Abstract:
:The therapy for patients with breast cancer has developed markedly in the past ten years. Our understanding of the molecular biology of tumours and the characteristics of the patients has shaped the recent advances. In this review we present the latest knowledge about the therapy for breast cancer. There are new tests and options not only in the field of anti-HER2 therapy but also in the management of triple negative and hormone receptor-positive patients. Comprehension of prognosis and therapeutic response to chemotherapies is little by little helping to define patient groups who will not respond to chemotherapy or who do not need treatment because their prognosis is extremely good. In the field of anti-HER2 therapy, work is continuing on the development of drugs suitable for and able to overcome trastuzumab resistance. For hormone receptor-positive cancers, we now have a better understanding of which therapy groups will benefit from which anti-endocrine drugs, and which will be able to overcome a possible resistance (treatment of the PI3K pathways, inhibition of the cell cycle). Molecular tests are still being evaluated with regard to the clinical situations in which they may have the greatest relevance for therapeutic decision-making; however, evidence is also increasing as to the fields in which good predictions for the prognosis can be obtained. On the whole, more work is needed to promote our understanding of the new developments in diagnostics and therapy and to involve both physicians and patients equally in the procedures. ZUSAMMENFASSUNG:Die Therapie von Patientinnen mit Mammakarzinom hat sich in den letzten 10 Jahren deutlich weiterentwickelt. Das Verständnis um die molekulare Biologie der Tumoren und Patientinneneigenschaften haben die jüngsten Entwicklungen geprägt. In diesem Review werden die neuesten Erkenntnisse zur Therapie des Mammakarzinoms dargestellt. Hierbei gibt es sowohl auf dem Gebiet der Anti-HER2-Therapie als auch bei der Behandlung von triple-negativen und hormonrezeptorpositiven Patientinnen neue Tests und Therapien. Das Verständnis um Prognose und Therapieansprechen auf Chemotherapien definiert nach und nach Patientinnengruppen, die nicht auf eine Chemotherapie ansprechen oder die keine Therapie benötigen, weil die Prognose außerordentlich gut ist. Auf dem Gebiet der Anti-HER2-Therapie wird weiterhin an Medikamenten gearbeitet, die bei einer Trastuzumab-Resistenz geeignet sind, diese zu überwinden. Für hormonrezeptorpositive Karzinome wird besser verstanden, welche Therapiegruppen von welchen antiendokrinen Medikamenten profitieren, und welche eine eventuelle Resistenz überwinden können (Behandlung des PI3K-Pathways, Inhibition des Zellzyklus). Molekulare Tests befinden sich weiterhin in der Evaluation, in welchen klinischen Situationen sie den größten Nutzen für Therapieentscheidungen bringen können, jedoch wächst die Evidenz, in welchen Bereichen eine gute Aussage über die Prognose gewonnen werden kann. Insgesamt muss daran gearbeitet werden, das Verständnis für die neuen Entwicklungen in Diagnostik und Therapie zu fördern und Ärzte und Patientinnen gleichermaßen in die Ausbildung mit einzubeziehen.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Maass N,Schütz F,Fasching PA,Fehm T,Janni W,Kümmel S,Kolberg HC,Lüftner D,Wallwiener M,Lux MPdoi
10.1055/s-0035-1545704subject
Has Abstractpub_date
2015-02-01 00:00:00pages
170-182issue
2eissn
0016-5751issn
1438-8804journal_volume
75pub_type
杂志文章abstract::For the evaluation of the effectiveness of contraceptives the Life Table method is at present the best method. It is a disadvantage that the original method of Tietze & Potter was restricted to the evaluation of intra-uterine contraception devices. A Belgian team is now in the process of developing a modified life tab...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 临床试验,杂志文章
doi:
更新日期:1978-08-01 00:00:00
abstract::Background Tumor grade is one of the more controversial factors, and the data regarding its prognostic impact in squamous cell carcinoma (SCC) of the uterine cervix are controversial. Methods The histological slides of 467 surgically treated FIGO stage IB1 to IIB cervical SCC were re-examined regarding the prognostic ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-0828-7681
更新日期:2019-02-01 00:00:00
abstract::In 127 samples of the plasma from the umbilical vein obtained between one and five minutes after spontaneous normal vertex delivery, the coagulation inhibition was measured. The inhibition increases with increasing bearing down. There is no correlation between the duration of the second stage and the duration of the p...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1039533
更新日期:1980-12-01 00:00:00
abstract::A data collection system on microcomputer connected with an automatic medical report system for operations, was developed to facilitate both medical report as well as documentation. Linking different commercial software products by use of a Pascal programme, we were able to speed up daily routine work as well as estab...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026352
更新日期:1990-09-01 00:00:00
abstract::Now that we know about the genetic production mechanisms of diseases of the trophoblast, interest is concentrated on the question which risk factors can produce a disposition in the patient - seen from a clinico-genetic angle - towards malignancy of a complete mole. Many years before the genetic interrelations became ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036215
更新日期:1985-02-01 00:00:00
abstract:UNLABELLED:The paper is a review on the actual possibilities and indications of the transplacentar therapy of the fetus. At first some principles of the pharmacodynamics of the materno-placento-fetal unit are explained in order to enable an effective drug administration and reach therapeutic levels in the fetus. Common...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1022783
更新日期:1995-02-01 00:00:00
abstract::The oxytocinase levels have been tested prior to, during and after oxytocin challenge tests in 42 pregnant women. There was no relation between labour and the activity of the enzyme. There was no change in the activity during and after oxytocin infusion. Repeated challenge tests did not change these results. The use o...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract::65 microcarcinomas and 189 Ca. in situ-cases were diagnosed by cone biopsy in the Department of Gynaecology and Obstetrics of the University in Kiel in the periods 1973-1976 and 1977-1980. During the first period the haemostasis of the conization crater was obtained by the conventional techniques. In 38% (microcarcino...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036799
更新日期:1982-06-01 00:00:00
abstract::Therapeutic results in advanced cervical cancer have not been showing any progress for more than 30 years. Only by means of systemic therapy does it seem possible, that further treatment results may be obtained similar to those in squamous cell carcinoma of the head and neck. Therefore, between 1985 and 1990 we tried ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1026177
更新日期:1991-06-01 00:00:00
abstract::During the past fifteen years strong evidence has accumulated that particular types of human papilloma viruses are involved in the aetiology of cervical cancer. Early reports suggested that women with cytological signs of papilloma virus infection have a significantly higher risk to develop cervical cancer. Recent stu...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:
更新日期:1990-07-01 00:00:00
abstract::Eight clinical and paraclinical parameters were investigated in a retrospective study of 100 patients who underwent operations for adenocarcinoma of the endometrium and compared to the vaginal cytology prior to treatment. The over-all accuracy of vaginal cytology was 61%. In advanced stages, with increasing dedifferen...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036660
更新日期:1984-05-01 00:00:00
abstract::Based on a case report of a 19-year-old woman with Hodgkin's disease in pregnancy and on several casuistic communications and comparative studies from the literature the problems of cytostatic therapy in pregnancy are discussed. The following conclusions may be drawn: Cytostatic therapy in varying combination seems no...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036632
更新日期:1983-06-01 00:00:00
abstract::As a key area of gynaecology, urogynaecology has undergone impressive changes in the past few years. Together with the high prevalence of functional pelvic floor disorders, modern anaesthesia procedures and the introduction of new, innovative minimally invasive operation techniques have led to a dramatic increase in t...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0031-1298335
更新日期:2012-03-01 00:00:00
abstract::Report on a 30-year old primigravida with a family history of bleeding and a personal history of nasopharyngeal bleeding since age four. Severe menorrhagia since her menarche. First seen at 20 weeks gestation with naso-pharyngeal bleeding and a twin pregnancy. The patient was found to have Glanzmann's disease (congeni...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-04-01 00:00:00
abstract::Among 62 patients with galactorrhoea a corpus luteum deficiency or anovulatory cycles were found in 35 cases by serum progesterone determination, endometrial biopsy or basal body temperature records. 27 patients had a hyperpro-lactenemic amenorrhoea-galactorrhoea syndrome. During treatment with 2.5-5 mg. of Pravidel d...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract::The author reports on a rare case of chronic uterine inversion during the puerperium resulting in severe and dangerous haemorrhage six weeks post partum, caused by a large placental polyp. A case of this kind has so far not been described in international medical literature. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036241
更新日期:1986-07-01 00:00:00
abstract::In 871 deliveries out of a total of 3980 effected during 1980-1982 at the Winterthur Gynaecological Hospital, we found it necessary to perform one or several microanalyses of blood (blood gas analyses) sub partu. Among these, we found retrospectively that in 22 cases the microanalysis of the blood gas had prevented us...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036305
更新日期:1984-09-01 00:00:00
abstract::Aim: To compare the change of maternal outlook towards birth due to a midwife led antenatal education programme versus hypnoreflexogenous self-hypnosis training for childbirth. Method: Before beginning of the classes and after the last class maternal perception on birth was evaluated using Osgood semantic differential...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0035-1558250
更新日期:2015-11-01 00:00:00
abstract::Recently a number of authors have published their results of conservative treatment in tubal gestations. Numerous operative techniques have been described. This review tries to summarize the different operative approaches under special consideration of microsurgical techniques in regard to the authors experience. As a...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036118
更新日期:1985-10-01 00:00:00
abstract::Suburethral tension-free vaginal tape is used for the treatment of stress urinary incontinence with a high success rate. Often patients report having stress incontinence, as well as co-existing micturition problems which are attributable to overactive bladder syndrome (OAB). The present study examines the effect of su...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0033-1351073
更新日期:2014-01-01 00:00:00
abstract::After 15 years of clinical experiences with Clomiphen treatment it seemed desirable to investigate the efficiency of this kind of therapy under routine conditions in a crowded out-patient clinic. 314 patients treated from 1972--1974 have been included in this study. From 242 sterility patients 730 cycles could be foll...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::Clinical reports on successful hormonal treatment of climacteric or menopausal sexual dysfunctions are in contradiction with the lack of oestrous phenomena in humans as well as with the results of double-blind studies finding no objective proof for the alleged hormonal influence. A review of recent studies on the topi...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1023732
更新日期:1993-11-01 00:00:00
abstract::This case report its on a haemorrhagic shock developing after amniocentesis during early pregnancy. Initially caused by a lesion of a small subserous artery in the upper uterine fundal wall, the patient consequently developed a protracted haemorrhagic shock that required emergency treatment and surgery. Thirteen days ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022812
更新日期:1995-07-01 00:00:00
abstract::The treatment of metastatic breast cancer has become more complicated due to increasing numbers of new therapies which need to be tested. Therapies are now being developed to treat special clinical or molecular subgroups. Even though intrinsic molecular subtypes play a major role, more and more new therapies for subgr...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0044-101614
更新日期:2018-03-01 00:00:00
abstract::In 1959 Rauscher and Spurny questioned the advantages of routine lymphadenectomy in radical Wertheim operations compared to selective lymphadenectomies. Our present review disagrees with the above mentioned doubts. Rauscher and Spurny base their results on clinical staging of cancer of the cervix in cases from 1947 to...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract::In the following up of the diagnosis of the female sterility we practised 123 hysterosalpingographies (HSG) from 1972--1978. Presupposition was the proof of the ovulation by base temperature. The HSG is the beginning of the diagnosis to recognize the intracanalicular changes of the uterus and to avoid senseless treatm...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037290
更新日期:1981-07-01 00:00:00
abstract::In a prospective study, 31 unselected patients with urge or urge incontinence, where previous treatment had been unsuccessful, were given repeated instillations of Lidocain gel for 11 days. Detailed histories were obtained by questionnaire both before instituting and after termination of the therapy. A cystourethroton...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026539
更新日期:1988-08-01 00:00:00
abstract::Incidental appendectomy is a more and more frequent part of gynaecological laparotomies. Doubts about the increased post-operative morbidity and mortality have been shown to be unfounded in numerous series. Opinions on contra-indications to incidental appendectomy are divided. German language authors do not do inciden...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036892
更新日期:1983-05-01 00:00:00
abstract::The introduction of percutaneous nephrostomy under xc-ray control or ultra-sonic control makes it possible to do the operation even in patients with a bad general condition. The decision for palliative urinary diversion in cases of cancer of the pelvis is therefore largely an ethical question. A group of patients with...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037150
更新日期:1982-10-01 00:00:00
abstract::In the near future, important translational questions of clinical relevance will be adressed by studies currently in progress. On the one hand, the role of PD-L1 expression must be further understood, after it was found to be relevant in the use of atezolizumab in first-line therapy of patients with metastatic triple-...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1039-4458
更新日期:2019-12-01 00:00:00