Richtlijn Behandeling van het Mammacarcinoom - Oncoline
Richtlijn Behandeling van het Mammacarcinoom - Oncoline
Richtlijn Behandeling van het Mammacarcinoom - Oncoline
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INHOUDSOPGAVESAMENSTELLING VAN DE WERKGROEP.............................................................. 5INLEIDING ................................................................................................................. 8HOOFDSTUK 1 PRIMAIRE LOKALE BEHANDELING VAN HET DCIS EN HETOPERABEL INFILTREREND MAMMACARCINOOM............................................. 131.1. Diagnostiek en behandeling <strong>van</strong> <strong>het</strong> Ductaal Carcinoma In Situ (DCIS) en <strong>het</strong>Lobulair Carcinoma In Situ (LCIS) .........................................................................131.2. Diagnostiek en behandeling <strong>van</strong> <strong>het</strong> operabel infiltrerend mammacarcinoom.......161.3. Diagnostiek en behandeling <strong>van</strong> de regionale klierstations ...................................251.4. Fysiotherapie .........................................................................................................301.5. <strong>Mammacarcinoom</strong> bij de man................................................................................321.6. Bestraling tijdens zwangerschap............................................................................32HOOFDSTUK 2 ADJUVANTE SYSTEMISCHE THERAPIE VOOR HET OPERABELMAMMACARCINOOM............................................................................................. 462.1. Resultaten <strong>van</strong> adju<strong>van</strong>te systemische therapie....................................................462.2. <strong>Behandeling</strong>sindicaties ..........................................................................................502.3. Behandeladvies adju<strong>van</strong>te systemische therapie ..................................................532.4 Volgorde chemotherapie, hormonale therapie, trastuzumab en radiotherapie .......602.5. Voorlichting en communicatie ................................................................................612.6. Osteoporose preventie...........................................................................................622.7. Adju<strong>van</strong>te systemische therapie tijdens zwangerschap.........................................632.8. Infrastructuur..........................................................................................................63HOOFDSTUK 3 LOKAAL UITGEBREID MAMMACARCINOOM .......................... 713.1. Diagnostiek ............................................................................................................723.2. <strong>Behandeling</strong> ...........................................................................................................723.3. Systemische behandeling ......................................................................................733.4. Locoregionale behandeling....................................................................................74HOOFDSTUK 4 FOLLOW-UP ................................................................................. 834.1. Locoregionaal recidief............................................................................................834.2. Metastasen op afstand...........................................................................................844.3. Nieuwe primaire tumor in de contralaterale mamma, of ipsilaterale mamma (naMST) ......................................................................................................................844.4. Bijwerkingen <strong>van</strong> behandeling(en) <strong>van</strong> mammacarcinoom....................................854.5. Ondersteunende zorg ............................................................................................874.6. Specifieke problemen in de follow-up ....................................................................894.7. Informatieverstrekking en communicatie................................................................89HOOFDSTUK 5 LOCOREGIONAAL RECIDIEF MAMMACARCINOOM................ 965.1. Diagnostiek ............................................................................................................965.2. <strong>Behandeling</strong> ...........................................................................................................97HOOFDSTUK 6 DIAGNOSTIEK EN BEHANDELING VAN HETGEMETASTASEERDE MAMMACARCINOOM..................................................... 1056.1. Diagnostiek ..........................................................................................................105<strong>Richtlijn</strong> ‘<strong>Behandeling</strong> <strong>van</strong> <strong>het</strong> mammacarcinoom’ 2005 3