Update Breast Cancer 2019 Part 3 – Current Developments in Early Breast Cancer: Review and Critical Assessment by an International Expert Panel

Abstract

The treatment of breast cancer patients in a curative situation is special in many ways. The local therapy with surgery and radiation therapy is a central aspect of the treatment. The complete elimination of tumour cells at the site of the primary disease must be ensured while simultaneously striving to keep the long-term effects as minor as possible. There is still focus on the continued reduction of the invasiveness of local therapy. With regard to systemic therapy, chemotherapies with taxanes, anthracyclines and, in some cases, platinum-based chemotherapies have become established in the past couple of decades. The context for use is being continually further defined. Likewise, there are questions in the case of antihormonal therapy which also still need to be further defined following the introduction of aromatase inhibitors, such as the length of therapy or ovarian suppression in premenopausal patients. Finally, personalisation of the treatment of early breast cancer patients is also being increasingly used. Prognostic tests could potentially support therapeutic decisions. It must also be considered how the possible use of new therapies, such as checkpoint inhibitors and CDK4/6 inhibitors could look in practice once study results in this regard are available. This overview addresses the backgrounds on the current votes taken by the international St. Gallen panel of experts in Vienna in 2019 for current questions in the treatment of breast cancer patients in a curative situation.

Update Breast Cancer 2020 Part 3 – Early Breast Cancer

“…Most high-penetrance and moderate-penetrance genes are already being investigated today in panel gene tests as part of predictive genetic diagnostics. In addition to BRCA1 and BRCA2, which are still the most important for planning individual prevention, other genes such as PALB2, CHEK2, ATM and others have been genotyped 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 . Since these gene changes are present very rarely in the general population, however, it is difficult to envisage that broad genotyping of these genes can contribute to a reduction in disease rates.…”

Therapie des fortgeschrittenen hormonrezeptor(HR)-positiven HER2-negativen Mammakarzinoms

“…Der Menopausenstatus, die Art der vorangegangenen Therapie, das Zeitintervall zwischen Ende der Primärtherapie und Diagnose der Metastasierung sowie verbliebene Langzeitfolgen der vorangegangenen Therapien und Symptome der Metastasierung bestimmen die Auswahl der Therapie. Endokrine Therapien haben eine geringe Toxizität bei hohem Wirkungsspektrum und werden daherund dies im Konsens nationaler und internationaler Leitlinienbei hormonrezeptorpositiven/HER2-negativen Formen präferiert unter Berücksichtigung eines langsamen Ansprechens [9,12,13,44,45]. Die Ansprechraten sind mit denen einer Chemotherapie vergleichbar.…”

Update Mammakarzinom 2020 Teil 1 – frühes Mammakarzinom: Konsolidierung des Wissens über bekannte Therapien

“…Genetische Testungen von Keimbahnmutationen sind Teil der Routineversorgung bei Patientinnen mit einer Indikation für eine genetische Testung geworden [1][2][3][4][5]. Die beiden Gene, die klinisch am relevantesten sind, sind Breast Cancer 1 (BRCA1) und BRCA2 [6].…”