乳腺癌须“分类而治”,贫困地区女性健康项目在沪启动

2018-03-13 屠俊 澎湃新闻

目前,我国乳腺癌的发病率呈急速增长态势,我国女性乳腺癌发病率为42.55/10万人,严重威胁女性健康。其中,每年偏远贫困地区女性乳腺癌发病约9.8万,占农村全部女性乳腺癌发病的14.11%。据中国抗癌协会乳腺癌专业委员会主任委员任国胜教授介绍,从病理上来看,乳腺癌包含四种分子亚型:Luminal A型,Luminal B型,HER2阳性,以及三阴性乳腺癌,确诊乳腺癌的患者应当及早进行分子病理检测

目前,我国乳腺癌的发病率呈急速增长态势,我国女性乳腺癌发病率为42.55/10万人,严重威胁女性健康。其中,每年偏远贫困地区女性乳腺癌发病约9.8万,占农村全部女性乳腺癌发病的14.11%。

据中国抗癌协会乳腺癌专业委员会主任委员任国胜教授介绍,从病理上来看,乳腺癌包含四种分子亚型:Luminal A型,Luminal B型,HER2阳性,以及三阴性乳腺癌,确诊乳腺癌的患者应当及早进行分子病理检测,并接受依据分子分型的规范化治疗,“由于靶向药物的出现,过去预后最差的HER2阳性乳腺癌只要治疗及时、规范,能明显改善预后。2017年,我国将36种创新药物纳入国家医保报销范围,其中也包括了抗HER2阳性乳腺癌靶向药物,极大地减轻了患者的负担。”

但由于我国医疗资源、诊疗水平发展不均衡,不同地区以及城乡之间的乳腺癌规范化治疗存在很大差异,很多经济欠发达地区的女性在确诊乳腺癌时已经是中晚期,还有一些乳腺癌患者因为当地医疗水平有限,无法接受到规范化检测与治疗,往往错过最佳的治疗时期。

“当下如何提高早诊早治、分类而治的意识仍然是提高乳腺癌规范化治疗水平的较大难题,也是制约广大边远地区以及经济社会欠发达地区的乳腺癌患者接受规范化治疗,延长生命、减轻医疗负担的主要瓶颈。”任国胜教授表示。

为进一步在全国范围推进乳腺癌规范化治疗,提高乳腺癌早诊早治,分类而治的观念,近日,由国家卫生计生委人口宣教中心指导,中国抗癌协会乳腺癌专业委员会主办的“2018年全国贫困地区女性健康促进试点项目”暨“乳此美丽,愈见未来”全国20城乳腺癌规范化诊疗公益培训及女性乳腺健康义诊在上海启动。

据专家志愿医疗队队长,中国抗癌协会乳腺癌专业委员会青委主任委员刘红教授介绍,此次活动将聚焦改善贫困地区基层医疗技术以及贫困地区女性健康。中国抗癌协会乳腺癌专业委员会将组织乳腺诊疗全国知名专家及中青年医生组成“专家志愿医疗队”下到基层,前往全国偏远贫困地区,如榆林清涧县、榆林子洲县、临汾大宁县、临汾永和县等20个城市、地区,开展乳腺癌规范化诊疗公益培训及女性乳腺健康义诊活动。该活动希望通过整合区域内医疗资源,促进优质医疗资源下沉,加强乳腺专科医联体的建设,提升完善基层医疗服务能力,为进一步推进落实分级诊疗夯实基础。

国家卫生计生委人口宣教中心主任姚宏文表示,加强贫困地区健康促进工作是健康扶贫的重要内容,如何改善贫困地区医疗卫生机构服务条件,提升基层贫困地医疗机构服务能力,缩小区域间卫生资源配置差距,是中央对扶贫开发工作的重点要求。健康扶贫需要多部门政策支持和全社会共同参与。

启动仪式上,中国抗癌协会乳腺癌专委会宣布搭建“乳此美丽,愈见未来”乳腺癌疾病教育线上H5平台,重点城市适龄女性及乳腺癌患者可以通过线上H5报名参与公益义诊和筛查活动,了解当地乳腺癌HER2基因检测中心,获取乳腺癌防治等相关信息。

此外,《全国HER2阳性乳腺癌诊疗认知》调研也将在今年同步展开,该调研旨在多角度了解目前我国HER2阳性乳腺癌认知、诊疗情况,为制定规范化诊疗政策提供重要参考,为调整医疗资源结构布局,提升当地医疗服务体系整体效能提供基础数据。

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    2018-03-14 明月清辉

    谢谢分享.学习了

    0

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    2018-03-14 13718711b3m

    学习了.获益匪浅.感谢分享

    0

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目前仅有骨转移(BO)的乳腺癌患者(MBC)的比例和结局尚未很好描述其特征。而近日在著名肿瘤学杂志JCO上发表的一篇文章则试图描述BO的MBC患者在临床试验中的不同结局,并探讨研究者与盲法独立中央评估之间是否存在放射学读数差异。

Nat Commun:ctDNA检测有助于预测药物对乳腺癌患者的有效性

循环肿瘤DNA(ctDNA)是肿瘤活检的一种替代指标,可用于评估驱动基因突变,如肺癌中的EGFR,还可以评估多发转移患者的克隆演变。目前多是用于癌症早期筛查研究。最新一项研究发现,ctDNA检测可以预测激素受体阳性、her2阴性乳腺癌患者对CDK4/6抑制剂palbociclib 的反应。

Int J Cardiol:蒽环类和曲妥珠单抗治疗乳腺癌后心脏效应的晚期特征!

由此可见,使用先进的CMR,当代化疗方案表现出最小的长期心脏毒性。这项研究表明这些患者在化疗12个月后应限制系列成像检查。

Oncologist:Ki67--新辅助化疗后未达pCR乳腺癌患者的标志物

不同分子亚型的乳腺癌预后不同。既往利用病理学完全缓解(pCR)来预测预后,但对某些分子亚型并不适用,因此找到替代标志物尤为必要。墨西哥一项研究表明,新辅助化疗(NAC)后残余肿瘤中Ki67降低是DFS和OS显著的预后因素。结果近日在线发表于《The Oncologist》杂志。

Nature:针刺疗法:癌症患者的止痛良方还是安慰剂?

一项大型研究表明,针刺或能缓解患癌女性因治疗引起的疼痛。

专访:柳光宇:为乳腺癌患者重塑“完整”人生

在复旦大学附属肿瘤医院,上午的门诊号一直看到下午不是什么新鲜事。作为乳腺外科主任医师,柳光宇忙着看诊、忙着查房、忙着手术。用一位患者的话说,就是看着“挺心疼”。这位患者和他接触不过两个月,从门诊到手术直到现在选择化疗方案,“柳医生不喜欢拐弯抹角,有什么问题就直接问,他会站在你的立场上帮忙解决。”让重塑的乳房有“感觉”乳腺癌患者的5年总生存率在肿瘤医院已经超过90%,这要归功于医学技术的发展以及人们