2012年EMSO乳腺癌复发和转移的诊断、治疗、随访指南

Breast cancer is the most common cancer in women in almost all countries, including developing countries. In 2008, 1 380 000 new cases and 458 000 breast cancer deaths were noted in the world and 332 000 new cases/89 000 deaths in the European Union. The age-standardized incidence in Europe was 62.8/100 000 and the mortality—16.7/100 000 women/year. Since 1990, the incidence rate has increased 1.5% annually. Owing to advances both in early detection and in adjuvant systemic therapy, mortality rates from breast cancer have been decreasing steadily in most Western countries since the early 1990s. However, it is still the leading cause of cancer death in women in both developing (269 000 deaths, 12.7% of total) and developed (189 000 deaths, 15.5% of total) regions. Approximately 5% to 10% of breast cancers are metastatic at diagnosis; of these, approximately one-fifth will survive 5 years. Depending on prognostic factors, up to 30% of node-negative and up to 70% of node-positive breast cancers will relapse. The

prevalence of metastatic disease is high because many women live with this  disease for several years; there is however, a major lack of accurate data on this prevalence in the great majority of countries since most cancer registries do not capture relapses. As there are significant variations in outcomes of early breast cancer among different regions, the burden of metastatic breast cancer (MBC) may differ from that of early disease.