Primärtherapie bei Patientinnen mit Mammakarzinom: Evidenz, Kontroversen, Konsens

Zusammenfassung

Die alle 2 Jahre stattfindende internationale Konsensuskonferenz in St. Gallen zur Behandlung von Patientinnen mit primärem Mammakarzinom wurde dieses Jahr zum 14. Mal veranstaltet und fand aus logistischen Gründen erstmals nicht in St. Gallen (Schweiz), sondern unter gleichem Namen in Wien (Österreich) statt. Da sich das internationale Panel in St. Gallen aus Experten unterschiedlicher Länder zusammensetzt, spiegelt der Konsensus ein internationales Meinungsbild wider. Aus deutscher Sicht erscheint es daher sinnvoll, die Abstimmungsergebnisse vor dem Hintergrund der aktualisierten Therapieempfehlungen der Arbeitsgemeinschaft Gynäkologische Onkologie (AGO-Mamma 2015) für den Therapiealltag in Deutschland zu konkretisieren. Eine deutsche Arbeitsgruppe aus 14 Brustkrebsexperten, von denen 3 Mitglieder des internationalen St.-Gallen-Panels sind, hat daher die Abstimmungsergebnisse der St.-Gallen-Konsensuskonferenz 2015 für den Klinikalltag in Deutschland zeitnah kommentiert. Inhaltliche Schwerpunkte der 14. St.-Gallen-Konferenz waren erneut operative Fragestellungen der Brust und der Axilla, radioonkologische und systemische Therapieoptionen des primären Mammakarzinoms unter Berücksichtigung der Tumorbiologie sowie der klinische Einsatz von Multigen-Assays. Ein Fokus lag zudem auf der Behandlung älterer und jüngerer Patientinnen, inkl. spezieller Situationen wie die Diagnostik/Behandlung eines Mammakarzinoms in und nach einer Schwangerschaft sowie den Erhalt der Fertilität.

Abstract

For the first time, this yearʼs St. Gallen International Consensus Conference on the treatment of patients with primary breast cancer, which takes place every two years, was held not in St. Gallen (Switzerland) but – for logistical reasons – in Vienna (Austria) under its usual name. The 2015 St. Gallen International Consensus Conference was the 14th of its kind. As the international panel of the St. Gallen conference consists of experts from different countries, the consensus mirrors an international cross-section of opinions. From a German perspective, it was considered useful to translate the results of the votes of the St. Gallen conference into practical suggestions, particularly in light of the recently updated treatment guideline of the Gynecologic Oncology Group (AGO-Mamma 2015) in Germany. A German group consisting of 14 breast cancer experts, three of whom are members of the international St. Gallen panel, has therefore provided comments on the results of this yearʼs votes at the 2015 St. Gallen Consensus Conference and their impact on clinical care in Germany. The 14th St. Gallen conference once again focused on surgery of the breast and the axilla, radio-oncologic and systemic treatment options for primary breast cancer depending on tumor biology, and the clinical use of multigene assays. The conference also considered targeted therapies for older and for younger patients, including such special circumstances as the diagnosis/treatment of breast cancer during and after pregnancy and the preservation of fertility.

Schlüsselwörter

Mammakarzinom - St.-Gallen-Konsensus - adjuvante Therapie - neoadjuvante Therapie - Multigensignaturen

Key words

breast cancer - St. Gallen consensus - adjuvant therapy - neoadjuvant therapy - multigene signatures

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