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ER、PR、HER2阴性(三阴性)乳腺癌的流行病学、危险因素以及临床治疗方法

Authors
Carey K Anders, MD
Lisa A Carey, MD
Section Editor
Daniel F Hayes, MD
Deputy Editor
Don S Dizon, MD, FACP
Translators
樊英, 副主任医师

引言

三阴性乳腺癌(triple-negative breast cancer, TNBC)定义为不表达雌激素受体(estrogen receptor, ER)、孕激素受体(progesterone receptor, PR)及人表皮生长因子受体2(human epidermal growth factor receptor 2, HER2)的乳腺癌。这类乳腺癌比其他类型乳腺癌表现出更强的侵袭性。不同于其他乳腺癌亚型(即ER阳性、HER2阳性的亚型)，TNBC除了给予化疗外没有可用的靶向治疗。尽管诊断和治疗TNBC的基本原则与一般性的乳腺癌相似，但TNBC在许多方面(包括危险因素、分子和病理学特征、自然病程以及化疗敏感性)都很独特，这些情况将总结在此。

关于非转移性乳腺癌的手术治疗、新辅助化疗、辅助化疗及转移性乳腺癌的治疗的更广泛讨论见其他专题。

流行病学

TNBC大约占全球已诊断乳腺癌的20%，每年总计发生近200,000例[1]。与激素受体阳性的乳腺癌相比，TNBC在40岁以下的女性中更常被诊断出。在一项研究中，40岁以下女性患TNBC的归因危险度是50岁以上女性的2倍(OR 2.13，95%CI 1.34-3.39)[2]。此外，与白人女性相比，TNBC似乎在黑人女性中更常见(OR 2.41，95%CI 1.81-3.21)[2]。

与TNBC诊断相关的危险因素包括：

                      

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-06.
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