活動日期：114年08月16日(週六)12:30-17:20(含課前及課後測驗時間)   課程直播過程如有異常請及時洽詢台灣乳房醫學會(02-2523-9118；bcst@ms46.hinet.net)
活動地點：線上直播。
主辦單位：台灣乳房醫學會
指導單位：衛生福利部國民健康署
課程表：課程總表；第四場課表
乳e學院介面操作手冊：請點此下載操作手冊

本堂課程認證學分申請中，如以下：
1.台灣乳房醫學會：5分
2.台灣外科醫學會：1積點
3.台灣醫學會：4.2分
4台灣護理學會：3.6分
5.台灣專科護理師學會：專科護理師2分
6.中華民國醫事放射學會：4.2分
7.中華民國放射線醫學會：1積點
8.中華民國癌症醫學會：腫瘤內科A類3學分、腫瘤外科A類3學分
9.中華民國醫用超音波學會：5分
10.公務人員時數：4小時
11.國民健康署疑異(疑陽)時數：4小時 
12.國民健康署乳篩時數：2小時 (本系列課程共同認列乳篩時數，當年度累積上限為3小時，且共計於年底一併上傳時數，詳細資訊請洽相關單位)

• 備註：
  本乳e學院平台系統中「積分登錄期間」係指學員於該時段完成課程，得獲取時數積分認證資格；「課程開放閱讀期間」係指包含報名、預習、複習等課程開放時段，惟複習等僅作為個人學習，並不包含測驗以及積分認證。
  若欲取得本堂課時數積分，請務必於「積分登錄期間」註記時間內參與並完成課程。

In hormone receptor-positive (HR+) breast cancer, the tumor immune microenvironment (TIM) is uniquely shaped by estrogen signaling, which not only suppresses immune activity but also fosters a microenvironment conducive to late recurrence. This makes late recurrence a critical issue that must not be underestimated in these patients. 

Estrogen promotes immunosuppressive mechanisms, such as polarizing macrophages toward the M2 subtype and enhancing Tregs and myeloid-derived suppressor cells (MDSCs). Conversely, CDK4/6 inhibitors and endocrine therapies offer a dual benefit: they block estrogen signaling while also reshaping the TIM. CDK4/6 inhibitors, in particular, have shown promise in triggering anti-tumor immunity and reducing recurrence risk. Excitingly, ongoing research is exploring how different CDK4/6 inhibitors uniquely modulate the TIM, potentially paving the way for more precise and effective treatment strategies in HR+ breast cancer.

Sacituzumab Govitecan (SG; Trodelvy) is a targeted therapy designed for adults with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) who have received hormone therapy and at least two additional treatments for metastatic disease. It is an antibody-drug conjugate that binds to the Trop-2 antigen, delivering a potent chemotherapy directly to cancer cells6. Clinical trials have demonstrated that SG significantly improves progression-free survival and overall survival compared to traditional chemotherapy in this patient population. This therapy offers a new treatment option for patients with HR+/HER2- MBC, who historically have had limited treatment choices and poor survival outcomes. SG's mechanism of action and clinical efficacy make it a valuable addition to the treatment landscape for this challenging form of breast cancer.

誠摯歡迎各位學員於11月19日(二)18:40登入乳e學院並”加入我的課程+”，收看聆聽講師們分享2024 ESMO治療最新趨勢

2025乳房醫學線上研討會，今年度共3場會議，將於6/27, 7/25, 08/29，在乳e學院線上進行，歡迎有意報考乳房專科醫師的學員及各位會員踴躍上網觀看影片!

In this session, to define the risk of recurrence there are multi-factors like tumor size, lymph node status, age, and genetic testing in assessing the risk for hormone receptor-positive early breast cancer patients.

In Part I, focuses on the impact of tumor size and lymph node status on high and low risk. A cross-generational study involving 151 clinical trials and over 150,000 patients shows that recurrence risk persists over time despite advancements in medication.

Although the more lymph node metastasis, the higher the recurrence risk, a 2024 ASCO retrospective study from MSKCC indicates a 3-year recurrence risk of 8.5% and a 5-year risk of 17.4% and 7 year risk of 25.7 in re-define high risk N0 population.

In part 2, focuses on discussing the impact of age and genetic testing on the risk for hormone receptor-positive early breast cancer patients.

Age is a significant prognostic factor, with younger patients having relatively poorer prognosis.

Genetic tests (e.g., Oncotype DX, MammaPrint, Prosigna, EndoPredict, Breast Cancer Index) are used to predict patient risk and guide treatment decisions.

Personalized treatment plans are developed based on age and genetic test results with more consideration treatment schedule needed.