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Erschienen in: Journal für Gynäkologische Endokrinologie/Schweiz 1/2019

12.02.2019 | Prävention

Management von gesunden BRCA1/2-Mutationsträgerinnen („previvors“)

verfasst von: Dr. med. Laura Knabben

Erschienen in: Journal für Gynäkologische Endokrinologie/Schweiz | Ausgabe 1/2019

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Zusammenfassung

In der Allgemeinbevölkerung sind BRCA1- und BRCA2-Mutationen selten. Für Betroffene bedeutet die Diagnose aber hohe Lebenszeitrisiken vor allem für Mamma- und Ovarialkarzinome in oft jungem Alter. Je nach Mutation, Alter, Lebenssituation und weiteren Faktoren muss für jede BRCA-Mutationsträgerin ein individuelles Betreuungskonzept erstellt werden. Die intensivierte senologische Früherkennung erfolgt meist 6‑monatlich. Neben klinischen Untersuchungen und Mammasonographien erhöht die MRT wesentlich die Sensitivität. Der Zeitpunkt, ab dem mit regelmässigen Mammographien begonnen werden sollte, ist nicht eindeutig geklärt. Trotzdem ist eine Durchführung spätestens ab dem 40. LJ empfehlenswert. Die prophylaktische Adnexektomie sollte zwischen dem 35. und 45. Lebensjahr durchgeführt werden. Aufgrund der negativen Folgen der vorzeitigen Menopause wird anschliessend eine Hormonersatztherapie empfohlen. Die gleichzeitige Hysterektomie muss aktuell noch unter Berücksichtigung der Vor- und Nachteile mit jeder Frau individuell diskutiert werden. Bei jungen Frauen stellt sich die Frage der Antikonzeption und der Familienplanung. Trotz eingeschränkter Evidenz wird zu einer Anpassung des Lebensstils (Sport, Normalgewicht, Vermeiden von Alkohol und Nikotin, ausgewogene Ernährung) geraten. Nicht zuletzt sollte eine psychoonkologische Betreuung angeboten werden.
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Metadaten
Titel
Management von gesunden BRCA1/2-Mutationsträgerinnen („previvors“)
verfasst von
Dr. med. Laura Knabben
Publikationsdatum
12.02.2019
Verlag
Springer Vienna
Erschienen in
Journal für Gynäkologische Endokrinologie/Schweiz / Ausgabe 1/2019
Print ISSN: 1995-6924
Elektronische ISSN: 2520-8500
DOI
https://doi.org/10.1007/s41975-019-0077-1

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