What kind of breast cancer patients need chemotherapy?

Breast Cancer Chemotherapy

The medical treatment of breast cancer, including chemotherapy (targeted therapy), and endocrine therapy. Can be divided according to status of chemotherapy in patients with neo-adjuvant chemotherapy, adjuvant chemotherapy and rescue therapy.

Of these, postoperative adjuvant chemotherapy after 20 years of development, the program from the CMF to anthracycline (doxorubicin, etc.), to the taxane, and targeted drug, clinical research and practice have been proven to improve patient survival and reduce the relapse rate and mortality.

Chemotherapy

For the axillary lymph node-positive patients, should be given adjuvant chemotherapy, both premenopausal and postmenopausal women, chemotherapy can reduce the relapse rate and mortality of patients on the effects of pre-menopausal patients with more significant. EBTCG a group of 75,000 cases of breast cancer patients, including 10 years of follow-up data showed that adjuvant chemotherapy can relapse rate in patients 50 years of age and mortality were decreased by 37% and 27%; over the age of 50 were decreased by 22% and 14 %.

For the axillary lymph node-negative patients, if the early stages, 10-year survival to 75%, so should have a high risk of relapse in patients with postoperative adjuvant chemotherapy.

High risk of relapse include:

Younger than 35 years old

Large tumor size

Vascular tumor thrombus

ER-negative

HER2 gene overexpression

Neoadjuvant chemotherapy

CMF is the first postoperative adjuvant chemotherapy for breast cancer, in 1985, when studies have shown that CMF program had increased the patient's disease-free survival and overall survival, is still used for low-risk patients with cardiovascular disease or with anthracycline Class allergy patients, CMF program is still an ideal solution.

CAF, AC, etc. for the anthracycline-containing joint program, EBCTCG studies have shown that, compared with CMF, anthracycline-containing drugs, the program could further reduce the risk of recurrence and death in patients with the risk of 11% and 16%.

Yew-type drugs in the last century, since the mid-90s for breast cancer, studies have shown that some lymph node-positive patients, plus with the taxane drugs, again reducing the risk of recurrence and death in patients. Common programs are AC-T, TAC.

For low-risk patients may be given after six cycles of CMF or 4 cycles of CAF programs or AC programs, high-risk patients need six CAF and the program cycle of drug-containing taxane chemotherapy.

The treatment of advanced breast cancer

Rescue treatment of advanced breast cancer are: control of disease development, improving quality of life and prolong survival, according to the situation can be used in patients with systemic treatment, such as chemotherapy and endocrine therapy or local excision or radiotherapy is used only to relieve symptoms.

Adjuvant chemotherapy regimen can be used in the program can also use the other unused programs, suitable patients can increase with the targeted therapy. There are other commonly used drugs Capecitabine, Gemcitabine, Vinorelbine, cisplatin and so on. Are often used for breast cancer treatment.

Chemotherapy response rate was 45-80%, in recent years, as new chemotherapy drugs, programs, and the application of treatment strategies, has greatly improved the treatment efficiency and prolong the survival of patients, some patients can be long-term survival.

Chemotherapy toxicity

Chemotherapeutic drugs kill tumor cells in the same time, there is also damage normal tissue, including the gastrointestinal tract, bone marrow hematopoietic tissue, skin, mucous membranes and nervous system. The characteristics of specific responses and drug-related, but also and the patient's tolerance to a certain extent. Anthracycline cardiac toxicity is more prominent, so that treatment has a cumulative high limit. Epirubicin toxicity is relatively small. Application of taxane drugs, a small number of patients will suffer allergies, need to be anticipated. Platinum drugs cisplatin gastrointestinal reactions, especially large, there is a certain degree of renal toxicity, elderly patients should pay attention to renal function. Rational use of medicines, patient safety can closely observe the conduct of chemotherapy.