Advertisement

Mammakarzinom: Adjuvante Hormon- und Chemotherapie

  • K. Possinger
Conference paper
Part of the Langenbecks Archiv für Chirurgie Gegründet 1860 Kongreßorgan der Deutschen Gesellschaft für Chirurgie book series (DTGESCHIR, volume 1990)

Zusammenfassung

Indikationen und Behandlungsmodalitäten hängen bei der adjuvanten Therapie der Mammakarzinome von der Anzahl infiltrierter Lymphknoten (Lk), dem Menopausen- und dem Hormonrezeptorstatus ab. Bei fehlendem Lk-Befall ist derzeit außerhalb von Therpiestudien keine Behandlungsindikation gegeben. Bei Befall der axillären Lymphknoten sollten prämenopausale Patientinnen unabhängig vom Hormonrezeptorstatus eine Polychemotherapie, postmenopausale Patientinnen mit positivem Rezeptorstatus eine mehrjährige Behandlung mit Tamoxifen erhalten.

Schlüsselwörter

Mamma-Ca adjuvante Chemotherapie Hormontherapie 

Breast Cancer: Adjuvant Hormonal and Cytotoxic Treatment

Summary

Indications and types of adjuvant treatment depend on the number of infiltrated axillary lymph nodes, menopausal and hormonal receptor status. In N0 situation is to date no indication for hormonal or cytotoxic therapy outside of clinical trials: disease-free survival may be improved but overall survival is not influenced. In N+ situation premenopausal patients should receive polychemotherapy independent from hormonal receptor status, postmenopausal patients with positive receptor status should be treated with tamoxifen up to 5 years: in this situation disease-free intervall and overall survival can be enhanced significantly.

Key words

Breast Cancer Adjuvant chemotherapy Hormonal therapy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Bonadonna G, Valagussa P (1988) Adjuvant chemotherapy for breast cancer. Sem Surg Oncol 4:250–255CrossRefGoogle Scholar
  2. 2.
    Consensus Conference (1985) Adjuvant chemotherapy for breast cancer. JAMA 254:3461–3463CrossRefGoogle Scholar
  3. 3.
    Multidisziplinäre Konsensus-Tagung, Brusterhaltende Therapie beim Mammakarzinom. Indikationen und Konsequenzen. Dtsch Ärzteblatt (1990) im DruckGoogle Scholar
  4. 4.
    Clinical Alert on breast cancer, National Cancer Institute, PDQ News, May 18 (1988)Google Scholar
  5. 5.
    Fisher B, Redmond C, Dimitrov NV, Bowman D, Legault-Poisson S, Wickerham DL, Wolmark N, Fisher ER, Margolese R, Sutherland C (1989) A randomiced clinical trial evaluating sequential methotrexate, and fluorouracil in the treatment of patients with node-negative breast cancer who have estrogen-receptor-negative tumors. N Engl J Med 320:473–478PubMedCrossRefGoogle Scholar
  6. 6.
    Mansour EG, Gray R, Shatila AH, Osborne CK, Tormey DC, Gilchrist KW, Cooper MR, Falkson G (1989) Efficacy of adjuvant chemotherapy in high-risk-node-negative breast cancer. An intergroup study. N Engl J Med 320:485–490PubMedCrossRefGoogle Scholar
  7. 7.
    Fisher B, Costantino C, Redmont C, Poisson R, Bowman D, Conture J, Dimitrov NW, Wolmark N, Wickerham DL, Fisher ER (1989) A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors. N Engl J Med 320:479–478PubMedCrossRefGoogle Scholar
  8. 8.
    Fornander T, Rutqvist LE, Cedermark B, Glas U, Mattson A, Silfversward C, Skoog L, Somell A, Theve T, Wilking N (1989) Adjuvant tamoxifen in early breast cancer: occurence of new primary cancers. Lancet I:117–120CrossRefGoogle Scholar
  9. 9.
    Spyratos F, Hacene K, Tubiana-Hulin M, Pallud C, Brunei M (1989) Prognostic value of estrogen and progesteron receptors in primary infiltrating ductal breast cancer, a sequential multivariate analysis of 1262 patients. Eur J Cancer Clin Oncol 25:1233–1240PubMedCrossRefGoogle Scholar
  10. 10.
    Silvestrini R, Daidone MG, Valagussa P, Di Fronzo G, Mezzanotte G, Bonadonna G (1989) Cell kinetics as a prognostic indicator in node-negative breast cancer. Eur J Cancer Clin Oncol 25:1165–1171PubMedCrossRefGoogle Scholar
  11. 11.
    Clark GM, Dressler LG, Owens MA, Pounds G, Oldaker T, McGuire WL (1989) Prediction of relapse or survival in patients with node-negative breast cancer by DNA flow cytometry. N Engl J Med 320:627–633PubMedCrossRefGoogle Scholar
  12. 12.
    Burki F, Ginsbourg M, Hellbardt A, Misset JL, Musset M, Despax R, Goldschmidt E, Ribaud P, Mathe G (1988) Screening for micrometastases in the bone marrow of breast cancer patients, prognostic value and correlation with other prognostic factors. 2nd Int. Congress on Neo-Adjuvant Chemotherapy, p 15Google Scholar
  13. 13.
    Bonadonna G (1985) Results of the Milan adjuvant chemotherapy trials. NHI Consensus Development Conference, Washington, Book of Abstracts p 31Google Scholar
  14. 14.
    Davidson NE, Lippman ME (1988) Adjuvant therapy for breast cancer. Diagnosis and Management of Breast Cancer. In: Lippmann ME et al. (eds) Saunders, Philadelphia, p 348–374Google Scholar
  15. 15.
    Jordan VC, Tormey DC (1988) Antiestrogen therapy for breast cancer, current strategies and future prospects. Cancer Treat Rep 39:97–110CrossRefGoogle Scholar
  16. 16.
    Stewart HJ, White GK (1988) Adjuvant tamoxifen in the management of operable breast cancer: the Scottish trial. 3rd International Conference on Adjuvant Therapy of Primary Breast Cancer, St. Gallen, Switzerland, p 13Google Scholar
  17. 17.
    Goldhirsch A, Gelber RD (1988) Chemo-endocrine Therapy or endocrine therapy alone for postmenopausal patients: Ludwig studies III and IV. 3rd International Conference on Adjuvant Therapy of Primary Breast Cancer. St. Gallen, Switzerland, p 16Google Scholar
  18. 18.
    Taylor SG, Knuiman MW, Sleeper LA, Olson JE, Tormey DC, Gilchrist KW, Falkson G, Rosenthal SN, Carbone PP, Cummings FJ (1989) Six-years results of Eastern Cooperative Oncology Group trial of observation versus CMFP versus CMFPT in postmenopausal patients with node-positive breast cancer. J Clin Oncol 7:879–889PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • K. Possinger
    • 1
  1. 1.GSF-Institut für Klinische Hämatologie, München, Medizinische Klinik III, Klinikum GroßhadernUniversität MünchenMünchen 70Deutschland

Personalised recommendations