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Der Gynäkologe

, Volume 51, Issue 7, pp 556–559 | Cite as

S3-Leitlinie Mammakarzinom: das lokoregionäre Rezidiv

  • Sara Y. Brucker
  • Andreas D. Hartkopf
  • Wolfgang Janni
Leitthema
  • 108 Downloads

Zusammenfassung

Die Behandlung des lokoregionär rezidivierten Mammakarzinoms ist eine interdisziplinäre Herausforderung. Neben operativen Maßnahmen, die in der Regel eine vollständige Resektion zum Ziel haben, sind Strahlentherapie und die Systemtherapie tragende Säulen in der Behandlung. In der neuen S3-Leitlinie wird das Thema in einem eigenen Kapitel behandelt. Als Neuerung im Vergleich zu den vorangegangenen Leitlinien wird betont, dass unter gewissen Voraussetzungen eine erneute brusterhaltende Operation (Re-BEO) möglich ist. Da je nach Tumorbiologie, Tumorstadium und Vorgeschichte ganz unterschiedliche Therapiekonzepte möglich sind, werden individuelle Risikobewertung und Aufklärung in der Leitlinie explizit hervorgehoben.

Schlüsselwörter

S3-Leitlinie Mammakarzinom Lokoregionäres Rezidiv Brusterhaltende Therapie Radiation 

S3 guidelines on breast cancer: locoregional recurrence

Abstract

Treatment of locoregionally relapsed breast cancer is an interdisciplinary challenge. In addition to surgical procedures, which usually aim for a complete resection, radiotherapy and systemic therapy are essential pillars of treatment. The topic is dealt within a separate chapter in the new German S3 guidelines. Compared to previous guidelines, it is emphasized that under certain conditions breast-conserving can be reconsidered. Depending on tumor biology, tumor stage and medical history, various therapy concepts are possible. This is why individual risk assessment and patient information are highlighted in the guidelines.

Keywords

S3 guidelines Breast carcinoma Locoregional relapse Breast-preserving therapy Radiation 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S.Y. Brucker, A.D. Hartkopf und W. Janni geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA (2016) American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol 34(6):611–635CrossRefPubMedGoogle Scholar
  2. 2.
    Voduc KD, Cheang MC, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H (2010) Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 28(10):1684–1691CrossRefPubMedGoogle Scholar
  3. 3.
    Metzger-Filho O, Sun Z, Viale G, Price KN, Crivellari D, Snyder RD, Gelber RD, Castiglione-Gertsch M, Coates AS, Goldhirsch A, Cardoso F (2013) Patterns of Recurrence and outcome according to breast cancer subtypes in lymph node-negative disease: results from international breast cancer study group trials VIII and IX. J Clin Oncol 31(25):3083–3090CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Moossdorff M, van Roozendaal LM, Strobbe LJ, Aebi S, Cameron DA, Dixon JM, Giuliano AE, Haffty BG, Hickey BE, Hudis CA, Klimberg VS, Koczwara B, Kuhn T, Lippman ME, Lucci A, Piccart M, Smith BD, Tjan-Heijnen VC, van de Velde CJ, Van Zee KJ, Vermorken JB, Viale G, Voogd AC, Wapnir IL, White JR, Smidt ML (2014) Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research. J Natl Cancer Inst 106(12):dju288CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Moy L, Newell MS, Mahoney MC, Bailey L, Barke LD, Carkaci S, D’Orsi C, Goyal S, Haffty BG, Harvey JA, Hayes MK, Jokich PM, Lee SJ, Mainiero MB, Mankoff DA, Patel SB, Yepes MM (2016) ACR appropriateness criteria stage I breast cancer: initial workup and surveillance for local recurrence and distant metastases in asymptomatic women. J Am Coll Radiol 13(11S):e43–e52CrossRefPubMedGoogle Scholar
  6. 6.
    Witteveen A, Kwast AB, Sonke GS, IJzerman MJ, Siesling S (2015) Survival after locoregional recurrence or second primary breast cancer: impact of the disease-free interval. PLoS ONE 10(4):e120832CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Houssami N, Ciatto S, Martinelli F, Bonardi R, Duffy SW (2009) Early detection of second breast cancers improves prognosis in breast cancer survivors. Ann Oncol 20(9):1505–1510CrossRefPubMedGoogle Scholar
  8. 8.
    Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino AP, Chappuis PO, Bouchardy C (2006) Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol 24(18):2743–2749CrossRefPubMedGoogle Scholar
  9. 9.
    Jobsen JJ, van der Palen J, Meerwaldt JH (2001) The impact of age on local control in women with pT1 breast cancer treated with conservative surgery and radiation therapy. Eur J Cancer 37(15):1820–1827CrossRefPubMedGoogle Scholar
  10. 10.
    Alpert TE, Kuerer HM, Arthur DW, Lannin DR, Haffty BG (2005) Ipsilateral breast tumor recurrence after breast conservation therapy: outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation. Int J Radiat Oncol Biol Phys 63(3):845–851CrossRefPubMedGoogle Scholar
  11. 11.
    Deutsch M (2002) Repeat high-dose external beam irradiation for in-breast tumor recurrence after previous lumpectomy and whole breast irradiation. Int J Radiat Oncol Biol Phys 53(3):687–691CrossRefPubMedGoogle Scholar
  12. 12.
    Andersson Y, de Boniface J, Jonsson PE, Ingvar C, Liljegren G, Bergkvist L, Frisell J, Swedish Breast Cancer G, Swedish Society of Breast S (2012) Axillary recurrence rate 5 years after negative sentinel node biopsy for breast cancer. Br J Surg 99(2):226–231CrossRefPubMedGoogle Scholar
  13. 13.
    Haffty BG, Fischer D, Beinfield M, McKhann C (1991) Prognosis following local recurrence in the conservatively treated breast cancer patient. Int J Radiat Oncol Biol Phys 21(2):293–298CrossRefPubMedGoogle Scholar
  14. 14.
    Waeber M, Castiglione-Gertsch M, Dietrich D, Thurlimann B, Goldhirsch A, Brunner KW, Borner MM, Swiss Group for Clinical Cancer R (2003) Adjuvant therapy after excision and radiation of isolated postmastectomy locoregional breast cancer recurrence: definitive results of a phase III randomized trial (SAKK 23/82) comparing tamoxifen with observation. Ann Oncol 14(8):1215–1221CrossRefPubMedGoogle Scholar
  15. 15.
    Aebi S, Gelber S, Anderson SJ, Lang I, Robidoux A, Martin M, Nortier JW, Paterson AH, Rimawi MF, Canada JM, Thurlimann B, Murray E, Mamounas EP, Geyer CE Jr., Price KN, Coates AS, Gelber RD, Rastogi P, Wolmark N, Wapnir IL, Investigators C (2014) Chemotherapy for isolated locoregional recurrence of breast cancer (CALOR): a randomised trial. Lancet Oncol 15(2):156–163CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Sara Y. Brucker
    • 1
  • Andreas D. Hartkopf
    • 1
  • Wolfgang Janni
    • 2
  1. 1.Department für FrauengesundheitUniversitätsklinikum TübingenTübingenDeutschland
  2. 2.Frauenheilkunde und GeburtshilfeUniversitätsklinikum UlmUlmDeutschland

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