Seltenheiten beim Mammakarzinom

Seltene Brustkrebstypen wie bspw. das inflammatorische oder metaplastische Mammakarzinom unterscheiden sich vom klassischen Brustkrebs zum Teil deutlich. Dies betrifft nicht nur die Tumorbiologie, sondern auch die klinische Präsentation, das Therapieansprechen und die Prognose. Aufgrund der Seltenheit solcher Karzinome existieren häufig nur eingeschränkte Daten im Hinblick auf die optimale Behandlung. Die folgende Arbeit soll einen Überblick über Studiendaten sowie aktuelle Empfehlungen bieten.

Kernaussagen

• Seltene Mammakarzinomformen (z. B. inflammatorischer, metaplastischer, apokriner oder sekretorischer Brustkrebs) zeigen zum Teil große Unterschiede hinsichtlich klinischer Präsentation, Therapieansprechen und Prognose im Vergleich zum klassischen Mammakarzinom.

• Beim inflammatorischen Mammakarzinom handelt es sich um eine lokal fortgeschrittene Brustkrebserkrankung mit schlechterer Prognose.

• Die Behandlung des inflammatorischen Mammakarzinoms ohne Fernmetastasen umfasst in der Regel eine neoadjuvante Systemtherapie, Mastektomie mit Axilladissektion, postoperative Bestrahlung und adjuvante medikamentöse Therapie.

• Patienten bzw. Patientinnen mit metaplastischem Mammakarzinom stellen sich meist mit einem intramammären Tastbefund vor.

• Der metaplastische Brustkrebs weist häufig eine Resistenz gegenüber Chemotherapie auf. Eindeutige Empfehlungen zum Einsatz medikamentöser Systemtherapie beim metaplastischen Mammakarzinom fehlen.

• Das apokrine Mammakarzinom zeichnet sich durch eine apokrine Zellmorphologie in > 90 % der Tumorzellen sowie einen positiven Androgenrezeptorstatus bei fehlender Östrogenrezeptor- und Progesteronrezeptorexpression aus.

• Beim sekretorischen Mammakarzinom stellt die klinische Abgrenzung zu benignen Befunden eine große Herausforderung dar.

Schlüsselwörter

Mammakarzinom - inflammatorisch - metaplastisch - apokrin - sekretorisch

Publication History

Article published online:
04 September 2025

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