乳腺癌新辅助治疗后外科处理策略

目前手术仍是乳腺癌治疗的重要手段，但患者生存获益显然更得益于多学科综合治疗。新辅助治疗的出现改变了传统的首选手术及大范围切除模式，并且在外科治疗的几个重要里程碑，如保乳手术、前哨淋巴结活检等方面都起到了重要的作用，其作为乳腺癌治疗的地位愈加重要。然而，目前仍有许多有争议的问题缺乏证据支持，如新辅助治疗合理人群及方案的选择、新辅助治疗对手术时机选择的影响等。人们对新辅助治疗后未获益的群体还缺乏关注，这提醒我们，在清醒地认识到新辅助治疗优势的同时，还需规避其在乳腺癌预防及治疗过程中带来的不利影响，合理地应用新辅助治疗，进一步优化乳腺癌治疗模式。

Progress of surgical treatment for breast cancer patients after neoadjuvant therapy

Surgical treatment is still an important approach for breast cancer, but the improved long-term outcome in patients benefits from an systemic therapy. Neoadjuvant therapy has changed the the way of surgical treatment as the preferred choice, and plays an important role in treating breast cancer, such as breast conserving surgery and sentinel lymph node biopsy. However, there are still many controversial issues, since we do not know who will benefit most from the neoadjuvant therapy and who will not, and the impact of delayed surgery on those without benefit from therapy. Therefore, as recognizing the advantages of the neoadjuvant therapy, we should avoid its negative affection to improve the therapy for breast cancer as far as possible.