Breast cancer (BC) is the most prevalent malignancy in women worldwide. Despite most cases being diagnosed in the early stages, patients typically require a multimodal treatment approach. This typically involves a combination of surgery, radiotherapy, systemic treatments (including chemotherapy or immunotherapy), targeted therapy, and endocrine therapy, depending on the disease subtype and the risk of recurrence. Moreover, patients with BC and germline mutations in the breast cancer genes 1 or 2 (BRCA1/BRCA2), (gBRCAm), who are typically young women, often require more aggressive therapeutic interventions. These mutations present unique characteristics that necessitate a distinct treatment approach, potentially influencing the side effect profiles of patients with BC. Regardless of the clear benefit observed with these treatments in terms of reduced recurrence and mortality rates, long-term, treatment-related adverse events occur that negatively affect the health-related quality of life (HRQoL) of BC survivors. Thus, long-term adverse events need to be factored into the treatment decision algorithm of patients with early BC (eBC). Physical, functional, emotional, and psychosocial adverse events can occur and represent a significant concern and a challenge for clinicians, patients, and their families. This review article provides an overview of the various long-term adverse events that patients with eBC may experience, including their associated risk factors, as well as management and prevention strategies. We also explore the evidence of the long-term impact of treatment on the HRQoL of patients with gBRCAm. By providing a comprehensive overview of current evidence and recommendations regarding patients’ HRQoL, we aim to equip clinicians with scientific and clinical knowledge and provide guidance to optimize care and improve long-term outcomes.
乳腺癌是全球女性中最常见的恶性肿瘤。尽管大多数病例在早期阶段被诊断，患者通常需要多模式治疗方案。根据疾病亚型和复发风险，这通常涉及手术、放疗、全身治疗（包括化疗或免疫治疗）、靶向治疗和内分泌治疗的组合。此外，携带乳腺癌基因1或2（BRCA1/BRCA2）种系突变（gBRCAm）的乳腺癌患者（通常为年轻女性）往往需要更积极的治疗干预。这些突变具有独特特征，需要采取不同的治疗策略，并可能影响乳腺癌患者的副作用特征。尽管这些治疗在降低复发率和死亡率方面显示出明确益处，但长期治疗相关不良事件的发生会对乳腺癌幸存者的健康相关生活质量产生负面影响。因此，在早期乳腺癌患者的治疗决策中需要考虑长期不良事件。身体、功能、情感和社会心理方面的不良事件可能发生，对临床医生、患者及其家庭构成重大关切和挑战。本综述概述了早期乳腺癌患者可能经历的各种长期不良事件，包括相关风险因素以及管理和预防策略。我们还探讨了治疗对gBRCAm患者健康相关生活质量的长期影响证据。通过全面梳理当前关于患者健康相关生活质量的证据和建议，我们旨在为临床医生提供科学和临床知识，并为优化护理和改善长期预后提供指导。
肿瘤(癌症)患者之家