2011年St.Gallen乳腺癌分子分型共识.doc

Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011 A. Goldhirsch1,*, W. C. Wood2, A. S. Coates3, R. D. Gelber4, B. Thurlimann5, H.-J. Senn6 Panel ¨ ? members International Breast Cancer Study Group, Department of Medicine, European Institute of Oncology, Milan, Italy; 2Department of Surgery, Emory University School of Medicine, N. E. Atlanta, USA; 3International Breast Cancer Study Group and University of Sydney, Sydney, Australia; 4International Breast Cancer Study Group Statistical Center, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA; 5Breast Center, Kantonsspital St Gallen, St Gallen; 6Tumor and Breast Center ZeTuP, St Gallen, Switzerland Received 21 April 2011; accepted 23 May 2011 The 12th St Gallen International Breast Cancer Conference (2011) Expert Panel adopted a new approach to the classi?cation of patients for therapeutic purposes based on the recognition of intrinsic biological subtypes within the breast cancer spectrum. For practical purposes, these subtypes may be approximated using clinicopathological rather than gene expression array criteria. In general, systemic therapy recommendations follow the subtype classi?cation. Thus, ‘Luminal A’ disease generally requires only endocrine therapy, which also forms part of the treatment of the ‘Luminal B’ subtype. Chemotherapy is considered indicated for most patients with ‘Luminal B’, ‘Human Epidermal growth factor Receptor 2 (HER2) positive’, and ‘Triple negative (ductal)’ disease, with the addition of trastuzumab in ‘HER2 positive’ disease. Progress was also noted in de?ning better tolerated local therapies in selected cases without loss of ef?cacy, such as accelerated radiation therapy and the omission of axillary dissection under de?ned circumstances. Broad treatment recommendations are presented, rec