乳癌是本港的頭號女性癌症，每14位婦女便有1人最終會患病¹，而在2019年已有逾4700宗新症²。幸而隨著癌症治療不斷進步，乳癌治療也大有進展，即使病情已進入較晚期階段，仍可以透過精準及針對性的治療方案，為病人帶來更理想的療效及生活質素³。

現時治療乳癌的方法有很多選擇，包括手術、電療、化療、荷爾蒙治療、標靶治療以至免疫治療等等。正因為選項多多，如何選擇並不簡單，醫生會視乎病人的癌症期數、腫瘤生物標記的特徵，以及身體狀況等因素，建議合適的個人化治療計劃⁴。

以佔乳癌約兩成個案的HER2乳癌為例，這類乳癌帶有較高水平的HER2生長因子，刺激癌細胞快速生長及惡化，所以通常是惡性較高及較易擴散的乳癌，而處理時亦一般會採用抑制HER2的標靶藥作為治療的主力，配合化療使用⁵，可以提升治療的效果，改善病人的無惡化存活及整體存活期⁶。

針對HER2乳癌的標靶藥亦有多種，例如單株抗體、酪胺酸激酶抑制劑⁶，近年更有新一代的抗體藥物複合體（antibody-drug conjugate）⁷。這類新型藥物結合了HER2標靶藥及化療藥，當中的標靶藥部分可找出及依附在癌細胞表面的HER2受體，然後釋放化療藥物對付癌細胞。由於藥物較直接對癌細胞發揮作用，比一般的化療藥更加精準，療效亦更佳⁷。

化療藥物一併影響快速生長的癌細胞及正常細胞，常見副作用包括嘔吐作悶及疲倦⁸等，但它始終是乳癌治療的重要一環。幸好現時用於舒緩副作用及相關不適的輔助藥物十分有效，加上針對HER2的治療令腫瘤的控制更為理想，減少由腫瘤惡化而產生的不適，都有助提高病人的生活質素⁷。

至於另兩類乳癌則為HR+(荷爾蒙受體陽性)及沒有HER2也非HR+的三陰性乳癌，前者會用到荷爾蒙治療，後者則以化療為主⁹，醫生亦可根據臨床需要加入其他治療。

患上乳癌固然令人不安，但病人毋須過份憂心，現時有不同類型的治療，無論是早期個案，還是病情已進入較晚期，都可透過適當的治療幫助控制病情⁹。

此文章由香港第一三共和阿斯利康香港支持

HK-8064 14/11/2022

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Reference:

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