Oligometastatic breast cancer represents an intermediate state between localized and disseminated disease with reasonable potential for clinical cure. Advancements in surgery, radiotherapy, and systemic therapy have improved prognosis. Due to the high prevalence of bone metastases, an increasing number of studies are evaluating new treatment strategies for oligometastatic bone disease. The decision to perform skeletal surgery is complex and depends on optimal patient selection. Major criteria include impending or pathologic long bone fractures, severe neurologic compromise, and an expected survival of over 3 months. Factors associated with improved survival include solitary bone metastases, preserved performance status, adequate surgical margins, absence of pathologic fracture, metachronous metastases, and ER-positivity status. Radiotherapy, especially SBRT, offers effective local control and palliation. Interventional radiology techniques such as percutaneous thermal ablation have also been described as potential treatment alternatives, particularly for fragile patients. Systemic treatment varies according to the tumor subtype. For HR+ and HER2 subtypes, a combination of endocrine therapy with CDK4/6 inhibitors may be considered. HER2+ patients are often treated with HER2-targeted therapies combined with chemotherapy. For triple-negative breast cancer, chemotherapy is the primary treatment. Bone-modifying agents are also recommended to maintain bone strength, prevent skeletal-related events, and reduce the need for additional interventions. Skeletal muscle metastases in breast cancer patients are rare and typically indicate advanced disease with poor prognosis. Treatment options include chemotherapy, radiotherapy, and surgical excision, but should be tailored to the patient’s clinical condition and prognosis.
寡转移性乳腺癌是介于局部病变与广泛播散之间的中间状态，具有临床治愈的合理可能性。外科手术、放射治疗及全身治疗的进步改善了患者预后。由于骨转移发生率较高，越来越多的研究正在评估针对寡转移性骨病的新治疗策略。骨骼手术决策具有复杂性，需基于最佳患者选择。主要标准包括即将发生或已发生的长骨病理性骨折、严重神经功能损害以及预期生存期超过3个月。与生存改善相关的因素包括孤立性骨转移、体能状态良好、手术切缘充分、无病理性骨折、异时性转移以及雌激素受体阳性状态。放射治疗特别是立体定向放射治疗能提供有效的局部控制和症状缓解。介入放射学技术如经皮热消融术也被认为是潜在治疗选择，尤其适用于体质脆弱患者。全身治疗方案因肿瘤亚型而异：激素受体阳性及HER2阳性亚型可考虑内分泌治疗联合CDK4/6抑制剂；HER2阳性患者常采用HER2靶向治疗联合化疗；三阴性乳腺癌则以化疗为主要治疗手段。同时推荐使用骨改良药物以维持骨强度、预防骨相关事件并减少额外干预需求。乳腺癌患者骨骼肌转移较为罕见，通常提示疾病晚期且预后不良，治疗方案包括化疗、放疗和手术切除，但需根据患者临床状况及预后进行个体化调整。
Management of Musculoskeletal Oligometastatic Disease in Breast Cancer
肿瘤(癌症)患者之家