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Endokrine antihormonelle Therapie in der Prämenopause

Zeitschrift:: Journal für Gynäkologische Endokrinologie/Schweiz > Ausgabe 4/2017

Autor:: Univ.-Ass.-Prof. Dr. Leo Auerbach

Wichtige Hinweise

Dieser Beitrag wird auch im Journal für Gynäkologische Endokrinologie/Österreich 2017, https://doi.org/10.1007/s41974-017-0022-8 veröffentlicht.

Zusammenfassung

Aktuelle Studien haben die Möglichkeiten der Therapie eines prämenopausalen Mammakarzinoms verändert und die Therapieleitlinien der internationalen und nationalen senologischen Gesellschaften ergänzt. Bei prämenopausalen Patientinnen mit niedrigem Rezidivrisiko ohne Chemotherapie bleibt Tamoxifen erste Wahl, wobei bei guter Verträglichkeit nach 5 Jahren die Verlängerung der Therapie mit Tamoxifen auf weitere 5 Jahre erwogen werden kann (individuelle, risikoadaptierte Entscheidung). Sollte die Patientin nach der TAM-Therapie in der Postmenopause sein, wäre eine Therapie mit Aromatasehemmer (AI) für weitere 5 Jahre empfehlenswert. Bei prämenopausalen Patientinnen mit hohem Rezidivrisiko, die eine Chemotherapie benötigen und nach der Chemotherapie noch prämenopausal sind, ist die Therapie mit Exemestan + Ovarian Function Suppression (OFS) (GnRH-Analoga) für 5 Jahre vorteilhaft (auch für Patientinnen mit einer Kontraindikation gegen Tamoxifen (TAM) [z. B. Thrombosen] optional). Bei Unverträglichkeit oder intolerablen Nebenwirkungen stellt die Kombination TAM + OFS eine Alternative dar. Für Patientinnen mit niedrigem Risiko und Kinderwunsch kann auch eine zeitreduzierte Therapieoption mit TAM + GnRH-Analogon Goserelin ± Zoledronsäure für 3 Jahre besprochen werden (ABCSG 12).

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Titel: Endokrine antihormonelle Therapie in der Prämenopause
Autor:: Univ.-Ass.-Prof. Dr. Leo Auerbach
Publikationsdatum: 01.12.2017
DOI: https://doi.org/10.1007/s41975-017-0023-z
Verlag: Springer Vienna
Zeitschrift: Journal für Gynäkologische Endokrinologie/Schweiz Revue de Endocrinologie Gynécologique
Ausgabe 4/2017
Print ISSN: 1995-6924
Elektronische ISSN: 2520-8500

Springer Medizin Österreich

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