278–84.

57. Loibl S. Primary systemic therapy for clinicians: medical and research perspectives. Breast 2015;24(Suppl 1):PG 8.01.

58. Masuda H., Baggerly K.A., Wang Y. et al. Differential response to neoadjuvant chemotherapy among 7 triple-negative breast cancer molecular subtypes. Clin Cancer Res 2013;19:5533–40.

59. Lehmann B.D., Bauer J.A., Chen X. et al. Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest 2011;121:2750–67.

60. Adams S., Gray R.J., Demaria S. et al. Prognostic value of tumor-infiltrating lymphocytes in triple-negative breast cancer from two phase III randomized breast cancer trials: ECOG 2197 and ECOG 1199. J Clin Oncol 2014;32(27):2959–66.

61. Loibl S. Primary systemic therapy for clinicians: medical and research perspectives. Breast 2015;24(Suppl 1):PG 8.01.

62. Perez E.A., Ballman K.V., Anderson S.K. et al. Stromal tumor-infiltrating lymphocytes (S-TILs): in the alliance N9831 S-TILs are associated with chemotherapy benefit but not associated with trastuzumab benefit. Proc SABCG 2014:S1-06.

63. Curigliano G. Immune pathways and immunome as a target. Breast 2015;24(Suppl 1):PG 4.02.

64. Herbst R.S., Soria J.C., Kowanetz M. et al. Predictive correlates of response to the antiPD-Ll antibody MPDL3280A in cancer patients. Nature 2014;515:563–7.

65. Nanda R., Chow L.Q., Dees E.C. et al. A phase lb study of pembrolizumab (MK-3475) in patients with advanced triple-negative breast cancer. Cancer Res 2015; Suppl:S1–9.

66. Finn R.S., Crown J.P., Lang I. et al. The cyclin-dependent kinase 4/6 inhibitor palbocidib in combination with letrozole versus letrozole alone as first-line treatment of oestrogen receptor-positive, HER2-negative, advanced breast cancer (PALOMA-l/TRIO18): a randomised phase 2 study. Lancet Oncol 2015;16:25–35.

67. Byrski T., Huzarski T., Dent R. et al. Pathologic complete response to neoadjuvant cisplatin in BRCAl-positive breast cancer patients. Breast Cancer Res Treat 2014;147:401–5.

68. Tutt A., Ellis P., Kilbum L.S. et al. TNT: A randomized phase III trial of carboplatin (C) compared with docetaxel (D) for patients with metastatic or recurrent locally advanced triple negative or BRCA1/2 breast cancer (CRUK/07/012). Cancer Res 2014;Suppl:S3-01.

69. Baselga J. Targeting PIK3CA pathway. Breast 2015;24(Suppl 1).

70. Andre F., Bachelot T., Campone M. et al. Targeting FGFR with dovitinib (TKI258): predinical and clinical data in breast cancer. Clin Cancer Res 2013;19:3693–3702.

71. Soria J.C., DeBraud F., Bahleda R. et al. Phase I/IIa study evaluating the safety, efficacy, pharmacokinetics, and pharmacodynamics of lucitanib in advanced solid tumors. Ann Oncol 2014;25:2244–51.

72. Phillips K.A., Milne R.L., Rookus M.A. et al. Tamoxifen and risk of contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. J Clin Oncol 2013;31:3091–9.

73. Hartmann L.C., Degnim A.C., Santen R.J. et al. Atypical hyperplasia of the breast – risk assessment and management options. N Engl J Med 2015;372:78–89.

74. Yi M., Huo L., Koenig K.B. et al. Which threshold for ER positivity? A retrospective study based on 9639 patients. Ann Oncol 2014;25:1004–11.

75. Feng Q., Zhang Z., Shea M.J. et al. An epigenomic approach to therapy for tamoxifen-resistant breast cancer. Cell Res 2014;24:809–19.

76. Denkert C., Loibl S., Muller B.M. et al. Ki-67 levels as predictive and prognostic parameters in pretherapeutic breast cancer core biopsies: a translational investigation in the neoadjuvant GeparTrio trial. Ann Oncol 2013; 24:2786–93.

77. Denkert C., von Minckwitz G., Brase J.C. et al. Tumor-infiltrating lymphocytes and response to neoadjuvant chemotherapy with or without carboplatin in human epidermal growth factor receptor 2-positive and triplenegative primary breast cancers. J Clin Oncol 2015;33:983–91.

78. Denkert C. Developing Ki67 as a useful marker. The Breast 2015;24(Suppl 1). PG 7.04.

79. Klauschen F., Wienert S., Schmitt W. et al. Standardized Ki-67 diagnostics using automated scoring – clinical validation in the Gepar Trio breast cancer study. Clin Cancer Res 2014.

80. Sikov W.M., Berry D.A., Perou C.M. et al. Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603 (Alliance). J Clin Oncol 2015;33:13–21.

81. von Minckwitz G., Schneeweiss A., Loibl S. et al. Neoadjuvant carboplatin in patients with triple-negative and HER2positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial. Lancet Oncol 2014;15:747–56.

82. Guarneri V., Dieci M., Carbognin L. et al. Activity of neoadjuvant lapatinib plus trastuzumabfor early breast cancer according to PIK3CA mutations: pathological complete response (pCR) rate in the CherLOB study and pooled analyss of randomized trials. Proc ESMO 2014. Abstr. 2540.

83. Loibl S., von Minckwitz G., Schneeweiss A. et al. PIK3CA mutations are associated with lower rates of pathologic complete response to anti-human epidermal growth factor receptor 2 (HER-2) therapy in primary HER-2-overexpressing breast cancer. J Clin Oncol 2014;32:3212–20.

84. Majewski I.J., Nuciforo P., Mittempergher L. et al. PIK3CA mutations are associated with decreased benefit to neoadjuvant human epidermal growth factor receptor 2-targeted therapies in breast cancer. J Clin Oncol 2015.

85. Allevi G., Strina C., Andreis D. et al. Increased pathological complete response rate after a long-term neoadjuvant letrozole treatment in postmenopausal oestrogen and/or progesterone receptor-positive breast cancer. Br J Cancer 2013;108:1587–92.

86. Dowsett M., Smith I.E., Ebbs S.R. et al. Prognostic value of Ki67 expression after shortterm presurgical endocrine therapy for primary breast cancer. J Natl Cancer Inst 2007;99: 167–70.

87. de Azambuja E., Procter M.J., van Veldhuisen D.J. et al. Trastuzumabassociated cardiac events at 8 years of median follow-up in the Herceptin Adjuvant trial (BIG 1-01). J Clin Oncol 2014;32:2159–65.

88. Piccart-Gebhart M.J., Holmes A.P., Baselga J. et al. First results from the phase III ALTTO trial (BIG 2-06; NCCTG [Alliance] N063D) comparing one year of anti-HER2 therapy with lapatinib alone (L), trastuzumab alone (T), their sequence (T->L), or their combination (T+L) in the adjuvant treatment of HER2-positive early breast cancer (EBC). J Clin Oncol 2014;32(Suppl 15):LBA4.

89. DeMichele A., Yee D., Berry D.A. et al. The neoadjuvant model is still the future for drug development in breast cancer. Clin Cancer Res 2015;21(13):2911–5.

90. Whelan T. Evolving standards in breast cancer radiotherapy: who should receive locoregional RT? Breast 2015;24(Suppl 1): PG 10.02.

91. Yarnold J. Hypofractionated radiotherapy in early breast cancer: clinical, dosimetric and radio-genomic issues. Breast 2015;24(Suppl 1):PG 10.01.

92. Thorsen L.B., Thomsen M.S., Berg M. et al. CT-planned internal mammary node radiotherapy in the DBCG-IMN study: benefit versus potentially harmful effects. Acta Oncol 2014;53:1027–34.

93. Davidson N. Endocrine therapy for premenopausal women: type and duration. Breast 2015;24(Suppl 1):PG 11.01.

94. Gnant M., Mlineritsch B., Stoeger H. et al. Zoledronic acid combined with adjuvant endocrine therapy of tamoxifene versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the ABCG12 Trial 12. Ann Oncol 2015;26:313–20.

95. Bernhard J., Luo W., Ribi К. et al. Patient-reported endocrine symptoms, sexual functioning, and quality of life (QoL) in the IBCSG TEXT and SOFT trials: adjuvant treatment with exemestane (E) plus ovarian function suppression (OFS) versus tamoxifen (T) plus OFS in premenopausal women with hormone receptor-positive (HR+) early breast cancer (BC). J Clin Oncol 2015;32 (Suppl 15):аbstr. 557.

96. Ribi K., Luo W., Francis P. et al. Patientreported endocrine symptoms, sexual functioning and quality of life (QoL) in the IBCSG SOFT trial: Adjuvant treatment with tamoxifen (T) alone versus T plus ovarian function suppression (OFS) in premenopausal women with hormone receptorpositive (HR+) early breast cancer (BC). Cancer Res 2014;Suppl:S3-09.

97. Tevaarwerk A.J., Wang M., Zhao F. et al. Phase III comparison of tamoxifen versus tamoxifen plus ovarian function suppression in premenopausal women with node-negative, hormone receptor-positive breast cancer (E-3193, INT-0142): a trial of the Eastern Cooperative Oncology Group. J Clin Oncol 2014;32:3948–58.

98. Goodwin P.J. Obesity and insulin: сlinical relevance and research priorities. Breast 2015;24(Suppl 1):PG 6.03.

99. Shulman L.N., Cirrincione C.T., Berry D.A. et al. Six cycles of doxorubicin and cyclophosphamide or paclitaxel are not superior to four cycles as adjuvant chemotherapy for breast cancer in women with zero to three positive axillary nodes: Cancer and Leukemia Group В 40101. J Clin Oncol 2012;30:4071–6.

100. Wolff A.C., Blackford A.L., Visvanathan К. et al. Risk of marrow neoplasms after adjuvant breast cancer therapy: The National Comprehensive Cancer Network Experience. J Clin Oncol 2015;33:340–8.

101. Eckhoff L., Knoop A., Jensen M.B. et al. Persistence of docetaxel-induced neuropathy and impact on quality of life among breast cancer survivors. Eur J Cancer 2015;51: 292–300.

102. Tolaney S.M., Barry W.T., Dang C.T. et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. N Engl J Med 2015;372:134–41.

103. Pagani О., Ruggeri M., Manunta S. et al. Pregnancy after breast cancer: Are young patients willing to participate in clinical studies? Breast 2015.

104. Hart C.D., Di Leo A. Defining optimal duration and predicting benefit from chemotherapy in patients with luminal-like subtypes. Breast 2015;24(Suppl 1):PG 12.02.

105. Davies C., Pan H., Godwin J. et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 2013;381: 805–16.


Для цитирования:

Семиглазов В.Ф., Палтуев Р.М., Семиглазов В.В., Дашян Г.А., Семиглазова Т.Ю., Криворотько П.В., Николаев К.С. Общие рекомендации по лечению раннего рака молочной железы St. Gallen-2015, адаптированные экспертами Российского общества онкомаммологов. Опухоли женской репродуктивной системы. 2015;11(3):43-60. https://doi.org/10.17650/1994-4098-2015-11-3-43-60

For citation:

Semiglazov V.F., Paltuev R.M., Semiglazov V.V., Dashyan G.A., Semiglazova T.Y., Krivorotko P.V., Nikolaev K.S. General St. Gallen-2015 guidelines for the treatment of early breast cancer (adapted by the experts of the Russian Society of Breast Oncologists). Tumors of female reproductive system. 2015;11(3):43-60. (In Russ.) https://doi.org/10.17650/1994-4098-2015-11-3-43-60

Просмотров: 954


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1994-4098 (Print)
ISSN 1999-8627 (Online)
109443, г. Москва, а/я 35, ООО «Издательский дом «АБВ-пресс».
создано и поддерживается NEICON
(лаборатория Elpub)
powered by PKP OJS