Zusammenfassung
Alle 2 Jahre findet in St. Gallen die internationale Konsensuskonferenz zur Behandlung
des primären Mammakarzinoms statt. Vor dem Hintergrund, dass das Konzept der St.-Gallen-Konsensuskonferenz
v. a. ein internationales Meinungsbild widerspiegelt, erscheint es sinnvoll, die Abstimmungsergebnisse
für den Therapiealltag in Deutschland zu konkretisieren. Eine Arbeitsgruppe von 28
Brustkrebsexperten, darunter 3 Mitglieder des internationalen St.-Gallen-Panels, hat
daher die Abstimmungsergebnisse der diesjährigen St.-Gallen-Konsensuskonferenz (2011)
aus deutscher Sicht kommentiert. Inhaltlicher Schwerpunkt der diesjährigen St.-Gallen-Konferenz
war die Tumorbiologie als Ausgangspunkt für die individuelle Therapieentscheidung.
Intensiver Diskussionsbedarf bestand bei der klinischen Relevanz prädiktiver und prognostischer
Faktoren und den möglichen Konsequenzen für die Therapieentscheidung. So fokussierten
insbesondere die Fragen zur Indikation einer adjuvanten Chemotherapie auf die Bedeutung
des molekularen Phänotyps des Tumors. Wichtige Diskussionspunkte waren darüber hinaus
der Stellenwert der kompletten Axilladissektion und der Einsatz der beschleunigten
Gesamtbrustbestrahlung.
Abstract
Every 2 years, the International Consensus Conference on the Treatment of Primary
Breast Cancer takes place in St. Gallen. Given that the concept of the St. Gallen
Consensus Conference mainly reflects an international opinion, it appears useful to
adapt the results of the vote for everyday therapy in Germany. A working group comprising
28 breast cancer experts, amongst whom there are 3 members of the international St.
Gallen panel, has therefore commented on this year's St. Gallen Consensus Conference
(2011) from the German viewpoint. The focus of interest of this year's St. Gallen
Conference was tumour biology as the starting point for decisions regarding individual
therapy. There was an intensive discussion in relation to the clinical relevance of
predictive and prognostic factors and possible consequences for decisions regarding
therapy. Therefore, questions concerning the indication for adjuvant chemotherapy
focused especially on the significance of the molecular phenotype of the tumour. In
addition, important points for discussion were also the value of complete axillary
dissection and the use of accelerated complete breast irradiation.
Schlüsselwörter
frühes Mammakarzinom - endokrine Therapie - neoadjuvante Chemotherapie - zielgerichtete
Therapie - prädiktive prognostische Marker
Key words
early breast cancer - endocrine therapy - neoadjuvant chemotherapy - targeted therapy
- predictive prognostic marker
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Prof. Dr. Michael Untch
Helios Klinikum Berlin Buch
Schwanebecker Chaussee 50
13125 Berlin
Email: michael.untch@helios-kliniken.de