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Das Management der AxilläRen Lymphknoten

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Mammakarzinom

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In der modernen interdisziplinären Behandlung des Mammakarzinoms kommt dem korrekten Staging der Axilla eine besondere Bedeutung zu. Der Status der Axilla ist der wichtigste prognostische Faktor und hat Auswirkungen auf die Operation und die Planung von Strahlen- und adjuvanter Therapie. Die axilläre Lymphknotendissektion der Kompartimente I–II (mit Einschränkung auch Level III) gilt als verlässliche Stagingmethode und ist nach wie vor Goldstandard. Neben ihrer diagnostischen hat die Axilladissektion auch therapeutische Bedeutung bei Patienten mit positivem Lymphknotenstatus. Die postoperative Morbidität bei der Chirurgie des Mammakarzinoms wird allerdings nahezu ausschliesslich von den Komplikationen der Axilladissektion bestimmt. Im Zeitalter des Mammographiescreenings hat die Mehrzahl der Patienten zum Zeitpunkt der Diagnose einen negativen Lymphknotenstatus. Diese Patienten müssten ohne therapeutischen Nutzen die Komplikationen der Axilladissektion zur Diagnose des Lymphknotenstatus in Kauf nehmen.

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  1. Brustambulanz AKH Wien, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18 - 20, 1090, Wien

    a.o. Univ.-Prof. Dr. S. Roka

  2. Klinische Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18 - 20, 1090, Wien

    o. Univ.-Prof. Dr. Dr. h. c. R. Jakesz (Leiter)

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  1. Klinische Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Wien, Österreich

    Raimund Jakesz

  2. Klinische Abteilung für Plastische und Rekonstruktive Chirurgie, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Wien, Österreich

    Manfred Frey

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Roka, S., Jakesz, R. (2007). Das Management der AxilläRen Lymphknoten. In: Jakesz, R., Frey, M. (eds) Mammakarzinom. Springer, Vienna. https://doi.org/10.1007/978-3-211-29685-1_7

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