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Dtsch Med Wochenschr 2018; 143(04): 267-278
DOI: 10.1055/s-0043-104456
CME-Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Mammakarzinom: Diagnostik und Therapie – das Wichtigste für den Internisten

Breast Cancer: Diagnostics and Therapy – the Most Important Facts for Internists
Ulrich Hamann
,
Christine Ankel
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Publication History

Publication Date:
22 February 2018 (online)

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Abstract

Learning Objectives After reviewing this article, the participant should be able to: 1. Understand the epidemiology of breast cancer, its incidence and impact. 2. Appreciate the importance of early diagnosis and treatment. 3. Understand the concept of comprehensive breast cancer management and its multidisciplinarity. 4. Be knowledgeable about the entire process required to manage breast cancer, since the early diagnosis until the management of non breast related conditions derived from the treatment. 5. Position their specialty and knowledge in the process and know clearly their role and involvement in the management of the patients with breast cancer.

Summary Breast carcinoma accounts for the majority of the malignant diseases in women. In Germany has an estimated incidence of 70 000 new cases per year, which is 30 % of all the malignancies in women, predominantly between 45 and 83 years old, although it can affect as well younger women and men, the latter, in a very low rate. It is accountable for 17.4 % mortality in the country.

The high frequency and impact of the mammary carcinoma had lead to the establishment and standardization of screening programs, encompassing self examination, early and regular consultation, sonography and mammography, aimed to the early detection not only of primary disease but also in recurrent or relapsing disease, and continued following up after treatment. Several treatment strategies and tools have been developed and are being chosen in accordance to the histology and biology of the tumor, the patient condition, the social and familiar status, with the increase of conservation of the mammary gland either by adjuvant or neoadjuvant therapies, with radiotherapy or by breast conserving surgery, improving therefore the quality of living without compromising the disease free survival. Next step in the process is the follow up, intended to maintain the patients the healthiest possible, not only from the malignancy but also minimizing the effects of the treatment strategies, incorporating lifestyle improving measures e.g. sports and nutrition, and alternative medicine resources like acupuncture, hence improving the disease free survival rate, the overall survival and diminishing the disease related impact yet personal, familiar, social and economical.

The aim of this CME is to give a thorough review of this multifactorial entity, helping the healthcare professional understand the scientific aspects of it and, through comprehensive reading, provide a clear understanding of their role and degree of involvement in the breast cancer management process.

Therapiert werden Patientinnen und Patienten mit einem Mammakarzinom überwiegend von Gynäkologen – am besten in zertifizierten Brustzentren mit einer engen Verzahnung vieler Disziplinen. Prävention, Früherkennung, Nachsorge und Palliativmedizin erfordern aber häufig auch eine gemeinsame internistisch-gynäkologische Betreuung. Dieser Beitrag fasst die Grundzüge der Diagnostik und Behandlung zusammen, die der Internist kennen sollte [1] [2] [3].

Schlüsselwörter

Brustkrebsfrüherkennung - brusterhaltende Therapie - endokrine Therapie - Tumornachsorge

Key words

breast cancer screening - breast conserving therapy - endocrine therapy - follow-up care
 

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