Abstract
In primary early breast cancer, the aim of treatment planning is to obtain an increasingly better understanding of the disease. The identification of patients with an excellent prognosis could help this group avoid unnecessary treatments. Furthermore, the planning of treatment is becoming increasingly patient-focussed. There is a growing understanding of those patients who benefit particularly from chemotherapy, as well as of those who could benefit from immunotherapy. Studies conducted on immunotherapies will be published shortly. Smaller individual studies offer an initial insight into the efficacy of checkpoint inhibitors (anti-PD1/PDL1 therapies). Not least, one of the largest breast cancer studies of all times has recently come to an end. The use of a multigene test has shown that it is sufficient to identify patients with such a good prognosis that chemotherapy is unnecessary. This review article is intended to summarise the current studies and give an outlook on current developments.
Highlights
One of the fundamental principles of medical practice, “primum non nocere”, Latin for “first, do no harm” is as topical in 2018 as ever
The other principles of this Hippocratic tradition such as “second, be careful” and “third, cure” have their correlates in the current study results, guidelines and treatment recommendations [1 – 3]. This means that the identification of patients with a good and poor prognosis, with good and poor treatment responses and with severe vs. mild adverse reactions continues to be one of the main areas of research and of efforts to transpose these findings into clinical practice
In the TAM + OFS group, this was the case with 91 % of patients (p = 0.033). Both analyses confirm the current recommendation of the S3 guideline [69] that the combination of endocrine therapy with OFS can be considered only in premenopausal women with a high risk and a premenopausal status post-chemotherapy, since the increased adverse effect rate must be taken into consideration, in terms of quality of life and compliance
Summary
One of the fundamental principles of medical practice, “primum non nocere”, Latin for “first, do no harm” is as topical in 2018 as ever. The adjuvant use of tamoxifen (TAM) in premenopausal women with hormone receptor-positive breast cancer is one of the most effective treatment options [62].
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