乳腺癌骨转移的诊治VIP免费

乳腺癌骨转移和骨乳腺癌骨转移和骨相关疾病的诊断和治相关疾病的诊断和治疗疗DiagnosisandtreatmentofDiagnosisandtreatmentofbonemetastasisofbreastcancerbonemetastasisofbreastcancer流行病学流行病学EpidemiologyEpidemiology骨转移的比例仅次于肺、肝脏的转移骨转移的比例仅次于肺、肝脏的转移TheratioofbonemetastasisissecondarytolungandTheratioofbonemetastasisissecondarytolungandliverliver通常为通常为多发多发，单发转移者仅占，单发转移者仅占10%10%UsuallyforUsuallyformultiplemultiplebonemetastasis,only10%forbonemetastasis,only10%forsinglesingle80%80%为为中轴骨中轴骨，如脊柱和骨盆，如脊柱和骨盆80%for80%foraxialskeletonaxialskeleton,suchasthespineandpelvis,suchasthespineandpelvis目录目录CatalogueCatalogue一．一．乳腺癌骨转移概述乳腺癌骨转移概述二．二．1.Overview1.Overview三．三．二二..乳腺癌骨转移诊断方法乳腺癌骨转移诊断方法2.Diagnosticmethod2.Diagnosticmethod三三..乳腺癌骨转移临床表现乳腺癌骨转移临床表现3.Clinicalmanifestation3.Clinicalmanifestation四四..乳腺癌骨转移治疗乳腺癌骨转移治疗4.Treatment4.Treatment概述概述OverviewOverview骨转移是乳腺癌骨转移是乳腺癌最常见最常见的的远处转移远处转移部位部位BonemetastasisisBonemetastasisisthemostthemostcommoncommondistantdistantmetastasesinmetastasesinbreastcancerpatientsbreastcancerpatients晚期乳腺癌骨转移发生率为晚期乳腺癌骨转移发生率为65%65%～～75%75%Theincidenceofbonemetastasisinterminalbreastcanceris6Theincidenceofbonemetastasisinterminalbreastcanceris65%5%～～75%75%骨痛、骨相关事件（骨痛、骨相关事件（SREsSREs）及生活质量降低是乳腺癌骨）及生活质量降低是乳腺癌骨转移的常见并发症转移的常见并发症Bonepain,bonerelatedevents(SREs)andreducedqualityoflBonepain,bonerelatedevents(SREs)andreducedqualityoflifearecommoncomplicationsofbonemetastasisofbreastcanifearecommoncomplicationsofbonemetastasisofbreastcancercer参考文献参考文献referencesreferences1.ColemanRE.CancerTreatRev.2001Jun;27(3):165-76.2.JohnR.Johnson,GrantWilliams,etal.JClinOncol21:1404-1411.3.KinnaneN.EurJOncolNurs.2007;1.ColemanRE.CancerTreatRev.2001Jun;27(3):165-76.2.JohnR.Johnson,GrantWilliams,etal.JClinOncol21:1404-1411.3.KinnaneN.EurJOncolNurs.2007;11Suppl2:S28-31.Epub2007Sep4.11Suppl2:S28-31.Epub2007Sep4.诊断方法诊断方法DiagnosisDiagnosis骨转移骨转移初筛初筛诊断方法：骨放射性核素扫描诊断方法：骨放射性核素扫描（（ECTECT））TheThepreliminaryscreeningmethodpreliminaryscreeningmethodofboneofbonemetastasismetastasis：：ECTECT推荐用于出现骨疼痛、骨折、推荐用于出现骨疼痛、骨折、AKPAKP升高、或高钙血升高、或高钙血症等可疑骨转移的常规初筛诊断检查症等可疑骨转移的常规初筛诊断检查Itisrecommendedtobeusedforpatientsofbonepain,Itisrecommendedtobeusedforpatientsofbonepain,fracture,AKPelevation,orhypercalcemiafracture,AKPelevation,orhypercalcemia乳腺癌分期＞乳腺癌分期＞T3N1M0T3N1M0患者常规检查患者常规检查RoutineexaminationofpatientswithbreastcancerstageRoutineexaminationofpatientswithbreastcancerstage>T3N1M0>T3N1M0复发转移乳腺癌复发转移乳腺癌患者的常规检查患者的常规检查RoutineexaminationofpatientswithRoutineexaminationofpatientswithrecurrentrecurrentmetastasismetastasis骨转移的影像学骨转移的影像学确诊确诊检查方法：骨检查方法：骨XX线线/CT/MRI/CT/MRIConfirmedConfirmedRadiographicdiagnosisRadiographicdiagnosisofboneofbonemetastasis:X-ray/CT/MRImetastasis:X-ray/CT/MRI60%-78%60%-78%溶骨性溶骨性破坏、破坏、10%-20%10%-20%成骨性、成骨性、12%-20%12%-20%混合混合性性...