摘要：
近年来,随着对乳腺癌筛查的重视以及乳腺癌诊疗技术的提高,我国乳腺癌患者的5年生存率显著提高,患者生存时间显著延长.乳腺癌患者术后治疗及随访过程中,由于治疗引起的不良反应或乳腺癌患者年龄、激素水平等自身因素的变化所导致的种种问题,已成为乳腺癌患者管理的新难题,其不仅影响到患者的生活质量,甚至转化为疾病复发和死亡风险.乳腺癌患者的管理不应局限在乳腺癌诊断治疗的过程和乳腺癌这一单学科,而是全程跟踪、整体干预,这对于提高患者的治疗效果,最大限度减少疾病对患者将来可能带来的各方面影响,提升患者健康水平和生存质量均有重大意义.基于当前中国乳腺癌患者的治疗及随访现状,根据相关文献及指南起草乳腺癌随访及伴随疾病全方位管理指南,包括随访路径图、随诊随访管理、伴随疾病及不良反应管理4个部分,旨在规范乳腺癌患者的长期随访,指导临床医师积极处理乳腺癌患者在术后随访期间的伴随疾病及不良反应,从而进一步提高中国乳腺癌患者的预后和生活质量.%In recent years, with the emphasis on breast cancer screening and the improvement of breast cancer diagnosis and treatment, five-year survival rate and the overall survival time of breast cancer patients have been significantly improved in China. The adverse events caused by patients′ age, changes in hormone levels or anti-cancer treatment during follow-up have become new challenges in the management of patients with breast cancer, not only affecting the quality of life, but also impacting disease recurrence and death. The management of patients should not be restricted to the diagnosis and treatment of breast cancer, but to a most comprehensive management. This could improve the therapeutic efficacy of anti-cancer treatment and the quality of life of patients. Based on the current landscape of treatment and follow-up of breast cancer patients in China, the experts committee drafted the "Comprehensive Management Guideline for Breast Cancer Follow-up and Concomitant Diseases" according to the literature and relevant guidelines. This guideline is composed of four parts: path diagram, follow-up management, concomitant diseases and adverse events management. It aims to standardize the long-term follow-up of breast cancer patients, guide clinicians to deal with the concomitant diseases and adverse events, and further improve the prognosis and quality of life of breast cancer patients in China.
