2025年美国国立综合癌症网络和中国临床肿瘤学会乳腺癌指南更新要点对比解读OA

In 2025,the version 4 of the National Comprehensive Cancer Network(NCCN)breast cancer guidelines and the Chinese Soci-ety of Clinical Oncology(CSCO)breast cancer diagnosis and treatment guidelines simultaneously focus on the precision medicine and com-prehensive management of breast cancer,completing core updates supported by new evidence from evidence-based medicine.In this arti-cle,we systematically compares the updated highlights of the two editions of the guidelines in three aspects:molecular typing and biomarker testing,neoadjuvant/adjuvant treament for early breast cancer,and salvage treatment for advanced breast cancer.Through comparison,it was found that the two editions of the guidelines have reached a high degree of consensus on the definition of human epidermal growth factor receptor 2(HER2)low/ultra-low expression,the clinical status of antibody-drug conjugate(ADC)drugs,the expansion of the application scenarios of immunotherapy,and the optimization of the combination strategy of cyclin-dependent kinases 4/6(CDK4/6)inhibitors.At the same time,due to the differences in medical systems,current status of drug accessibility,and population characteristics between China and the United States,there are significant differences in recommendation grading,the priority of treatment options,and localization adaptation strategies between the two editions.By analyzing the evidence behind the guidelines and the underlying reasons for the differences,this paper provides a reference for clinicians to balance international standards and local practices,and helps to unify the standardization,indi-vidualization,and accessibility of breast cancer diagnosis and treatment.