Der Gynäkologe

, Volume 39, Issue 8, pp 618–626

Stadienadaptierte Therapie des Mammakarzinoms

Zum Thema

Zusammenfassung

Jährlich erkranken über 50.000 Frauen in Deutschland an einem Mammakarzinom, 19.000 sterben daran. Durch den Einsatz neuer Therapieformen und optimal aufeinander abgestimmter Therapien ist es auch in Deutschland gelungen, die Mortalität trotz steigender Inzidenz zu senken. Der folgende Artikel verdeutlicht, dass nicht mehr das Erkrankungsstadium für die Therapieentscheidung alleine ausschlaggebend ist; vielmehr müssen die prädiktiven und prognostischen Faktoren miteinbezogen werden. Dies sind neben den Hormonrezeptoren (Östrogen- und Progesteronrezeptoren) der Her-2/ neu -Status. Wenn alle Informationen bereits zum Zeitpunkt der Diagnosestellung vorliegen und die adjuvante Therapie vor der Operation festgelegt werden kann, ist die neoadjuvante Therapie nach den heutigen Erkenntnissen als der adjuvanten Therapie gleichwertig anzusehen. Lokale Therapien (Operation, Strahlentherapie) sind bei der Primärbehandlung bisher unerlässlich. Im Stadium der Fernmetastasierung sind v.a. die Vortherapien und die palliative Zielsetzung zu berücksichtigen.

Schlüsselwörter

Adjuvante/neoadjuvante Therapie Lokale Therapien Metastasiertes Mammakarzinom Prädiktive Faktoren Prognosefaktoren Duktales Carcinoma in situ 

Stage-adapted therapy of breast cancer

Abstract

In Germany more than 50,000 women are newly diagnosed with breast cancer each year of whom 19,000 die. The mortality is decreasing probably because of better and more consequent adjuvant and metastatic treatment rather than increasing incidence. The following article demonstrates that not only the stage of breast cancer but also prognostic and predictive factors, like hormone (estrogen, progesterone) receptor status and the her-2/ neu status, are of the utmost importance when deciding on the adjuvant and metastatic treatment. Neoadjuvant treatment should be considered if all information is available at the time of diagnosis before surgery and the decision on the adjuvant treatment can be made at that time point. Local therapy, such as surgery and radiation are absolutely necessary in the treatment of primary breast cancer. In advanced and metastatic breast cancer the pre-treatment and palliative targets are the main factors which have to be considered.

Keywords

Adjuvant/neoadjuvant treatment Local therapy Metastatic breast cancer Prognostic and predictive factors Ductal carcinoma in situ 

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  • M. Kaufmann
    • 1
  • S. Loibl
    • 1
  • A. Rody
    • 1
  • G. von Minckwitz
    • 1
  1. 1.Klinik für Gynäkologie und GeburtshilfeJohann Wolfgang Goethe-UniversitätFrankfurt

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