CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(11): 1056-1088
DOI: 10.1055/a-0646-4630
GebFra Science
Guideline/Leitlinie
Georg Thieme Verlag KG Stuttgart · New York

Interdisziplinäre Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Leitlinie der DGGG und DKG (S3-Level, AWMF-Registernummer 032/045OL, Dezember 2017) – Teil 2 mit Empfehlungen zur Therapie des primären, rezidivierten und fortgeschrittenen Mammakarzinoms

Artikel in mehreren Sprachen: English | deutsch
Achim Wöckel
1   Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
,
Jasmin Festl
1   Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
,
Tanja Stüber
1   Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
,
Katharina Brust
1   Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
,
Mathias Krockenberger
1   Universitätsfrauenklinik Würzburg, Universität Würzburg, Würzburg, Germany
,
Peter U. Heuschmann
2   Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
,
Steffi Jírů-Hillmann
2   Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
,
Ute-Susann Albert
3   AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
,
Wilfried Budach
4   Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
,
Markus Follmann
5   Office des Leitlinienprogrammes Onkologie, Berlin, Germany
,
Wolfgang Janni
6   Universitätsfrauenklinik Ulm, Ulm, Germany
,
Ina Kopp
3   AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
,
Rolf Kreienberg
6   Universitätsfrauenklinik Ulm, Ulm, Germany
,
Thorsten Kühn
7   Frauenklinik, Klinikum Esslingen, Esslingen, Germany
,
Thomas Langer
5   Office des Leitlinienprogrammes Onkologie, Berlin, Germany
,
Monika Nothacker
3   AWMF-Institut für Medizinisches Wissensmanagement, Marburg, Germany
,
Anton Scharl
8   Frauenklinik, Klinikum St. Marien Amberg, Amberg, Germany
,
Ingrid Schreer
9   Diagnostische Radiologie, Hamburg-Eimsbüttel, Germany
,
Hartmut Link
10   Praxis für Hämatologie und Onkologie, Kaiserslautern, Germany
,
Jutta Engel
11   Tumorregister München, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
,
Tanja Fehm
12   Universitätsfrauenklinik Düsseldorf, Düsseldorf, Germany
,
Joachim Weis
13   Stiftungsprofessur Selbsthilfeforschung, Tumorzentrum/CCC Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
,
Anja Welt
14   Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum, Universitätsklinikum Essen, Essen, Germany
,
Anke Steckelberg
15   Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
,
Petra Feyer
16   Klinik für Strahlentherapie und Radioonkologie, Vivantes Klinikum, Neukölln Berlin, Germany
,
Klaus König
17   Berufsverband der Frauenärzte, Steinbach, Germany
,
Andrea Hahne
18   BRCA-Netzwerk, Bonn, Germany
,
Traudl Baumgartner
18   BRCA-Netzwerk, Bonn, Germany
,
Hans H. Kreipe
19   Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
,
Wolfram Trudo Knoefel
20   Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
,
Michael Denkinger
21   AGAPLESION Bethesda Klinik, Geriatrie der Universität Ulm, Ulm, Germany
,
Sara Brucker
22   Universitätsfrauenklinik Tübingen, Tübingen, Germany
,
Diana Lüftner
23   Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Campus Benjamin Franklin, Universitätsklinikum Charité, Berlin, Germany
,
Christian Kubisch
24   Institut für Humangenetik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
,
Christina Gerlach
25   III. Medizinische Klinik und Poliklinik, uct, Interdisziplinäre Abteilung für Palliativmedizin, Universitätsmedizin der Johannes Gutenberg Universität, Mainz, Germany
,
Annette Lebeau
26   Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
,
Friederike Siedentopf
27   Brustzentrum, Martin-Luther-Krankenhaus, Berlin, Germany
,
Cordula Petersen
28   Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
,
Hans Helge Bartsch
29   Klinik für Tumorbiologie an der Universität Freiburg, Freiburg, Germany
,
Rüdiger Schulz-Wendtland
30   Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Germany
,
Markus Hahn
22   Universitätsfrauenklinik Tübingen, Tübingen, Germany
,
Volker Hanf
31   Frauenklinik Nathanstift, Klinikum Fürth, Fürth, Germany
,
Markus Müller-Schimpfle
32   Klinik für Radiologie und Nuklearmedizin, Klinikum Frankfurt Höchst, Frankfurt, Germany
,
Ulla Henscher
33   Physiotherapie, Hannover, Germany
,
Renza Roncarati
34   Frauenselbsthilfe nach Krebs – Bundesverband e. V., Bonn, Germany
,
Alexander Katalinic
35   Institut für Sozialmedizin und Epidemiologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
,
Christoph Heitmann
36   Ästhetisch plastische und rekonstruktive Chirurgie, Camparihaus München, München, Germany
,
Christoph Honegger
37   Gynäkologie und Geburtshilfe, Zuger Kantonsspital, Baar, Switzerland
,
Kerstin Paradies
38   Konferenz Onkologischer Kranken- und Kinderkrankenpflege, Hamburg, Germany
,
Vesna Bjelic-Radisic
39   Universitätsfrauenklinik, Abteilung für Gynäkologie, Medizinische Universität Graz, Graz, Austria
,
Friedrich Degenhardt
40   Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover, Hannover, Germany
,
Frederik Wenz
41   Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Mannheim, Mannheim, Germany
,
Oliver Rick
42   Klinik Reinhardshöhe Bad Wildungen, Bad Wildungen, Germany
,
Dieter Hölzel
11   Tumorregister München, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, München, Germany
,
Matthias Zaiss
43   Praxis für interdisziplinäre Onkologie & Hämatologie, Freiburg, Germany
,
Gudrun Kemper
44   Arbeitskreis Frauengesundheit, Berlin, Germany
,
Volker Budach
45   Klinik für Radioonkologie und Strahlentherapie, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Carsten Denkert
46   Institut für Pathologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Bernd Gerber
47   Universitätsfrauenklinik am Klinikum Südstadt, Rostock, Germany
,
Hans Tesch
48   Centrum für Hämatologie und Onkologie Bethanien, Frankfurt, Germany
,
Susanne Hirsmüller
49   Hospiz am Evangelischen Krankenhaus Düsseldorf, Düsseldorf, Germany
,
Hans-Peter Sinn
50   Pathologisches Institut, Universität Heidelberg, Heidelberg, Germany
,
Jürgen Dunst
51   Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
,
Karsten Münstedt
52   Frauenklinik Offenburg, Ortenau Klinikum Offenburg-Gengenbach, Offenburg, Germany
,
Ulrich Bick
53   Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Eva Fallenberg
53   Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Reina Tholen
54   Deutscher Verband für Physiotherapie, Referat Bildung und Wissenschaft, Köln, Germany
,
Roswita Hung
55   Frauenselbsthilfe nach Krebs, Wolfsburg, Germany
,
Freerk Baumann
56   Centrum für Integrierte Onkologie Köln, Uniklinik Köln, Köln, Germany
,
Matthias W. Beckmann
57   Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
,
Jens Blohmer
58   Klinik für Gynäkologie incl. Brustzentrum, Charité – Universitätsmedizin Berlin, Berlin, Germany
,
Peter Fasching
57   Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
,
Michael P. Lux
57   Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
,
Nadia Harbeck
59   Brustzentrum, Frauenklinik, Universität München (LMU), München, Germany
,
Peyman Hadji
60   Klinik für Gynäkologie und Geburtshilfe, Krankenhaus Nordwest, Frankfurt, Germany
,
Hans Hauner
61   Lehrstuhl für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München, München, Germany
,
Sylvia Heywang-Köbrunner
62   Referenzzentrum Mammographie München, München, Germany
,
Jens Huober
6   Universitätsfrauenklinik Ulm, Ulm, Germany
,
Jutta Hübner
63   Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
,
Christian Jackisch
64   Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach, Germany
,
Sibylle Loibl
65   German Breast Group, Neu-Isenburg, Germany
,
Hans-Jürgen Lück
66   Gynäkologisch-onkologische Praxis, Hannover, Germany
,
Gunter von Minckwitz
65   German Breast Group, Neu-Isenburg, Germany
,
Volker Möbus
67   Klinik für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany
,
Volkmar Müller
68   Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
,
Ute Nöthlings
69   Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms Universität Bonn, Bonn, Germany
,
Marcus Schmidt
70   Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Universitätsmedizin der Johannes Gutenberg-Universität Mai, Germany nz, Mainz
,
Rita Schmutzler
71   Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln, Germany
,
Andreas Schneeweiss
72   Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
,
Florian Schütz
72   Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Germany
,
Elmar Stickeler
73   Klinik für Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen, Aachen, Germany
,
Christoph Thomssen
74   Universitätsfrauenklinik Halle (Saale), Halle (Saale), Germany
,
Michael Untch
75   Klinik für Geburtshilfe und Gynäkologie, Helios Klinikum Berlin-Buch, Berlin, Germany
,
Simone Wesselmann
76   Deutsche Krebsgesellschaft, Berlin, Germany
,
Arno Bücker
77   Klinik für Diagnostische und Interventionelle Radiologie am UKS, Universität des Saarlandes, Homburg, Germany
,
Andreas Buck
78   Nuklearmedizinische Klinik und Poliklinik des Universitätsklinikums Würzburg, Würzburg, Germany
,
Stephanie Stangl
2   Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, Würzburg, Germany
› Institutsangaben
Weitere Informationen

Publikationsverlauf

received 19. Juni 2018

accepted 20. Juni 2018

Publikationsdatum:
26. November 2018 (online)

Zusammenfassung

Ziele Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren.

Methode Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-Fragen (PICO: Patients/Interventions/Control/Outcome), systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen – und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden.

Empfehlungen Teil 2 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Therapie des primären, rezidivierten und metastasierten Mammakarzinoms: Die lokoregionären Therapien erfahren in der aktuellen Leitlinie eine Deeskalation. Neben einer Verringerung des Sicherheitsabstandes bei den operativen Verfahren gibt die Leitlinie auch Empfehlungen zu einer reduzierten Radikalität bei axillären Interventionen. Die Systemtherapie richtet sich nach den tumorbiologischen Eigenschaften, neue Substanzen stehen insbesondere beim metastatierten Mammakarzinom zur Verfügung.

 
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