Richtlijn: Mammacarcinoom (2.0) - Kwaliteitskoepel
Richtlijn: Mammacarcinoom (2.0) - Kwaliteitskoepel
Richtlijn: Mammacarcinoom (2.0) - Kwaliteitskoepel
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Inhoudsopgave<br />
Pathologie<br />
Bepalingen van hormoonreceptoren en HER2.................................................................................92<br />
Stadiëring d.m.v. SWK-procedure en/of OKD..................................................................................94<br />
Minimale criteria voor de diagnose DCIS - dd. invasief carcinoom..................................................95<br />
Beoordeling na neoadjuvante chemo- of endocriene therapie.........................................................96<br />
Risicoprofilering..........................................................................................................................................99<br />
Prognostische factoren.....................................................................................................................99<br />
Adjuvante systemische therapie..............................................................................................100<br />
Genexpressie profielen..................................................................................................................101<br />
Prognostische waarde.............................................................................................................101<br />
Predictieve waarde..................................................................................................................102<br />
Adjuvante systemische therapie.............................................................................................................104<br />
Chemotherapie...............................................................................................................................108<br />
Anthracycline-bevattende chemotherapie................................................................................108<br />
Taxaan-bevattende chemotherapie.........................................................................................110<br />
Chemotherapie in combinatie met trastuzumab......................................................................112<br />
Toxiciteit...................................................................................................................................114<br />
Hormonale therapie........................................................................................................................116<br />
Uitschakeling van de ovariële functie.......................................................................................116<br />
Tamoxifen................................................................................................................................117<br />
Aromataseremmers.................................................................................................................117<br />
Volgorde therapie...........................................................................................................................121<br />
Adjuvante therapie met bisfosfonaten............................................................................................122<br />
Neoadjuvante systemische therapie.......................................................................................................124<br />
Diagnostiek.....................................................................................................................................125<br />
Neoadjuvante systemische therapie..............................................................................................126<br />
Chemotherapie........................................................................................................................127<br />
Neoadjuvante hormonale therapie...........................................................................................128<br />
Neoadjuvante trastuzumab......................................................................................................129<br />
Lokale behandeling........................................................................................................................130<br />
Chirurgie..................................................................................................................................130<br />
Radiotherapie van de mamma of thoraxwand.........................................................................132<br />
Locoregionaal recidief mammacarcinoom.............................................................................................136<br />
Diagnostiek.....................................................................................................................................137<br />
Behandeling...................................................................................................................................137<br />
Lokale behandeling van het lokaal recidief na mastectomie....................................................138<br />
Lokale behandeling van het lokaal recidief na MST................................................................138<br />
Lokale behandeling van regionale recidieven..........................................................................139<br />
Systemische behandeling locoregionaal recidief.....................................................................139<br />
Gemetastaseerd mammacarcinoom........................................................................................................142<br />
Diagnostiek.....................................................................................................................................142<br />
Systemische therapie.....................................................................................................................144<br />
Hormonale therapie.................................................................................................................144<br />
Chemotherapie........................................................................................................................146<br />
Doelgerichte Therapie..............................................................................................................148<br />
Bisfosfonaten..................................................................................................................................150<br />
Behandeling bij comorbiditeit.........................................................................................................151<br />
Het hereditair mammacarcinoom...................................................................................................152<br />
Palliatieve chirurgie en radiotherapie.............................................................................................152<br />
Behandeling van specifieke problemen..........................................................................................154<br />
<strong>Mammacarcinoom</strong> bij de man..................................................................................................................156<br />
Diagnostiek.....................................................................................................................................156<br />
Primaire behandeling.....................................................................................................................156<br />
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