Oncology Frontier: What are the effective prognostic and predictive factors for local recurrence in early breast cancer?

　　《肿瘤瞭望》：早期乳腺癌局部复发的有效预后预测因素有哪些？

　　Dr Cyr: In terms of risk factors for local recurrence， younger women are at higher risk of local recurrence regardless of the surgery they undergo. Women who have more aggressive subtypes of breast cancer， like ER-negative breast cancer， are at higher risk for local recurrence. And those in the more advanced stages. Also margins that are positive are also a risk factor for local recurrence.

　　Cyr博士：以下乳腺癌患者的局部复发风险较高：其一是年轻患者，无论她们接受什么样的手术其局部复发风险都比较高；其二是侵袭性强的乳腺癌亚型，比如雌激素受体阴性乳腺癌；其三是分期较高的肿瘤；其四，手术切缘阳性也是乳腺癌局部复发的风险因素。

　　Oncology Frontier: For patients who have positive nodes before neoadjuvant chemotherapy that become pathologically negative after chemotherapy， can local regional radiotherapy be omitted after mastectomy or tumor resection?

　　《肿瘤瞭望》：若淋巴结阳性早期乳腺癌在新辅助化疗后为淋巴结阴性，术后（乳房切除术或肿瘤切除术）可否不行局部放疗？

　　Dr Cyr: This we don’t know yet. We have a couple of studies underway right now specifically looking at that question. In general， our radiation oncologists are radiating women who do have positive lymph nodes even if they have converted to node-negative after neoadjuvant therapy， but there is a study specifically looking at that question. Women who are treated with neoadjuvant chemotherapy， if they convert to being node-negative after chemotherapy， we have them randomized to receive axillary lymph node radiation versus not. Hopefully we will have that answer but we don’t have it just yet. Right now though， most of us err on the side of radiating.

　　Cyr博士：这一点我们还不清楚。关于这个问题目前有一些进行中研究。按照目前的做法，即使淋巴结阳性患者在新辅助化疗后转为淋巴结阴性，一般情况下还是需要进行放疗，目前大多数观点支持放疗。关于这些患者是否能省略放疗，目前有一个专门的研究，研究者把新辅助化疗后淋巴结阴性的患者随机分入两组：一组患者接受腋窝淋巴结放疗，另一组不进行放疗。但目前还没有获得研究结果。