Zusammenfassung
Die systemische adjuvante Therapie ist ein integraler Bestandteil der Therapie von Frauen mit Mammakarzinomen in lokalisierten Stadien und trägt wesentlich zur Reduktion der Brustkrebsmortalität bei. Entscheidungen hinsichtlich der Therapieauswahl in der adjuvanten Therapie sind sehr komplex geworden und bedürfen einer individualisierten Risikobeurteilung, die nicht nur klinisch-pathologische Kriterien wie Tumorgröße und Lymphknotenstatus berücksichtigt, sondern auch molekulare Prädiktoren des biologischen Verhaltens des Tumors mit einbezieht. Durch die Entwicklung von zielgerichteten Therapien gegen HER-2 und durch die Verfügbarkeit von Aromatase-Inhibitoren der dritten Generation, sind neue Therapieoptionen verfügbar, die in Therapiealgorithmen integriert werden müssen. In dieser Übersichtsarbeit diskutieren wir die Leitlinien und Empfehlungen zur systemischen adjuvanten Therapie bei Mammakarzinomen in lokalisierten Stadien auf der Basis der gegenwärtigen Risikoklassifikation.
Abstract
Systemic adjuvant treatment is an integral component in the treatment of women with early-stage breast cancer and contributes significantly to the reduction of breast cancer-specific mortality. Decisions regarding adjuvant treatment modalities are becoming increasingly complex and demand individualised risk assessments based not only on clinicopathological criteria such as tumour size and axillary lymph node status but also on molecular predictors of the biological behaviour of the cancer. In addition, with the development of targeted therapies targeting HER-2 and with the availability of third generation aromatase inhibitors, new therapeutic options are available and need to be integrated into the treatment algorithms. In this review, we discuss the guidelines and recommendations concerning adjuvant systemic treatment of early-stage breast cancer based on current risk classifications.
Schlüsselwörter
Brustkrebs im lokalisierten Stadium - zielgerichtete Therapie - adjuvante systemische Therapie
Key words
early‐stage breast cancer - targeted therapy - adjuvant systemic treatment
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Dr. med. MD, MBA Martin Görner
Hämatologie und Onkologie
Städtische Kliniken Bielefeld Mitte
Teutoburger Straße 50
33604 Bielefeld
eMail: martin.goerner@sk-bielefeld.de
