Leitlinienprogramm OnkologieBreast Cancer

1. Information about this Guideline – Breast Cancer

Version 4.4 · May 2021 · AWMF 032/045OL
Leitlinienprogramm Onkologie · Deutsche Krebsgesellschaft · Deutsche Krebshilfe · AWMF

1.1 Editors

German Guideline Program in Oncology of the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V., AWMF), the German Cancer Society (Deutsche Krebsgesellschaft e. V., DKG), and German Cancer Aid (Deutsche Krebshilfe, DKH).

1.2 Leading Scientific Societies

Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG)

Deutsche Krebsgesellschaft vertreten durch Ihre Arbeitsgemeinschaften (DKG)

1.3 Funding of the Guideline

This Guideline was funded by the German Cancer Aid (Deutsche Krebshilfe, DKH) as part of the German Guideline Program in Oncology.

1.4 Contact

Guideline Program in Oncology Office 


c/o German Cancer Society (DKG)


Kuno-Fischer-Strasse

8
14057 Berlin, Germany

www.leitlinienprogramm-onkologie.de

1.5 How to cite

Leitlinienprogramm-Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Interdisciplinary Evidenced-based Practice Guideline for the Early Detection, Diagnosis, Treatment and Follow-up of Breast Cancer, Langversion 4.4, 2021, AWMF-Registernummer 032/045OL, http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom/

1.6 Previous Changes of Version 4.4

April 2018 Version 4.1: General editorial revision. The background text in Chapter 3.2.2. was edited, as were Figure 4 and Figure 5. In the recommendation boxes 3.8, 3.13, 4.40, 4.53, 4.69, 4.72, “Recommendation” was changed to “Statement”. The parentheses around “(SLNE ≥ 3 Lnn.)“ were omitted in Table 9. Correction made to QI 6 (mi added).

1.7 Special Comment

Medicine is constantly evolving. This makes all information—particularly about diagnostic and therapeutic procedures—only as good as the state of knowledge at the time the Guideline went to print. The greatest possible care has been taken with the recommendations given herein for treatment as well as for the choice and dosage of medications. Nevertheless, guideline users are advised to refer to the manufacturer's instruction leaflet and the prescribing information and, in case of doubt, consult a specialist. In everybody's general interest, please report any inconsistencies or discrepancies you may find to the editorial board of the German Guideline Program in Oncology.

The user remains personally liable for all diagnostic and therapeutic applications, medications and dosages.

Registered trademarks and brand names are not specifically identified in these care guidelines. It therefore cannot be inferred that a trademark is free merely by the lack of any such reference.

This work is protected in whole and in part. Any use that could infringe on copyright laws is prohibited and constitutes a criminal offence unless written permission for said use has been obtained from the editorial board of the German Guideline Program in Oncology. No part of this book may be reproduced in any form whatsoever without the written permission of the editorial board of the German Guideline Program in Oncology. This holds in particular for copies, translations, microfiche, as well as the saving, use, and exploitation in electronic systems, intranets, and the internet.

1.8 Objectives of the GGPO

With the German Guideline Program in Oncology, the Association of the Scientific Medical Societies in Germany (AWMF), the German Cancer Society (DKG), and the German Cancer Aid (DKH) have set themselves the task of jointly promoting and supporting the development, updating and use of scientifically founded and practicable guidelines in oncology. The program is based on medical-scientific knowledge of the professional societies and the DKG, the consensus of medical experts, users and patients, as well as regulations of the guideline preparation of the AWMF and the expert support and funding by the German Cancer Aid. To map current medical knowledge and account for progress in the field of medicine, guidelines have to be reviewed and updated regularly. The AWMF Guidance Manual forms the basis for the development of high-quality oncologic guidelines. As guidelines constitute an important quality assurance and quality management tool in oncology, they should be incorporated specifically and consistently into routine care. Active implementation measures and evaluation programs are therefore an important component in promoting the Guideline Program in Oncology. The objective of the program is to create professional and medium-term financially secure preconditions for the development and production of high-quality guidelines in Germany. These high-quality guidelines serve not only the structured transfer of knowledge, but may also find their place in health care system structures. Worth mentioning here are evidence-based guidelines as the basis for preparing and updating disease management programs or for implementing guideline-derived quality indicators (QIs) for the certification of organ cancer centers.

1.9 Additional Documents relating to this Guideline

This document is the comprehensive version of the Interdisciplinary S3 Practice Guideline for the Early Detection, Diagnosis, Treatment and Follow-up of Breast Cancer and can be accessed via the links listed below: In addition to this comprehensive version, the following supplementary documents are available:

  • Short version of the guideline
  • Lay version (patient guideline)
  • Guideline Report on its development process
  • Evidence tables This Guideline and all additional documents are available via the following websites.
  • Guideline Program in Oncology (http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom/)
  • AWMF (www.leitlinien.net)
  • Guidelines International Network (www.g-i-n.net)

In addition, a print version of the Patient Guidelines can be ordered from the DKH (https://www.krebshilfe.de/informieren/ueber-krebs/infothek/)

1.10 Composition of the Guideline Group

1.10.1 Coordination and Reaction

Guideline coordination

Prof. Achim Wöckel, M.D., Clinic for Women (Department of Obstetrics and Gynecology), University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany

Co-coordinators:

Prof. Rolf Kreienberg, M.D., Landshut Prof. Wolfgang Janni, M.D., Department of Obstetrics and Gynecology
Ulm University Hospital

Guideline Secretariat

Katharina Brust, B.Sc., Clinic for Women
 (Department of Obstetrics and Gynecology)
 University Hospital of Würzburg 
Josef-Schneider-Str. 4,
97080 Würzburg, Germany

1.10.2 Involved Professional Societies and Organisations

The Guideline Group was convened by the coordinator after consultation with the Guideline Steering Committee. All the professional associations, working groups and organizations involved in the production of the second update were approached.

They were asked to designate experts as mandate holders for voting procedures (consensus procedure) as well as for substantive teamwork in specific groups (Table 4). All experts were selected and invited based on their expertise and professional area of competence. The editors’ representatives from the professional associations, organizations and working groups of the Guideline Group were confirmed in writing by the respective boards (mandate). The aim was to ensure multidisciplinarity and cross-specialty professionalism within the Guideline Group commensurate with substance and scope of the Guideline. From the very beginning, representatives of the self-help groups played an active role in the update process in order to contrast the problems of the disease and care more strongly from the perspective of those affected.

Individual, content-specific working groups had already been formed during the preparations for the first consensus process. Each working group named a spokesperson and a deputy spokesperson. The spokespersons of the working groups were the primary liaisons to the Guideline Steering Committee and responsible for formulating of the topics assigned to each working group, compliance with the methodological standards and adherence to program phases. They also prepared and presented the working group’s results, key messages and recommendations within the framework of the consensus conferences, while also drafting the background texts in consultation with the working group. Each topic-specific working group was tasked to present the current state of medical and scientific knowledge relating to their field and describe interdisciplinary aspects relevant to the respective treatment concept, including proposals for interface solutions.

The members of the working groups and the authors of this Guideline are made up of the members of the Guideline Steering Committee, the mandate holders and proxies designated by the participating professional associations and organizations as well as of the experts invited by the Guideline Steering Committee. Only those mandate holders nominated by the participating professional associations and organizations were entitled to vote in the voting processes (consensus procedure).

Table 1: Beteiligte Fachgesellschaften und Organisationen

Beteiligte Fachgesellschaften und OrganisationenMandatsträger
Arbeitsgemeinschaft Deutscher Tumorzentren (ADT)Prof. Dr. Jutta Engel
Prof. Dr. Dieter Hölzel
Arbeitsgemeinschaft für Psychoonkologie in der DKG (PSO)Prof. Dr. Joachim Weis
Arbeitsgemeinschaft Gynäkologische Onkologie der DGGG und DKG (AGO)Prof. Dr. Tanja Fehm
Prof. Dr. Anton Scharl
Arbeitsgemeinschaft Internistische Onkologie in der DKG (AIO)PD Dr. Anja Welt
Dr. Matthias Zaiss
Arbeitsgemeinschaft Prävention und integrative Medizin in der Onkologie in der DKG (PRiO)Prof. Dr. Volker Hanf
Prof. Dr. Karsten Münstedt
Arbeitsgemeinschaft Radiologische Onkologie in der DKG (ARO)Prof. Dr. Wilfried Budach
Prof. Dr. Frederik Wenz
Arbeitsgemeinschaft Supportive Maßnahmen in der Onkologie, Rehabilitation und Sozialmedizin (ASORS)Prof. Dr. Hartmut Link
Prof. Dr. Oliver Rick
Arbeitskreis Frauengesundheit (AKF)Prof. Dr. Anke Steckelberg
Gudrun Kemper
Berufsverband der Frauenärzte (BVF)Dr. Klaus König
Berufsverband Deutscher Pathologinnen und Pathologen (BDP)Prof. Dr. Annette Lebeau
Prof. Dr. Hans-Peter Sinn
Berufsverband Deutscher Strahlentherapeuten (BVDST)Prof. Dr. Petra Feyer
Prof. Dr. Volker Budach
BRCA-NetzwerkAndrea Hahne
Traudl Baumgartner
Chirurgische Arbeitsgemeinschaft für Onkologie (CAO-V)Prof. Dr. Wolfram Trudo Knoefel
Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC)Prof. Dr. Christoph Heitmann
Deutsche Gesellschaft für Geriatrie (DGG)Prof. Dr. Michael Denkinger
Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG)Prof. Dr. Sara Y. Brucker
Prof. Dr. Bernd Gerber
Deutsche Gesellschaft für Humangenetik (GfH)Prof. Dr. Christian Kubisch
Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO)Prof. Dr. Diana Lüftner
Prof. Dr. Hans Tesch
Deutsche Gesellschaft für Nuklearmedizin (DGN)Prof. Dr. Andreas Buck
Deutsche Gesellschaft für Palliativmedizin (DGP)Dr. Christina Gerlach
Dr. Susanne Hirsmüller
Deutsche Gesellschaft für Pathologie (DGP)Prof. Dr. Hans H. Kreipe
Prof. Dr. Carsten Denkert
Deutsche Gesellschaft für Psychosomatische Frauenheilkunde und Geburtshilfe (DGPFG)PD Dr. Friederike Siedentopf
Deutsche Gesellschaft für Radioonkologie (DEGRO)Prof. Dr. Cordula Petersen
Prof. Dr. Jürgen Dunst
Deutsche Gesellschaft für Rehabilitationswissenschaften (DGRW)Prof. Dr. Hans Helge Bartsch
Deutsche Gesellschaft für Senologie (DGS)Prof. Dr. Rüdiger Schulz-Wendtland
Deutsche Gesellschaft für Ultraschall in der Medizin (DEGUM)Prof. Dr. Markus Hahn
Deutsche Krebsregister (DKR)Prof. Dr. Alexander Katalinic
Deutsche Röntgengesellschaft (DRG)Prof. Dr. Markus Müller-Schimpfle
Deutscher Verband für Physiotherapie (ZVK)Ulla Henscher
Reina Tholen
Frauenselbsthilfe Krebs - Bundesverband (FSH)Dr. Renza Roncarati
Roswita Hung
Konferenz Onkologischer Kranken- und Kinderkrankenpflege in der DKG (KOK)Kerstin Paradies
Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe (SGGG)Dr. Christoph Honegger
Ultraschalldiagnostik in Gynäkologie und Geburtshilfe (ARGUS)Prof. Dr. Dr. Friedrich Degenhardt
Österreichische Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG)Prof. Dr. Vesna Bjelic-Radisic

1.10.3 Arbeitsgruppen

 

Working groups and their members of this guideline (former working groups and chapter authors of the respective chapters can be found in Annex 11.6)

Steering Committee

The tasks of the steering group included establishing contacts and feedback to the participating professional societies and organisations, implementing the methodological guidelines, drawing up a project plan, managing financial resources, supporting the experts' work on content, bringing together and editing the texts prepared by the experts and working groups. The members of the steering group can be found in Table 1.

Members of the Guidelines Steering Group

 

Name

City

1

Prof. Dr. Ute-Susann Albert

Frankfurt

2

Prof. Dr. Wilfried Budach

Düsseldorf

3

Dr. Markus Follmann, MPH, MSc

Berlin

4

Prof. Dr. Wolfgang Janni

Ulm

5

Prof. Dr. Ina Kopp

Marburg

6

Prof. Dr. Rolf Kreienberg

Landshut

7

PD Dr. Mathias Krockenberger

Würzburg

8

Prof. Dr. Thorsten Kühn

Esslingen

9

Dipl.-Soz. Wiss. Thomas Langer

Berlin

10

Dr. Monika Nothacker

Marburg

11

Prof. Dr. Anton Scharl

Amberg

12

Prof. Dr. Ingrid Schreer

Hamburg-Eimsbüttel

13

Prof. Dr. Achim Wöckel

Würzburg

Methodological consulting: Prof. Dr. P. U. Heuschmann, University of Würzburg

Table 2: Arbeitsgruppen

Arbeitsgruppe

Mitglieder der Arbeitsgruppe (AG-Leiter fett markiert)

3.1 Patientinneninformation und - aufklärung

Ingrid Schreer, Joachim Weis, Susanne Hirsmüller, Roswita Hung, Gudrun Kemper, Klaus König, Renza Roncarati, Anke Steckelberg, Kerstin Paradies

3.2 Früherkennung, Mammographiescreening

Markus Müller-Schimpfle, Ute-Susann Albert, Ingrid Schreer, Friedrich Degenhardt, Jutta Engel, Markus Hahn, Sylvia Heywang-Köbrunner, Dieter Hölzel, Alexander Katalinic

3.3 Frauen mit erhöhtem Risiko für Brustkrebs

Peter Fasching, Ute-Susann Albert, Rita Schmutzler, Friedrich Degenhardt, Eva Fallenberg, Christoph Heitmann, Andrea Hahne, Gudrun Kemper, Christian Kubisch, Annette Lebeau, Hans-Jürgen Lück, Markus Müller-Schimpfle, Anke Steckelberg, Barbara Zimmer

4.2 Diagnostik bei der Abklärung auffälliger Befunde sowie prätherapeutische Ausbreitungsdiagnostik bei gesichertem Mammakarzinom

Sylvia Heywang-Köbrunner, Markus Hahn, Eva Fallenberg, Friedrich Degenhardt, Markus Müller-Schimpfle

4.3 DCIS und Risikoläsionen

Bernd Gerber, Hans-Peter Sinn, Sara Y. Brucker, Wilfried Budach, Carsten Denkert, Tanja Fehm, Christoph Heitmann, Hans H. Kreipe, Wolfgang Kühn, Annette Lebeau, Ingrid Schreer

4.4 Operative Therapie des invasiven Karzinoms

Wilfried Budach, Tanja Fehm, Vesna Bjelic-Radisic, Jürgen Dunst, Jutta Engel, Christoph Heitmann, Christoph Honegger, Wolfgang Janni, Wolfgang Kühn, Cordula Petersen, Anton Scharl, Hans-Peter Sinn, Achim Wöckel

4.5 Pathomorphologische Untersuchung

Bernd Gerber, Annette Lebeau, Sara Y. Brucker, Carsten Denkert, Hans H. Kreipe, Marcus Schmidt, Rüdiger Schulz-Wendtland, Hans-Peter Sinn

4.6 Adjuvante Strahlentherapie des Mammakarzinoms

Wilfried Budach, Christoph Thomssen, Volker Budach, Jürgen Dunst, Jutta Engel, Tanja Fehm, Petra Feyer, Dieter Hölzel, Alexander Katalinic, Cordula Petersen, Anton Scharl, Rüdiger Schulz-Wendtland

4.7.2 Endokrine Therapie

Marcus Schmidt, Jens Blohmer, Hans Helge Bartsch, Vesna Bjelic-Radisic, Tanja Fehm, Dieter Hölzel, Christian Jackisch, Hartmut Link, Diana Lüftner, Anton Scharl, Hans Tesch

4.7.3 Adjuvante Chemotherapie

Diana Lüftner, Elmar Stickeler, Sara Y. Brucker, Bernd Gerber, Nadia Harbeck, Volker Möbus, Volkmar Müller, Andreas Schneeweiss, Rüdiger Schulz-Wendtland, Hans Tesch

4.7.4 Neoadjuvante Therapie

Andreas Schneeweiss, Michael Untch, Sara Y. Brucker, Bernd Gerber, Jens Huober, Sibylle Loibl, Gunter von Minckwitz

4.7.5 Antikörpertherapie

Diana Lüftner, Marcus Schmidt, Andreas Schneeweiss, Jens Blohmer, Elmar Stickeler, Michael Untch

4.7.6 Knochengerichtete Therapie

Peyman Hadji, Florian Schütz, Rüdiger Schulz-Wendtland, Elmar Stickeler

4.7.7 Beeinflussbare Lebensstilfaktoren

Freerk Baumann, Wolfgang Janni, Volker Hanf, Hans Hauner, Ute Nöthlings

5.2 Diagnostik des lokalen/lokoregionalen Rezidivs

Eva Fallenberg, Jens Blohmer, Friedrich Degenhardt, Markus Hahn, Klaus König, Markus Müller-Schimpfle, Anton Scharl, Elmar Stickeler

5.3 Therapie des lokalen/lokoregionalen Rezidivs

Wilfried Budach, Sara Y. Brucker, Bernd Gerber, Christoph Heitmann, Susanne Hirsmüller, Christian Jackisch, Michael Lux

5.4 Fernmetastasen - Chemo

Hans Tesch, Jens Huober, Hans Helge Bartsch, Sara Y. Brucker, Wilfried Budach, Bernd Gerber, Christina Gerlach, Susanne Hirsmüller, Wolfram Trudo Knoefel, Hartmut Link, Diana Lüftner, Rüdiger Schulz-Wendtland, Anja Welt, Matthias Zaiss, Frederik Wenz

5.4 Fernmetastasen - Endokrin

Hans-Jürgen Lück, Volkmar Müller, Hans Helge Bartsch, Sara Y. Brucker, Wilfried Budach, Bernd Gerber, Christina Gerlach, Susanne Hirsmüller, Wolfram Trudo Knoefel, Hartmut Link, Diana Lüftner, Rüdiger Schulz-Wendtland, Anja Welt, Matthias Zaiss, Frederik Wenz

5.4 Fernmetastasen – Spez. Metastasenlokalisation

Cordula Petersen, Marcus Schmidt, Hans Helge Bartsch, Sara Y. Brucker, Wilfried Budach, Bernd Gerber, Christina Gerlach, Susanne Hirsmüller, Wolfram Trudo Knoefel, Hartmut Link, Diana Lüftner, Rüdiger Schulz-Wendtland, Anja Welt, Matthias Zaiss, Frederik Wenz

5.5 Palliativmedizin

Christina Gerlach, Susanne Hirsmüller, Renza Roncarati, Marcus Schmidt

6.2 Psychoonkologische Aspekte

Joachim Weis, Friederike Siedentopf, Hans Helge Bartsch, Susanne Hirsmüller, Roswita Hung, Renza Roncarati

6.3 Supportivtherapie

Hans Helge Bartsch, Michael Lux, Petra Feyer, Christina Gerlach, Ulla Henscher, Roswita Hung, Hartmut Link, Renza Roncarati

6.4 Nachsorge

Ute-Susann Albert, Klaus König, Matthias W. Beckmann, Vesna Bjelic-Radisic

6.5 Rehabilitation

Hans Helge Bartsch, Wilfried Budach, Ulla Henscher, Dieter Hölzel, Roswita Hung, Wolfgang Janni, Oliver Rick, Renza Roncarati, Rüdiger Schulz-Wendtland, Joachim Weis

6.6 Komplementäre Medizin

Matthias W. Beckmann, Volker Hanf, Jasmin Festl, Roswita Hung, Karsten Münstedt, Renza Roncarati

6.7 Dokumentation, Versorgungskoordination und Qualitätsmanagement

Matthias W. Beckmann, Jutta Engel, Simone Wesselmann, Wilfried Budach, Christina Gerlach, Susanne Hirsmüller, Dieter Hölzel, Jutta Hübner, Alexander Katalinic, Michael Lux, Rüdiger Schulz-Wendtland, Achim Wöckel

7. Mammakarzinom in Schwangerschaft und Stillzeit, Schwangerschaft nach Mammakarzinom, Fertilitätserhalt

Nadia Harbeck, Sibylle Loibl, Friedrich Degenhardt, Peyman Hadji

8. Mammakarzinom der älteren Patientin

Hans-Jürgen Lück, Jens Huober, Ute-Susann Albert, Michael Denkinger, Christina Gerlach, Anton Scharl

9. Mammakarzinom des Mannes

Volkmar Müller, Christoph Thomssen, Ute-Susann Albert

1.10.4 Other Patient Involvement (without voting rights)

 

experts in an advisory capacity

Name

City

PD Dr. Freerk Baumann

Cologne

Prof. Dr. Matthias Beckmann

Erlangen

Prof. Dr. Jens Blohmer

Berlin

Prof. Dr. Peter Fasching

Erlangen

Prof. Dr. Nadia Harbeck

Munich

Prof. Dr. Peyman Hadji

Frankfurt

Prof. Dr. Hans Hauner

Munich

Prof. Dr. Sylvia Heywang-Köbrunner

Munich

Prof. Dr. Jens Huober

Ulm

Dr. Jutta Hübner

Berlin

Prof. Dr. Christian Jackisch

Offenbach

Prof. Dr. Sibylle Loibl

Neu-Isenburg

Prof. Dr. Hans - Jürgen Lück

Hanover

Prof. Dr. Michael Lux

Erlangen

Prof. Dr. Gunter von Minckwitz

Neu-Isenburg

Prof. Dr. Volker Möbus

Frankfurt

Prof. Dr. Volkmar Müller

Hamburg

Prof. Dr. Ute Nöthlings

Bonn

Prof. Dr. Marcus Schmidt

Mainz

Prof. Dr. Rita Schmutzler

Cologne

Prof. Dr. Andreas Schneeweiss

Heidelberg

Prof. Dr. Florian Schütz

Heidelberg

Prof. Dr. Elmar Stickeler

Aachen

Prof. Dr. Christoph Thomssen

Halle (Saale)

Prof. Dr. Michael Untch

Berlin

Dr. Simone Wesselmann

Berlin

Dr. Barbara Zimmer, MPH, MA (Competence Center Oncology, MDK North Rhine, no author at the explicit request of the MDK)

Düsseldorf

Other research assistants:

Katharina Brust, B.Sc. (Guidelines Secretariat)

Würzburg

Dr. Jasmin Festl (guideline evaluation, literature selection)

Würzburg

Steffi Hillmann, MPH (guideline research and evaluation)

Würzburg

PD Dr. Mathias Krockenberger (literature selection)

Würzburg

Stephanie Stangl, MPH

Würzburg

Dr. Tanja Stüber (literature selection)

Würzburg

1.10.5 Patient Involvement

This Guideline was prepared with the direct involvement of 4 patient advocates.

Ms. Roncarati and Ms. Hung of the German Self-Help Group for Women after Cancer (Frauenselbsthilfe nach Krebs) were involved from the very beginning in the preparation of the guideline and participated in the consensus conferences with their own voting rights. Prof. Steckelberg and Ms. Kemper “Working Group on Women’s Health” (AKF) were also involved and took part in the consensus conferences with their own right to vote.

1.10.6 Methodological Support

Methodological support was provided by the Guideline Program in Oncology:

  • Monika Nothacker, M.D. MPH (AWMF)
  • Professor Ina Kopp, M.D. (AWMF)
  • Dr. Markus Follmann MPH, MSc. (DKG)
  • Thomas Langer, Social Scientist (DKG)


Through external sub-contractors:

  • Simone Wesselmann, M.D., MBA (update of quality indicators)

1.11 Abkürzungsverzeichnis

Table 3: Abkürzungen

AbkürzungenErläuterungen
ADH

(intra-)duktale atypische Hyperplasie

AI

aromatase inhibitor

AML

Akute myeloische Leukämie

APBI

accelerated partial breast irradiation

ASCO

American Society of Clinical Oncology

ATL

Aktivitäten des täglichen Lebens

AUC

Area Under the Curve

BÄK

Bundesärztekammer

bds

beiderseits

BET

brusterhaltende Therapie

CISH

Chromogene-in-situ-Hybridisierung

CNB

Core Needle Biopsy

CT

Computertomographie

DBT

digitale Brust-Tomosynthese

DCIS

Duktales Carcinoma in situ

DFS

Krankheitsfreies Überleben (engl. disease-free survival)

DGS

Deutsche Gesellschaft für Senologie e.V.

DKG

Deutsche Krebsgesellschaft e.V.

ECE

extrakapsulären Tumorwachstum an den Lymphknoten

EIC

extensive intraduktale Komponente

EK

Expertenkonsens

ER

Estrogenrezeptor

ESA

Erythropoese-stimulierende Agenzien

ESAS

Edmonton Symptom Assessment System

ET

Östrogen-Therapie

FEA

flache Epithelatypie

FISH

Floureszenz-in-situ Hybridisierung

FN

febrile Neutropenie

FNA

Feinnadelaspiration

FNB

Feinnadelbiopsie

G-CSF

Granulozyten-Kolonie-stimulierender Faktor

GnRHa

gonadotropin-releasing hormone agonist

HADS

Hospital Anxiety and Depression Scale

HER2

Human Epidermal Growth Factor Receptor Typ 2

HT

Hormontherapie

IARC

International Agency for Research on Cancer, internationales Institut für Krebsforschung

IBC

inflammatorisches Mammakarzinom

iFE

intensivierte Früherkennung

IHC

Immunhistochemie

IMRT

intensitätsmodulierte Radiotherapie

IORT

intraoperative Strahlentherapie

IQWiG

Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen

ISH

In-situ-Hybridisierung

ITC

intrathekale Chemotherapie

KD

kognitive Dysfunktion

KM-MRT

Kontrastmittel-Magnetresonanztomographie

KPE

komplexe Physikalische Erstauungstherapie

LABC

locally advanced breast cancer

LCIS

lobuläres Carcinoma in situ

LK

Lymphknoten

LL

Leitlinie

LN

lobuläre Neoplasie

LoE

Level of Evidence

LVEF

linksventrikuläre Ejektionsfraktion

LVI

(Lymph-)Gefäßinvasion

LWS

Lendenwirbelsäule

MAK

Mamillen-Areola-Komplex

MDS

Myelodysplatisches Syndrom

MG

Mammographie

MRT

Magnetresonanztomographie

MSP

Mammographie-Screening-Programm

NACT

neoadjuvante Chemotherapie

NCCN

National Comprehensive Cancer Network

NICE

National Institute for Health and Care Excellence

NNT

Number needed to treat

NZGG

New Zealand Guidelines Group

OP

Operation

OS

Gesamtüberleben / overall survival

PBI

partial breast irradiation

pCR

pathological complete remission (dt.: pathologische Komplettremission)

PET

Positronen-Emissions-Tomographie

PFS

progressionsfreies Überleben (engl.: progression-free survival)

PI

Proliferationsindex

PMRT

postoperative Strahlentherapie

PNP

Polyneuropathie

POS

Palliative Care Outcome Scale

PST

primär systemische Therapie

QoL

Lebensqualität / Quality of Life

RCT

Randomized Controlled Trial

RFA

Radiofrequenzablation

ROR

risk of recurrence

RR

Relatives Risiko

RS

Recurrence Score

SABCS

San Antonio Breast Cancer Symposium

SBRT

stereotaktische Bestrahlung

SGB

Sozialgesetzbuch

SIB

simultan-integrierter Boost

SIGN

Scottish Intercollegiate Guidelines Network

SISH

Silber verstärkte In-situ-Hybridisierung