Oncology - Breast Ca

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    ... ..

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    2006 . 50292

    2006 . 22670

    2001 2006 . 11,1%

    .., .., 2004

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    Clinical Oncology 3rd edition. 2004

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    BRCA1\BRCA2

    TP53

    1,5-9

    60-80%

    30-40%

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    16

    50

    1,2

    1,5

    2,0

    4,3 %

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    ,

    10

    , ,

    1,3-1,6

    1,2

    1

    1,1-1,4

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    IGF-1

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    39,0

    13,0

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  • 7/30/2019 Oncology - Breast Ca

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    :

    -

    -

    -

  • 7/30/2019 Oncology - Breast Ca

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    : ,,

    ..

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  • 7/30/2019 Oncology - Breast Ca

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    - FNA, Core-, , - ( )

    :- Rg - -

    :- Rg- - , , - - -153-

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    TNMT

    0

    isin situ

    Tis (DCIS)in situ

    Tis (LCIS)in situ

    Tis (Paget`s)

    T12T1 mic0,1

    T1a - >0,1 , 0,5 , 1 , 2 , 5T4 ()

    (b)

    T4a

    T4b ( ),

    ,

    T4c

    , T4a

    T4b

    T4d

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    TNMN

    Nx(

    )

    N0

    N1

    N2,

    N2a,

    .

    N2b

    N3

    ,

    N3a

    N3b

    N3c

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    TNM

    M

    0M1

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    0 TisN0M0 (in situ)

    I T1N0M0 ,

    IIA 0N1M0

    T1N1M0

    T2N0M0

    2-5

    ,

    ( )

    II B T2N1M0

    T3N0M0

    2-5 ( T3N0M0)

    ,

    (

    ) ( T3N0M0)

    III A T0N2M0

    T1N2M0T2N2M0

    T3N1M0

    T3N2M0

    - ,

    5

    ( T1-3N2M0)

    ( T3N1M0)

    III B T4N0M0

    T4N1M0

    T4N2M0

    III C T N3M0 ,

    IV T N M1

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    N

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    (>35 )

    ( )

    (ER, PR)( )

    (G1-3)

    HER2\neu

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    +\-

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    4 , T4

    \

    / (, )

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    T4

    HER2/neu

    (>35 )

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    AC, CAF, FEC-

    , , -

    6 21-28

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    ( )

    - (, , LH-RH ())

    -

    -

    -

    2-3 , 5 , 3

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    T4

    (>35 )

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  • 7/30/2019 Oncology - Breast Ca

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    , ,

    -

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    (, ) (

    ) (

    ) ( )

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    ()

    40

    30%

    , ,

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    ()

    ER:ERRAR:RXR

    PG E2

    AA

    Ras, Raf

    PI3K

    MAPK, JNK,p38, AKT

    2

    RA

    SERMs

    E2

    EGFHRG

    -

    P.Brown, 2004

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    (SERM)

    IBIS-I

    7000

    20

    /

    5

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    BCTP (), MORE(), IBIS-I ():

    - SERM 32 74%-

    -

    (NSABP P-2 STAR)- (, )

    -

    (SERM)

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    (AI)

    3-

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    (AI)

    ATAC (Arimidex, Tamoxifen Alone or in Combination)

    I II

    +/- +/-

    1 /

    +

    3125

    14

    + 20 /3115

    33

    1 /

    + 20 /3125

    28

    ATAC trialists, 2002

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    (AI)

    AI ER+

    (ATAC BIG 1-98() ( )

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    (AI)

    IBIS-2 MAP-3

    6000

    4500

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    (AI)

    LCIS

    SERM STAR 5

    +

    5

    2,5 5

    +SERM

    5

    NSABP P-4

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    OX-2 ()

    , , 1

    OX-2 DCIS2

    COX-2 ER+

    ER- 3

    1. Howe LR, et al. Cancer Res. 2002, 62:5405-5407

    2. Shim V, et al. Cancer Res. 2003, 63:2347-2350

    3. Harris RE, et al. Cancer Res. 2000, 60:2101-2103

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    OX-2 ()

    -

    -

    , PGE2

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    OX-2 ()

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    ( )

    Veronesi U et al. J Natl Cancer Inst Vol. 91, No. 21, 1847-1856, 1999

    http://www.jncicancerspectrum.oxfordjournals.org/sub-journals/jnci/html/content/vol91/issue21/images/large/5f3.jpeg
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    (RXR)In vitro:

    ER+ ER-

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    -

    GPx

    Hu YL, Diamond A.Cancer Research 63, 3347-3351, June 15, 2003

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