文章：

乳腺癌的药理学预防：现有证据、挑战与未来方向

Pharmacological Prevention in Breast Cancer: Current Evidence, Challenges, and Future Directions

原文发布日期：7 November 2025

DOI: 10.3390/cancers17223597

类型: Article

开放获取: 是

英文摘要：

Background/Objectives:Pharmacological prevention is an evidence-based strategy to reduce the incidence of hormone receptor-positive breast cancer in high-risk women. Despite strong data from randomized trials, clinical uptake remains low. This review aims to summarize the efficacy, safety, and clinical implementation of pharmacoprevention and explore novel approaches to improve uptake.Methods: A comprehensive literature review was conducted on pharmacologic agents used for breast cancer risk reduction, including selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). The review also examines risk assessment models, guideline recommendations, barriers to implementation, and emerging strategies such as low-dose therapies and digital decision aids.Results: Tamoxifen, raloxifene, and AIs significantly reduce the incidence of estrogen receptor-positive breast cancer in high-risk populations. However, adverse effects and poor awareness limit their use. Personalized risk models and newer approaches, including low-dose tamoxifen, digital health tools, and emerging agents such as SERDs and GLP-1 receptor agonists, may improve acceptability and adherence.Conclusions: Pharmacoprevention offers substantial benefits in appropriately selected women. Future efforts should focus on new drugs, precision risk stratification, individualized decision-making, and overcoming barriers to implementation to maximize the impact of preventive strategies in breast cancer control.

摘要翻译： 

**背景/目的：** 药物预防是一种基于证据的策略，旨在降低高危女性激素受体阳性乳腺癌的发病率。尽管随机试验提供了有力数据，但其临床应用率仍然较低。本综述旨在总结药物预防的疗效、安全性及临床实施情况，并探讨提高应用率的新方法。 **方法：** 对用于降低乳腺癌风险的药物进行了全面的文献综述，包括选择性雌激素受体调节剂（SERMs）和芳香化酶抑制剂（AIs）。同时，综述还评估了风险评估模型、指南建议、实施障碍以及新兴策略（如低剂量疗法和数字化决策辅助工具）。 **结果：** 他莫昔芬、雷洛昔芬和AIs能显著降低高危人群中雌激素受体阳性乳腺癌的发病率。然而，不良反应和认知不足限制了其应用。个性化风险模型及新策略（包括低剂量他莫昔芬、数字健康工具以及SERDs和GLP-1受体激动剂等新兴药物）可能提高药物的可接受性和依从性。 **结论：** 药物预防对适当选择的女性具有显著益处。未来工作应聚焦于新药研发、精准风险分层、个体化决策以及克服实施障碍，以最大限度发挥预防策略在乳腺癌控制中的作用。

原文链接：

Pharmacological Prevention in Breast Cancer: Current Evidence, Challenges, and Future Directions