Aktuelle Kontroversen in der adjuvanten systemischen Therapie des Mammakarzinoms

Zusammenfassung

Die Sterblichkeit von Brustkrebs konnte, vor allem dank der Früherkennung und systemischer Therapiemaßnahmen, seit den 90er-Jahren signifikant gesenkt werden. Allerdings steht eine Reihe von modernen Therapieformen aufgrund ihrer größeren Nebenwirkungen und der hohen Kosten im Zentrum der Kritik. Häufig stehen die Frauenärztin oder der Frauenarzt vor der Therapieentscheidung zwischen einer vermeintlich modernen, aber kontroversen Behandlungsform, oder einer bewährten, aber vielleicht nicht mehr zeitgemäßen Therapie. Dieser Artikel soll einen kurzen Überblick zu den Kontroversen und zum Stand der Evidenz zum Einsatz der Aromataseinhibitoren, der Taxane, der dosisdichten Chemotherapie und von Trastuzumab in der adjuvanten Therapie des Mammakarzinoms geben.

Abstract

On the basis of screening programs and improvements in systemic treatment, mortality in breast cancer patients has significantly declined over the last two decades. On the other hand, modern systemic treatment is frequently associated with severe toxicity and causes vast expenses. On day to day basis, physicians have to decide between conventional and innovative treatment. This article summarizes the most relevant pros and cons for the implementation of aromatase inhibitors, the taxanes, dose dense chemotherapy and the use of trastuzumab in the adjuvant treatment of breast cancer.

Schlüsselwörter

Chemotherapie - endokrine Therapie - Radiotherapie - Prognose - Rezidiv - Mammakarzinom - Kontroversen

Key words

chemotherapy - endocrine therapy - radiotherapy - prognosis - recurrence - breast cancer - controversies

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