[Hormone therapy, chemotherapy and immunotherapy in breast carcinoma. The best strategy for your patient].
Modern treatment of cancer of the breast is based on established prognostic factors (patient age, receptor status, tumor size, lymph node involvement, tumor grading), and thus takes the patient's individual risk profile into account. In addition to the antiestrogen, tamoxifen, new hormonal preparations, such as the aromatase inhibitors, hold out promise of improved results from adjuvant treatment in elderly women. In premenopausal women, additional hormone blockade by means of GnRH analogs is of advantage. Neoadjuvant (preoperative) chemotherapy protocols will enable rapid evaluation of new therapeutic options. When metastases have developed, treatment with hormonal drugs is indicated in the case of slowly progressing disease (low risk), while clinically progressive metastasization (high risk) requires cytostatic chemotherapy. Here, studies involving more recent substances with improved tolerability, and tumor-specific antibodies, confirm an improvement in the prognosis. The concentration of drug treatment in interdisciplinary centers is a necessary element of quality assurance and therapeutic optimization.
Sayer
H G
HG
Klinik und Poliklinik für Innere Medizin II (Onkologie, Hämatologie, Endokrinologie und Stoffwechselerkrankungen), Friedrich-Schiller-Universität Jena.  Herbert.Sayer@med.uni-jena.de
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D000328:Adult; D000367:Age Factors; D000368:Aged; D000077384:Anastrozole; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007167:Immunotherapy; D000077289:Letrozole; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009570:Nitriles / Q000627:therapeutic use; D017697:Premenopause; D011379:Prognosis; D011787:Quality of Health Care; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013629:Tamoxifen / Q000627:therapeutic use; D013997:Time Factors; D017312:Toremifene / Q000627:therapeutic use; D000068878:Trastuzumab; D014230:Triazoles / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D004791:Enzyme Inhibitors; D004965:Estrogen Antagonists; D009570:Nitriles; D020845:Selective Estrogen Receptor Modulators; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; D020849:Raloxifene Hydrochloride; D000077289:Letrozole; D017312:Toremifene; D000068878:Trastuzumab