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本文介绍1例改良根治术后复发转移的乳腺癌病例的多学科诊治过程。患者术后8年复查发现双肺、颈淋巴结转移,经过多学科讨论后患者接受靶向药物联合化疗控制病情,后续联合内分泌治疗维持。随访近2年后再次发现颈淋巴结转移,经多学科讨论后治疗再次获得缓解。19月后复查发现肝转移灶,经多学科讨论,于部分肝切除术成功的基础上行全身化疗,使用创新性联合抑制雌激素受体(estrogen receptor,ER)、人表皮生长因子受体2(human epidermal growth receptor-2,HER2)、哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,m TOR)方案,患者获益显著,无进展生存期>27月。该病例的诊治过程说明,分析病例需要把握病情发展中的主要问题,需要多学科交流以避免出现认识上的误区和局限。应当普及多学科讨论以进一步保证治疗方案的合理性和优化。
This article describes a case of modified radical mastectomy recurrence and metastasis of breast cancer cases of multidisciplinary diagnosis and treatment process. Eight-year postoperative recheck found in patients with lung and cervical lymph node metastasis, after multidisciplinary discussion patients receive targeted chemotherapy combined with chemotherapy to control the disease, followed by joint endocrine therapy to maintain. After nearly two years of follow-up, cervical lymph node metastasis was found again and the treatment was again relieved after multidisciplinary discussion. 19 months after the review found that liver metastases, after multidisciplinary discussion, in part of the successful radical liver resection underwent systemic chemotherapy, the use of innovative joint inhibition of estrogen receptor (estrogen receptor, estrogen receptor, human epidermal growth factor receptor 2 ( The human epidermal growth receptor-2 (HER2) and mammalian target of rapamycin (mTOR) regimens benefited patients with progression-free survival> 27 months. The case diagnosis and treatment process shows that the analysis of cases need to grasp the main problems in the development of the disease, the need for multidisciplinary exchanges to avoid cognitive errors and limitations. Multidisciplinary discussions should be popularized to further ensure the rationality and optimization of treatment options.