Avancés dans le traitement adjuvant du cancer du sein à haut risque : une approche clinique canadienne
Résumé
Le cancer du sein demeure la deuxième cause de décès par cancer chez les femmes au Canada. Au stade précoce de la maladie, l’objectif des traitements adjuvants, après résection chirurgicale, est de réduire le risque de récidive. L’avènement de l’hormonothérapie (HT) adjuvante a permis de réduire considérablement la récidive et la mortalité liées au cancer du sein. Par contre, certaines patientes présentent une récidive de la maladie même 20 ans après le diagnostic initial. Plusieurs avancées ont donc été réalisées afin d’optimiser les taux de guérison et améliorer les résultats à long terme. Les issues du cancer du sein, en tant que maladie hétérogène, sont influencées par des caractéristiques cliniques, histologiques et génomiques, qui guident le pronostic et la sélection du traitement adjuvant. Cette revue se concentrera sur les traitements adjuvants récents et émergents, en particulier pour les patientes à haut risque, pour tous les sous-types de cancer du sein : cancer du sein à récepteurs hormonaux positifs (RH+), cancer du sein à récepteur de type 2 du facteur de croissance épidermique humain positif (HER2+) et cancer du sein triple négatif (CSTN).
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