2025年改变早期乳腺癌临床实践的重要研究成果及展望OA

With the optimization of tumor screening strategies and increasing public health awareness,the proportion of early breast cancer diagnoses has continued to rise.High-quality clinical studies provide the evidence for clinical guidelines and expert consensus and drive continuous refinement of early breast cancer management.Based on updates of domestic and international breast cancer guidelines and consensuses in 2025,this article reviews key studies that have influenced clinical practice.In local treatment,the INSEMA study confirmed the non-inferiority of omitting surgical axillary staging in clinically node-negative T1-T2 patients;the COMET study explored active surveillance in low-risk ductal carcinoma in situ;and the BRCA BCY Collaboration study demonstrated improved long-term survival in young patients with germline BRCA mutations undergoing prophylactic surgery.IMPORT LOW,HYPART,and NSABP B-51 supported individualized radiotherapy fields and fractionation strategies.In the neoadjuvant setting,neoCARHP and CompassHER2-pCR supported de-escalated strategies based on dual human epidermal growth factor receptor 2(HER2)blockade in HER2-positive early breast cancer,while DESTINY-Breast11 showed that trastuzumab deruxtecan(T-DXd)combined with dual blockade further improved pathological complete response in high-risk patients.In triple-negative breast cancer,the PLANeT study explored the feasibility of low-dose pembrolizumab combined with chemotherapy.In the adjuvant setting,long-term follow-up of APHINITY and KATHERINE reinforced the roles of dual HER2 blockade and trastuzumab emtansine(T-DM1)in high-risk HER2-positive disease,while DESTINY-Breast05 demonstrated improved invasive disease-free survival with T-DXd in patients with residual disease after neoadjuvant therapy.In hormone receptor-positive breast cancer,the EBCTCG meta-analysis and the monarchE and NATALEE studies supported intensified endocrine therapy combined with CDK4/6 inhibitors in high-risk populations,whereas TAILORx and ASTER 70s refined chemotherapy decision-making by age and genetic risk.Regarding comprehensive patient management,the POSITIVE study showed that temporary interruption of endocrine therapy to achieve pregnancy under strict monitoring was feasible in selected young patients,and the EUROPA study compared single-modality radiotherapy and endocrine therapy in older low-risk patients from a health-related quality-of-life perspective.Overall,key studies in 2025 advanced precision local treatment,risk-adapted systemic therapy,and comprehensive patient management,with evidence increasingly translated into guideline recommendations for individualized early breast cancer care.