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Back| 1. Postoperative Recurrence Risk Grouping | |||
|---|---|---|---|
| Risk Level | Lymph Node Metastasis | Others | |
| Low | Negative | Meets all of the following 6 criteria: ① Lesion size (pT) ≤ 2cm; ② Gradea I; ③ No tumor invasion in peritumoral vesselsb; ④ ER and/or PR positive; ⑤ No overexpression or amplification of HER2 genec; ⑥ Age ≥ 35 years | |
| Moderate | Negative | Meets at least 1 of the following 6 criteria: ① Lesion size (pT) > 2cm; ② Grade II~III; ③ Tumor invasion in peritumoral vessels; ④ ER and PR negative; ⑤ Overexpression or amplification of HER2 gene; ⑥ Age < 35 years | |
| 1~3 Positive | ER and/or PR positive and no overexpression or amplification of HER2 gene | ||
| High | 1~3 Positive | ER and PR negative, or overexpression or amplification of HER2 gene | |
| ≥4 Positive | |||
| Note: a: Histological grade/nuclear grade; b: Peritumoral vessel invasion is controversial, it only affects the risk classification of lymph node-negative patients; but does not affect the classification of lymph node-positive patients; c: HER2 testing must be performed by immunohistochemistry or FISH, CISH methods with strict quality control. | |||
| 2. Postoperative Systemic Adjuvant Therapy Selection | |||
|---|---|---|---|
| Risk Level | Systemic Adjuvant Therapy Selection Recommendations | ||
| High Response to Endocrine Therapy | Partial Response to Endocrine Therapy | No Response to Endocrine Therapy | |
| Low Risk | Endocrine Therapy | Endocrine Therapy | Not Applicable for Endocrine Therapy |
| Moderate Risk | Endocrine Therapy Alone or Chemotherapy → Endocrine Therapy | Chemotherapy → Endocrine Therapy or Endocrine Therapy Alone | Chemotherapy |
| High Risk | Chemotherapy → Endocrine Therapy | Chemotherapy → Endocrine Therapy | Chemotherapy |
Notes
Postoperative adjuvant therapy includes chemotherapy, endocrine therapy, and biological therapy. Individualized plans are adopted based on the response to endocrine therapy (i.e., ER expression status) and the grouping of recurrence risk.
