Zusammenfassung

Chirurgie und Gesamtbehandlung des Brustdrüsenkarzinoms — z. T. in chirurgischen, z. T. in gynäkologischen Händen — haben im letzten Dezennium wesentliche Änderungen erfahren. Vor allem ist die brusterhaltende — besser würde man sagen „teilbrusterhaltende“ — Operation für kleinere Tumoren (Stadium I und II) in Kombination mit Nachbestrahlung als den radikalen Operationen gleichwertig zu betrachten. Große randomisierte Studien erlauben heute v. a. bei Kenntnis des Hormonrezeptorstatus, der Lymphknotensituation und anderer Risikofaktoren Empfehlungen bezüglich adjuvanter und therapeutischer Strahlen-, Hormon- und Chemotherapie. Doch weist ein rascher Wandel solcher Empfehlungen in den letzten 10 Jahren auf ihre Vorläufigkeit hin; durch neue chemo- oder immuntherapeutische Ansätze werden sie schnell überholt. Bei der sicher weiterhin berechtigten Durchführung der Mammakarzinomchirurgie vielerorts, d.h. außerhalb von darauf spezialisierten Zentren, sind jeweiliger Wissensstand und die Sicherung von Voraussetzungen zur adäquaten Gesamtbehandlung zu berücksichtigen; hierzu gehört besonders die obligate Untersuchung von Karzinomgewebe im Primärtumor und in Metastasengewebe auf Hormonrezeptoren.

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Literatur

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© Springer-Verlag Berlin Heidelberg 1991

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  • R. Schwarz

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