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Local-regional radiation therapy is one of the major therapeutic means in the management of breast cancer. Three questions however arise from the important advances achieved in this domain in the past years. The first question concerns the possibilities to identify and overcome the radioresistance of a subset of tumours. The second question is how to recognize women likely to benefit from adjuvant radiation therapy, and therefore to diminish treatment indications in other groups. Finally, the third question is how to identify subjects at high risk for long term injury following breast irradiation, in order to adapt techniques and indications in such populations. The major advances of breast cancer molecular genetics in the past years should provide clinicians with tools to answer these important questions. In this paper, we review the molecular germline (BRCA1, BRCA2, ATM, ...) and somatic (p53, tyrosine kinase receptors, as well as actors of cell cycle, signal transduction, apoptosis, DNA repair ...) main bases of breast cancer radiosensitivity. Recent methods of exploration of the genetic background of both the host and the tumours (gene and protein expression profiles) are also reviewed as major tools of breast cancer management in the next few years.
机译:局部区域放射治疗是乳腺癌治疗中的主要治疗手段之一。然而,过去几年在该领域取得的重要进展提出了三个问题。第一个问题涉及识别和克服一部分肿瘤的放射抗性的可能性。第二个问题是如何识别可能受益于辅助放射治疗的女性,从而减少其他人群的治疗指征。最后,第三个问题是如何识别乳房照射后长期受伤的高风险受试者,以适应此类人群的技术和适应症。过去几年中,乳腺癌分子遗传学的重大进展应为临床医生提供回答这些重要问题的工具。在本文中,我们综述了分子种系(BRCA1,BRCA2,ATM等)和体细胞(p53,酪氨酸激酶受体,以及细胞周期,信号转导,细胞凋亡,DNA修复...等)的主要基础对乳腺癌的放射敏感性。近年来,探索宿主和肿瘤遗传背景(基因和蛋白质表达谱)的最新方法也被视为乳腺癌管理的主要工具。

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