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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(01): 48-53
DOI: 10.1055/s-0043-124082
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Ist eine Operation der Brust bei Komplettremission nach neoadjuvanter Chemotherapie des Mammakarzinoms notwendig?

Article in several languages: English | deutsch
Hannah Richter
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
André Hennigs
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Benedikt Schaefgen
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Markus Hahn
2   Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
,
Jens Uwe Blohmer
3   Brustzentrum der Klinik für Gynäkologie, Campus Charité Mitte, Berlin, Germany
,
Sherko Kümmel
4   Brustzentrum der Kliniken Essen-Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
,
Thorsten Kühn
5   Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen GmbH, Esslingen, Germany
,
Marc Thill
6   Brustzentrum, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
,
Kay Friedrichs
7   Mammazentrum am Krankenhaus Jerusalem Hamburg, Hamburg, Germany
,
Christof Sohn
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Michael Golatta
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Jörg Heil
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

received 22 September 2017
revised 02 December 2017

accepted 03 December 2017

Publication Date:
22 January 2018 (online)

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Zusammenfassung

Die Wahrscheinlichkeit einer pathologischen Komplettremission (pCR) bei Brustkrebs nach neoadjuvanter Chemotherapie (NACT) nimmt zu; vor allem in den Subgruppen der tripel-negativen und HER-2-positiven Tumoren. Daher stellt sich die Frage, ob bei einer Komplettremission nach NACT eine operative Therapie der Brust notwendig ist, und ob es einen Vorteil für das onkologische Behandlungsergebnis hat, wenn kein Tumor mehr nachgewiesen werden kann. Ein Verzicht auf die Operation und gegebenenfalls auch auf die Radiotherapie ist jedoch nur auf der Basis einer verlässlichen pCR-Diagnose ohne Operation denkbar. Bildgebende Verfahren erreichen derzeit nicht die nötige Sensitivität und Spezifität, um die Diagnose einer pathologischen Komplettremission sicher zu stellen. Daher sind weitere Studien nötig, um herauszufinden, welche Methode die bestmögliche Evaluation des Tumoransprechens auf NACT erlaubt. Erste vielversprechende Ergebnisse zeigen sich in Studien zu bildgebungsgesteuerten, minimalinvasiven Biopsien nach NACT. Diese evaluieren die Möglichkeit einer pCR-Diagnose vor der Operation und könnten die Grundlage für weitere Studien zu einem möglichen Verzicht auf eine Operation in diesem ausgewählten Kollektiv sein.

Schlüsselwörter

neoadjuvante Chemotherapie - minimalinvasive Biopsie - Brustkrebs - Diagnose - Operation/Chirurgie
 

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