Neoadjuvante Chemotherapie bei lokal fortgeschrittenen Mammakarzinomen: Tumorregression und perioperative Komplikationen

Wallwiener, D.; Diel, IJ; Solomayer, E.-F.; Schoenmakers, C.; Grischke, Eva Maria; Junkermann, H.; Sinn, Hans‐Peter; Kaufmann, M.; Bastert, G.

doi:10.1055/s-2007-1022119

Cited by 4 publications

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“…The paradigm shift [43] in therapeutic thinking is based on reducing and adjusting the radicality of surgery to the requirements of the individual patient to preserve the breast whenever possible. This can be achieved using improved surgical techniques such as oncoplastic or reconstructive procedures [44], enabling a growing number of patients to have breast-conserving surgery while reducing the local recurrence rate due to histologically complete tumour resection [45]. …”

Section: Discussionmentioning

confidence: 99%

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Multidisciplinary breast centres in Germany: a review and update of quality assurance through benchmarking and certification

Wallwiener

Brucker

Wallwiener

2012

Arch Gynecol Obstet

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PurposeThis review summarizes the rationale for the creation of breast centres and discusses the studies conducted in Germany to obtain proof of principle for a voluntary, external benchmarking programme and proof of concept for third-party dual certification of breast centres and their mandatory quality management systems to the German Cancer Society (DKG) and German Society of Senology (DGS) Requirements of Breast Centres and ISO 9001 or similar. In addition, we report the most recent data on benchmarking and certification of breast centres in Germany.MethodsReview and summary of pertinent publications. Literature searches to identify additional relevant studies. Updates from the DKG/DGS programmes.Results and conclusionsImprovements in surrogate parameters as represented by structural and process quality indicators suggest that outcome quality is improving. The voluntary benchmarking programme has gained wide acceptance among DKG/DGS-certified breast centres. This is evidenced by early results from one of the largest studies in multidisciplinary cancer services research, initiated by the DKG and DGS to implement certified breast centres. The goal of establishing a nationwide network of certified breast centres in Germany can be considered largely achieved. Nonetheless the network still needs to be improved, and there is potential for optimization along the chain of care from mammography screening, interventional diagnosis and treatment through to follow-up. Specialization, guideline-concordant procedures as well as certification and recertification of breast centres remain essential to achieve further improvements in quality of breast cancer care and to stabilize and enhance the nationwide provision of high-quality breast cancer care.

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Section: Discussionmentioning

confidence: 99%

“…In addition, systemic tumour control and neoadjuvant and adjuvant therapy [45] are increasingly being considered as treatment modalities. Thus, local tumour control has been integrated into multimodal systemic treatment strategies based on a definitive diagnosis by, e.g.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary breast centres in Germany: a review and update of quality assurance through benchmarking and certification

Wallwiener

Brucker

Wallwiener

2012

Arch Gynecol Obstet

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“…rekonstruktive Maßnahmen [32]. Dabei werden nicht nur bei immer mehr Patientinnen brusterhaltende Vorgehensweisen möglich, gleichermaßen wird die Lokalrezidivrate durch die histologisch kontrollierte Tumorresektion verringert [33].…”

Section: Zusammenfassende Wertungunclassified

“…Immer mehr wird auch der systemischen Tumorkontrolle sowie einer neoadjuvanten und adjuvanten Therapie [33] Rechnung getragen. So erfolgte die Integration der lokalen Tumorkontrolle in multimodale systemische Therapiekonzepte entsprechend einer differenzierten Indikationsstellung z.…”

Section: Zusammenfassende Wertungunclassified

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Leitthema Das Mammakarzinom ist nach wie vor die häufigste maligne Tumor erkrankung der Frau. Nach Schät zungen des RobertKochInstituts er kranken in der Bundesrepublik jähr lich etwa 47.500 Frauen neu an Brust krebs [30], andere Quellen gehen von etwa 55.000 Neuerkrankungen aus [7, 13, 23]. Das mittlere Lebenszeit risiko beträgt in Deutschland 9,2%; es erkrankt somit durchschnittlich je de 11. Frau im Lauf ihres Lebens an Brustkrebs [30].Durch eine Reihe von Analysen gilt mittlerweile als gesichert, dass ei ne spezialisierte Teambildung und Zentralisierung in "Mammaschwer punkten" ("cancer units") zu einer Verbesserung der Therapie -und da mit des Outcome -des Mammakarzi noms führt, vorausgesetzt Qualitäts sicherung und management werden definiert und auch quantitativ über prüft (Benchmarking).

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