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Senologie - Zeitschrift für Mammadiagnostik und -therapie 2014; 11(2): 85-90
DOI: 10.1055/s-0034-1366392
Wissenschaftliche Arbeit
© Georg Thieme Verlag KG Stuttgart · New York

Die Therapieplanung junger Frauen mit Mammakarzinom – eine besondere Herausforderung

Treatment Planning in Young Breast Cancer Patients – a Special Challenge
A. Farr
,
C. F. Singer
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Publikationsverlauf

Publikationsdatum:
03. Juni 2014 (online)

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Zusammenfassung

Patientinnen unter 40 Jahren werden allein aufgrund ihres Alters oft unabhängig von der vorhandenen Tumorbiologie als Hochrisikogruppe betrachtet und einer aggressiven Therapie zugeführt. Diese Patientinnengruppe befindet sich jedoch in einer speziellen Lebensphase, in der Über- und Untertherapie sowie unnötige Behandlungen strikt zu vermeiden sind. Die Wahl eines falschen oder zu aggressiven Chemotherapie-Regimes kann bei Frauen im reproduktiven Alter zur eingeschränkten Ovarialfunktion oder gar dem Verlust der Fertilität führen. Dieses und andere spezifische Themen sollten bei der Therapieplanung junger Mammakarzinompatientinnen interdisziplinär mit Gynäkologen, Onkologen und Strahlentherapeuten diskutiert werden. Das frühe Auftreten der Erkrankung bei Patientinnen in einer speziellen Lebenssituation stellt das Team insbesondere bei der Wahl des richtigen Therapiekonzepts oftmals vor eine Herausforderung.

Kernaussagen:

  • Die zugrundeliegende Tumorbiologie bedingt das Risiko.

  • Die Indikation zu einer leitliniengerechte Standardtherapie ist obligat.

  • Die besondere Lebenssituation erfordert die Berücksichtigung wichtiger Themen vor Therapiebeginn: Kinderwunsch, ggf. bestehende Schwangerschaft, Abklärung familiärer Belastungen, Risikoberatung bei < 35 Jahren, Abwägung Wirksamkeit der Therapie vs. Langzeit-Toxizitäten, Verhütung

  • Junge Patientinnen benötigen obligat ein im interdisziplinären Tumorboard festgelegtes Therapiekonzept.

  • Nicht alle prognostischen Tests sind für junge Frauen einsetzbar.

  • Es besteht keine Indikation zur prophylaktischen Gabe von Bisphosphonaten.

Abstract

Due to their young age, patients under the age of forty are considered as a high-risk group independent from the existing tumor biology. Therefore, this group of patients often undergoes more aggressive treatment concepts. However, the special phase of life of young patients should prohibit over- or under-therapy and unnecessary treatments are to be strictly avoided. For women in reproductive age, the choice of wrong or too aggressive chemotherapy regimens can result in restricted ovarian function or even loss of fertility. With respect to the individual situation of the patient, specific issues should be discussed involving an interdisciplinary board of gynecologists, oncologists and radiotherapists. The early appearance of the disease in patients with individual living conditions often represents a challenge for the involved team.

Schlüsselwörter

Mammakarzinom, - junge Patientin - Risiko - Chemotherapie - Gentests - Biomarker

Key words

breast cancer - young patient - risk - chemotherapy - genetic testing - biomarkers
 

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