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Mammakarzinom—Standards der Versorgung heute und morgen

Breast cancer—current and future standards of care

  • Leitthema
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Der Onkologe Aims and scope

Zusammenfassung

Das Mammakarzinom ist eine der häufigsten Krebserkrankungen in unserer Gesellschaft. Inzidenz, Risikofaktoren, Prävention, Früherkennung, Heilungsrate nach Diagnosestellung und Prognose nach Metastasierung unterliegen einem steten Wandel. Riskofaktoren sind die Verlängerung der hormonellen Exposition, das zunehmende Alter bei der ersten Geburt, fettreiche Ernährung, fehlende körperliche Aktivität und längere Lebenserwartung. Eine medikamentöse Prävention kann in Zukunft vielleicht in manchen Situationen das Erkrankungsrisiko senken. Vorstufen und Frühformen des Mammkarzinoms können durch eine geeignete Früherkennung (Mammographie-Screening) entdeckt werden. Die mammakarzinombedingte Mortalität kann dadurch nachweislich erheblich gesenkt werden.

Die Prognose nach Diagnosestellung hat sich v. a. durch den Einsatz effektiverer adjuvanter Therapieformen verbessert. Eine adäquate Behandlung des Primärtumors durch Operation und ggf. Bestrahlung soll die lokale Ausbreitung des Tumors kontrollieren. Die Entwicklung neuer Medikamente in der Chemotherapie und in der endokrinen Therapie und mehr Wissen über ihren Einsatz gewährleisten eine effektivere und z. T. auch nebenwirkungsärmere adjuvante Behandlung.

Abstract

Breast cancer is one of the most frequently occurring cancers in our society. Incidence, risk factors, prevention, early detection, cure rate at primary diagnosis and prognosis after metastasis may change and influence the mortality.

Major risk factors for developing breast cancer include prolonged hormonal exposure, increasing age at first delivery, nutritional factors, lack of physical activity, and extended life expectancy. Available pharmaceutical agents for prevention may perhaps decrease the disease risk in many precarious situations. Pre-invasive lesions and early stages of breast cancer can be detected by an adequate screening (mammography screening), and thus, breast cancer-related mortality can be substantially reduced.

Once the diagnosis has been determined, the prognosis has improved due in large part to more effective forms of adjuvant therapy. Adequate treatment of the primary tumour, and if necessary irradiation, is aimed at controlling local spread of the tumour. New cytotoxic and endocrine drugs and more knowledge on how best to employ them will ensure more effective adjuvant treatment, perhaps even with fewer side effects.

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Interessenkonflikt:

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Pfizer, Novartis, Astra-Zeneca, Bristol-Myers Squibb, Sanofi-Aventis, Amgen (Vorträge, Advisory Board, Forschungsprojekte).

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  1. Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle-Kröllwitz, Martin-Luther-Universität Halle-Wittenberg

    C. Thomssen

  2. Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle-Kröllwitz, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06097 , Halle (Saale)

    C. Thomssen

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Thomssen, C. Mammakarzinom—Standards der Versorgung heute und morgen. Onkologe 11, 265–272 (2005). https://doi.org/10.1007/s00761-005-0835-3

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