Endless learning, re-exhibition: 2022 breast tumor elite practice and exchange project - Guizhou Station, kicked off!

In order to promote the progress of standardized diagnosis and treatment of breast cancer and promote in-depth and extensive exchanges in the field of breast cancer, the "2022 Breast Tumor Elite Practice and Exchange Project" sponsored by the China Medical Education Association is scheduled to be held offline nationwide from June to December 2022, and will be broadcast live online to provide a platform for doctors to share and learn, so as to further improve the diagnosis and treatment level and work efficiency in the field of breast cancer in China, so as to benefit the majority of female breast
。

The Guizhou station of this project kicked off on August 12, and the conference invited famous experts from the industry as chairmen: Professor Liu Dequan of Yunnan Cancer Hospital, Professor Luo Ke of the Affiliated Hospital of Guizhou Medical University, Professor Chen Ling of the First Affiliated Hospital of Xi'an Jiaotong University, Professor Fang Yanman of Guiyang Maternal and Child Health Hospital, Professor Liu Yufei of Tongren People's Hospital, and Professor
Zhang Li of the Affiliated Hospital of Guizhou Medical University.
The four speakers were Dr.
Wang Xiaolong from Xi'an International Medical Center Hospital, Dr.
Zhang Yonglin from the Affiliated Hospital of Guizhou Medical University, Dr.
Liu Yang from Yunnan Cancer Hospital and Dr.
Wang Minkai from the Third Affiliated Hospital of Guizhou Medical University.

(Chair: Professor Liu Dequan, Yunnan Cancer Hospital)

(Chair: Professor Luo Ke, Affiliated Hospital of Guizhou Medical University)

(Guest: Professor Chen Ling, The First Affiliated Hospital of Xi'an Jiaotong University)

(Commentator: Professor Fang Yanman, Guiyang Maternal and Child Health Hospital)

(Commentator: Professor Liu Yufei, Tongren People's Hospital)

(Guest: Professor Zhang Li, Affiliated Hospital of Guizhou Medical University)

Conference scene: wonderful sharing of cases

Case 1 Sharing: Xi'an International Medical Center Hospital - Dr.
Wang Xiaolong

This is a 51-year-old patient with stage VI HR+ and Her-2+ breast malignancies diagnosed on September 20, 2020
.
TCbHP chemotherapy was performed on September 30, and the efficacy was rated as CR
on February 26, 2021.
Capecitabine + double target was given from March 19 to June 20 and surgery
on July 23.
Multiple studies have demonstrated that fulvestrant is the preferred choice for AI-assisted endocrine monotherapy after relapse or metastasis
.
As a result, on August 17, 2021, we started using fulvestrant + dual target + exemetane, and the treatment regimen has been maintained until now, and the patient's condition is stable
.
Through the diagnosis and treatment process of this case, it can be seen that for patients with recurrent or metastatic advanced breast cancer, the effect of choosing fulvestrant maintenance therapy is significant
.

Comments:

The speaker gave a fluent speech, clearly expressed the diagnosis and treatment process of the case, the standard of case diagnosis and treatment, the beautiful production of PPT, sufficient data, and the
clear organization of on-site answers.

(Speaker's Highlight Moment: Dr.
Wang Xiaolong, Xi'an International Medical Center Hospital)

Case 2 sharing: Affiliated Hospital of Guizhou Medical University - Dr.
Zhang Yonglin

This is a case of HR+, HER2-advanced breast cancer, 62 years old, menopause, early June 2018, left breast invasive ductal carcinoma (cT2N1M0 stage IIB), HER2 negative
.
From June 2018 to November 2018, AC-T regimen had 8 cycles of chemotherapy, surgical treatment on November 28, postoperative chest wall radiotherapy of 50Gy/25f in January 2019, anastrozole was given from January 2019 to July 2020, and bone metastases
were found in July 2020.
Analyze the cause, which may be related to the patient's primary resistance to previous endocrine therapy
.
According to guideline level I recommendations, for patients with advanced breast cancer after postmenopausal HR+HER- AI therapy failure, the preferred regimen is fulvestrant + CDK4/6 inhibitor.

Therefore, in August 2022, we switched to lovestrant + zoledronic acid, but the patient refused to use CDK4/6 inhibitors for economic reasons, so we were treated with fulvestrant monotherapy with PFS for 25 months
.
It can be seen from the diagnosis and treatment process of this case that the entire diagnosis and treatment conforms to the guideline protocol, and for patients with advanced breast cancer after HR+HER- AI treatment failure after menopause, even if the patient cannot combine CDK4/6 inhibitors, the use of fulvestrant monotherapy can inhibit tumor growth
to a certain extent.

Comments:

The speaker clearly expressed his own views, the case structure was complete, the entire diagnosis and treatment process was in line with the specifications, and the PPT production pictures were clear, which fully reflected the speaker's unique thinking ability
.

(Speaker's Highlight Moment: Dr.
Zhang Yonglin, Affiliated Hospital of Guizhou Medical University)

Case 3 Sharing: Yunnan Cancer Hospital - Dr.
Liu Yang

This is a 53-year-old, menopausal patient with invasive right breast carcinoma cT3N1M0 stage IIIA (HR positive/HER-2 negative), diagnosed
on 10 December 2018.
Preoperative chemotherapy was selected for the TE regimen for a total of 6 cycles
.
Surgery was performed on April 16, 2019, followed by radiotherapy to the chest wall and regional lymph nodes and endocrine therapy with anastrozole, until liver metastases
were detected on February 22, 2021.
For patients with HR+HER-2-negative advanced breast cancer after failure of NSAID-AI therapy, the guideline level I recommends fulvestrant + CDK4/6 inhibitors
.
Therefore, we start using fulvestrant + CDK4/6 inhibitor or fulvestrant
.
On April 10, 2021, liver metastasis, the efficacy was rated as PD.

The MONARCH2 study demonstrated that Abemaciclib + fulvestrant in the treatment of HR+/HER2-premenopausal/perimenopausal/postmenopausal patients with ET-resistant advanced breast cancer had a more pronounced effect than placebo combined with fulvestrant, with a significantly longer median PFS and a more significant benefit
in overall survival.
As a result, from May 2021, we will use fulvestrant + abeccilil
.
Three months after treatment, MRI on August 3 showed that the liver metastases had shrunk and the efficacy was rated as SD, and the condition has been stable
so far.

Comments:

The case description is clear, the expression and the scene are infectious, the speed of speech is stable, the use of concise language, the logical exposition of their views, the PPT is beautifully produced and logically organized, the content is fully based, and the on-site answer is calm and calm
.

(Speaker's Highlight Moment: Dr.
Liu Yang, Yunnan Cancer Hospital)

Case 4 sharing: The Third Affiliated Hospital of Guizhou Medical University - Dr.
Wang Minkai

The patient is 49 years old and initially diagnosed with invasive ductal carcinoma of the right breast, Luminal type A (ER, PR 100%, Her-2 negative)
on 14 January 2019.
At that time, the patient was not treated, and after 2020, multiple bone metastases were found throughout the body, and TAC regimen chemotherapy was performed, and the bone metastases were reduced and shrunk
compared with before chemotherapy.
Surgery in May 2021, postoperative AC regimen chemotherapy for two months, endocrine therapy for 1 year, letrozole, goserelin, fulvestrant
.
New pyramidal lesions
appeared in March and May 2022.
According to the guidelines, patients with HER-2-negative advanced breast cancer who have failed previous AI therapy can be used with fulvestrant + CDK4/6 inhibitors
.

Comments:

The diagnosis and treatment of cases are standardized, the medical records are complete, and the speakers analyze and explain based on professional theoretical knowledge and relevant literature, with clear views and key points, showing meticulous clinical thinking
.

(Speaker's Highlight Moment: Dr.
Wang Minkai, The Third Affiliated Hospital of Guizhou Medical University)

After the multi-angle evaluation of experts and the voting of the audience, Dr.
Liu Yang from Yunnan Cancer Hospital was elected as the best speaker of this conference, and she will also participate in the next stage of sharing to bring you more excellent clinical experience sharing
.

The "2022 Breast Cancer Elite Practice and Exchange Program" provides a platform for clinical breast cancer doctors to exercise themselves, help improve the personal ability and clinical diagnosis and treatment level of young doctors, and look forward to the future work of young doctors to continuously improve their clinical comprehensive ability and protect the mental health
of patients.

(Photo of all experts)