Because of the diversity and complexity of this disease, the care of patients with breast cancer cannot be carried out successfully by individual disciplines alone, but only through interdisciplinary cooperation between gynaecologists, radiologists, oncologists, radiotherapists and plastic surgeons.
This is best done in a quality-controlled breast centre that acts as a centre of expertise for all diseases of the breast, in particular breast cancer. Only by making full use of all available interdisciplinary diagnostic and treatment options can the greatest possible success be achieved.
Overview of treatment for breast cancer
Adjuvant chemotherapy and radiotherapy serve to achieve remission (shrinkage) of a tumour that may still need to be resected.
Neoadjuvant chemotherapy and radiotherapy are used in particular in metastatic disease and in palliative therapy.
Anti-oestrogen therapies (e.g. tamoxifen) are part of the treatment regimen for
hormone receptor-sensitive tumour types.
Antibody preparations (e.g. trastuzumab) are established in the adjuvant therapy of
tumours overexpressing the HER2/neu oncogene.
Surgical treatment is divided into
- breast-conserving tumour excision,
- mastectomy,
- palliative tumour resection,
- reconstruction of the breast and chest wall.
Reconstruction takes many forms; for breast-conserving tumour excisions, for example, it consists of local tissue rearrangements and silicone implant placement to restore the shape of the breast.
After mastectomy (simple mastectomy, periareolar skin-sparing mastectomy), both simple reconstructions with
subpectoral implant placement (definitive implant or expander) and more complex procedures can be chosen.
Options include pedicled myocutaneous flaps (latissimus dorsi flap with and without silicone implant, pedicled muscle-sparing transverse rectus abdominis muscle flap, TRAM flap) and free fasciocutaneous so-called perforator flaps
(DIEP flap, “deep inferior epigastric perforator flap”) in one or two stages. Reconstruction with freely transplanted autologous skin and fat tissue in particular represents a high standard in breast reconstruction with few long-term complications.
Sources and further information
