乳腺癌骨转移诊治.pptVIP

乳腺癌骨转移和骨相关疾病的诊断和治疗 Diagnosis and treatment of bone metastasis of breast cancer? 流行病学Epidemiology 骨转移的比例仅次于肺、肝脏的转移 The ratio of bone metastasis is secondary to lung and liver 通常为多发，单发转移者仅占10% Usually for multiple bone metastasis,only 10% for single 80%为中轴骨，如脊柱和骨盆 80% for axial skeleton, such as the spine and pelvis 目 录Catalogue 乳腺癌骨转移概述 1. Overview 二. 乳腺癌骨转移诊断方法 2. Diagnostic method 三. 乳腺癌骨转移临床表现 3. Clinical manifestation 四. 乳腺癌骨转移治疗 4. Treatment 概 述 Overview 骨转移是乳腺癌最常见的远处转移部位 Bone metastasis is the most common distant metastases in breast cancer patients 晚期乳腺癌骨转移发生率为65%～75% The incidence of bone metastasis in terminal breast cancer is 65%～75% 骨痛、骨相关事件（SREs）及生活质量降低是乳腺癌骨转移的常见并发症 Bone pain, bone related events (SREs) and reduced quality of life are common complications of bone metastasis of breast cancer 参考文献 references 1.Coleman RE. Cancer Treat Rev. 2001 Jun;27(3):165-76. 2.John R. Johnson, Grant Williams,et al. J Clin Oncol 21:1404-1411. 3.Kinnane N. Eur J Oncol Nurs. 2007;11 Suppl 2:S28-31. Epub 2007 Sep 4. 诊断方法 Diagnosis 骨转移初筛诊断方法：骨放射性核素扫描（ECT） The preliminary screening method of bone metastasis：ECT 推荐用于出现骨疼痛、骨折、AKP升高、或高钙血症等可疑骨转移的常规初筛诊断检查 It is recommended to be used for patients of bone pain, fracture, AKP elevation, or hypercalcemia 乳腺癌分期＞T3N1M0患者常规检查 Routine examination of patients with breast cancer stage T3N1M0 复发转移乳腺癌患者的常规检查 Routine examination of patients with recurrent metastasis 骨转移的影像学确诊检查方法：骨X线/ CT /MRI Confirmed Radiographic diagnosis of bone metastasis:X-ray/CT/MRI 60%-78%溶骨性破坏、10%-20%成骨性、12%-20%混合性 Osteolysis 60%-78%, ossify 10%-20%, mixed 12%-20% 骨活检：诊断乳腺癌骨转移的金标准 Biopsy: Diagnostic criteria for bone metastasis in breast cancer 临床表现Clinical manifestation 症状：疼痛、病理性骨折、高钙血症、肢体功能障碍等 Symptoms: pain, pathological fracture, hypercalcemia, and limb dysfunction 乳癌骨转移特点：早期一般无症状，晚期疼痛剧烈，以夜间痛为主。 In early stage: general asymptomatic; In the late severe pain, and it mainly happens at night 治疗方法Treatment 化疗、内分泌治疗、分子靶向治疗等 Chemotherapy, endo