中国乳腺癌相关心脏病诊疗共识（2022年版）

沈赞; 邵志敏; 中华医学会肿瘤学分会肿瘤支持康复治疗学组; 中国乳腺癌相关心脏病诊疗共识编写委员会

doi:10.19401/j.cnki.1007-3639.2022.10.010

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中国乳腺癌相关心脏病诊疗共识（2022年版）

指南与共识 | 更新时间：2025-12-31

- 中国乳腺癌相关心脏病诊疗共识（2022年版）
- Chinese consensus of cardio-oncology in breast cancer
- 中国癌症杂志 2022年32卷第10期页码：1016-1036
- 作者机构：
  
  1. 上海交通大学附属第六人民医院肿瘤内科，上海 200233
  2. 复旦大学附属肿瘤医院乳腺外科，上海 200032
- 作者简介：
  
  [ "沈赞（ORCID: 0000-0002-7934-4396），主任医师，上海市第六人民医院肿瘤内科行政主任，E-mail:sshenzzan@vip.sina.com香港大学肿瘤学博士，主任医师，上海交通大学博士研究生导师。现任上海交通大学附属第六人民医院肿瘤内科行政主任。担任中华医学会肿瘤分会委员兼肿瘤支持康复治疗学组组长、国家卫健委骨软组织肿瘤合理化用药专家组常委兼秘书、中国医药教育协会疑难肿瘤专委会主任委员、中国宋庆龄基金会肿瘤产学研医联体常务副理事长、擅长乳腺癌内科治疗、骨转移癌及骨和软组织肉瘤的诊治。以第一作者和通信作者身份在SCI收录期刊上发表论文61篇，总影响因子150.7分。作为项目负责人主持国家重点研发专项1项、国家自然科学基金面上项目4项。2008年获上海市高级归国人才计划“浦江人才计划”资助。" ]
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.10.010
  中图分类号： R737.9
- 收稿：2022-08-15，
  
  修回：2022-09-04，
  
  网络出版：2022-10-30，
- 稿件说明：
移动端阅览
沈赞, 邵志敏, 中华医学会肿瘤学分会肿瘤支持康复治疗学组, 等. 中国乳腺癌相关心脏病诊疗共识（2022年版）[J]. 中国癌症杂志, 2022,32(10):1016-1036.

Zan SHEN, Zhimin SHAO, Branch Cancer Support Rehabilitation Therapy Group of Chinese Medical Association Oncology, et al. Chinese consensus of cardio-oncology in breast cancer[J]. China Oncology, 2022, 32(10): 1016-1036.
沈赞, 邵志敏, 中华医学会肿瘤学分会肿瘤支持康复治疗学组, 等. 中国乳腺癌相关心脏病诊疗共识（2022年版）[J]. 中国癌症杂志, 2022,32(10):1016-1036. DOI： 10.19401/j.cnki.1007-3639.2022.10.010.

Zan SHEN, Zhimin SHAO, Branch Cancer Support Rehabilitation Therapy Group of Chinese Medical Association Oncology, et al. Chinese consensus of cardio-oncology in breast cancer[J]. China Oncology, 2022, 32(10): 1016-1036. DOI： 10.19401/j.cnki.1007-3639.2022.10.010.

摘要

乳腺癌和心血管疾病是现代社会的两大“杀手”，严重威胁着中国女性的健康，目前两个学科之间关联共性尚未引起临床医师足够的重视，为相关的跨学科合作实践带来一定困难。因此，对于那些已存在心血管系统疾病或心血管疾病风险的乳腺癌患者，临床医师在进行相关抗肿瘤诊疗时，应用类似乳腺癌干预策略的方法来综合评估相关风险，进行相关心脏毒性的预防及治疗干预。目前不少发达国家，已经建立了肿瘤心脏病专科门诊、病房和对应的多学科治疗团队（multidisciplinary treatment teams，MDT）。而在国内，相关学科发展才刚刚开始。可以预见的是，随着乳腺癌检测和治疗手段的不断进步，会有越来越多的乳腺癌患者获得长期的生存，这意味着其中部分患者必然要面临抗肿瘤治疗相关心脏毒性所带来的并发症的风险。因此，一份具有强有力循证医学证据支持的相关指南和临床共识能够为临床医师提供针对性的随访、监测、治疗流程和有效的管理手段，具有十分重要的临床指导意义。本共识旨在指导临床医师对乳腺癌患者进行相关抗肿瘤治疗（化疗、靶向治疗、手术、内分泌治疗、免疫治疗及放疗）的前提下，将心脏保护作为一个整体进行评估和监测，根据监测的结果决定后续干预手段，并决定是否及何时由心脏科医师进行专业会诊，避免因对乳腺癌相关心脏毒性认识不够，导致治疗不及时产生相关不良后果，为中国乳腺癌心脏病诊疗防治提供一份切实可行的临床实践操作流程，最终为改善中国乳腺癌患者的预后作出贡献。

Abstract

Recent advances in the medical oncological treatment options for cancer have led to a clear improvement in the survival rate worldwide; however

many of the recently developed new drugs are directly or indirectly associated with cardiovascular side effects. Cardiovascular diseases are already the most frequent non-cancerous cause of death in tumor patients. Prevention and early detection of these complications

correct management and timely initiation of specific cardiac medical treatment are the keys to improvement of the cardiovascular prognosis. At present

many developed countries have established oncology-cardiology specialist clinics

wards and related multidisciplinary teams (MDT). In our country

development of cardio-oncology has just on the way. With improvement of survival of breast cancer patients

it is reasonable to foresee that more and more breast cancer patients might suffer from cardiovascular disease

which indicates that it is necessary to focus on risk associated with antitumor therapy-related cardiotoxicity. Therefore

an elaborate guideline supported by solid medical evidence is strongly needed for clinicians major in oncology. This consensus provides an overview and comprehensive summary of the possible cardiotoxic side effects of important oncological therapies and offers possible practical strategies with respect to risk stratification

cardiological follow-up care and management approaches for chemotherapy-induced left ventricular dysfunction. We believe this consensus will provide a practical clinical procedures for treatment and prevention of cardio-oncology in breast cancer in China

and make contributions to improvement of outcome of cardiotoxicity in Chinese breast cancer patients.

关键词

Keywords

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