Breast cancer: Care in Germany

Every year, more than 70 000 women in Germany develop an invasive breast tumor. This makes breast cancer the most common tumor disease in women. The current edition of Deutsches Ärzteblatt International (Edition 35/36) contains no less than three articles focusing on breast cancer.

Elke Peters of University Medical Center Schleswig-Holstein et al. examined the adjuvant therapy provided to older women with primary breast cancer (Dtsch Arztebl Int 2015; 112: 577-84). To this end they evaluated data from the PATH tumor database, obtained from more than 3000 patients at initial diagnosis and after two years' follow-up. They found that older women aged over 69 years, who accounted for 22% of those investigated, were less likely than younger women to receive breast-conserving surgery, chemotherapy, or radiotherapy.

Christina Köster of the AQUA Institute Göttingen et al. analyzed the correlation between case number and quality of care in breast surgery (Dtsch Arztebl Int 2015; 112: 585-92). The basis of their research was data from an external program for quality assurance in inpatient care. Evaluation covered data from 153 475 patients and 939 hospitals. Overall, their results indicate better quality of care in hospitals with larger case numbers.

The article by Bernd Gerber of Rostock University's Department of Obstetrics and Gynecology et al. is based on evaluation of the latest publications. It provides an overview of the options, indications, and contraindications for breast reconstruction (Dtsch Arztebl Int 2015; 112: 593-600). Among other issues, they examine the best time for reconstruction. If no radiotherapy is needed, immediate implant-based reconstruction can take place. However, if radiotherapy is indicated following breast removal, later reconstruction using autologous material is the first-line procedure.

The subject of breast cancer is introduced in an editorial by Carolin Nestle-Krämling and Christoph Andree (Dtsch Arztebl Int; 112: 575-6). They conclude that new treatment and breast reconstruction options should be tailored to both the individual patient's tumor stage and to her wishes and life situation, and that they should be offered to patients of all ages.

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Elke Bartholomäus

bartholomaeus@aerzteblatt.de