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2017 | OriginalPaper | Hoofdstuk

25. Mammatumoren

Auteurs : C. J. H. van de Velde, C. J. van Asperen, P. J. van Diest, P. H. M. Elkhuizen, S. C. Linn, H. M. Zonderland, G. J. Liefers

Gepubliceerd in: Leerboek oncologie

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

Ondanks de toenemende incidentie van mammacarcinoom, neemt de sterfte aan mammacarcinoom in de westerse wereld iets af. Dit is te danken aan vroegdiagnostiek en verbeterde adjuvante systemische therapie. De vroegdiagnostiek kan worden verdeeld in de screening binnen de kaders van het bevolkingsonderzoek en buiten deze kaders, waarbij het dan vooral gaat om familiaire belasting. Door moleculair-genetisch onderzoek kunnen genmutatiedraagsters worden geïdentificeerd, die een screeningsprogramma op maat krijgen aangeboden. Dankzij moleculair-genetisch onderzoek van het carcinoom kan een toegesneden behandeling worden aangeboden, gebaseerd op het risicoprofiel. De verbeterde neoadjuvante therapeutische mogelijkheden verhogen de kwaliteit van leven, doordat in toenemende mate borstsparende therapie of reconstructieve chirurgie mogelijk blijkt. Het huidige beleid is er bovendien op gericht direct na de primaire lokale behandeling micrometastasen uit te schakelen met adjuvante systemische therapie. Bij het optreden van een recidief of bij een nieuwe tumor kan bij vroege detectie en indien zonder afstandsmetastasen alsnog curatie worden bereikt. Ondanks de ontwikkelingen in de oncologie, is curatie van de patiënt met metastasen op afstand in de regel echter niet mogelijk. Wel heeft circa 3 % van de borstkankerpatiënten met metastasen op afstand een overleving van langer dan 20 jaar. De overleving is afhankelijk van factoren van velerlei aard, zoals jonge leeftijd, tumor load, gevoeligheid voor hormonale behandeling, snelle progressie van metastasen en een kort ziektevrij interval. Dat optimale zorg op maat voor alle patiënten niet mogelijk is zonder multidisciplinair overleg, voorlichting en begeleiding van de patiënt spreekt voor zichzelf.
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Metagegevens
Titel
Mammatumoren
Auteurs
C. J. H. van de Velde
C. J. van Asperen
P. J. van Diest
P. H. M. Elkhuizen
S. C. Linn
H. M. Zonderland
G. J. Liefers
Copyright
2017
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-0442-4_25