[Diagnosis and treatment of breast cancer]

Today, the treatment of breast cancer should be carried out in interdisciplinary centers. Preoperative diagnosis comprises clinical examination, mammography, ultrasound, and possibly magnetic resonance imaging. To exclude metastases, X-ray of the thorax, ultrasound examination of the abdomen (liver), and skeletal scintigraphy have to be performed. Preoperatively, the possibility of primary systemic therapy to reduce the size of the tumor can be investigated in order to increase the likelihood of surgery preserving the breast, the goal in at least 70% of cases and which always requires radiation therapy. Histopathological investigation to confirm the R0 resection must always be carried out. In the case of intraductal components, the tumor-free periphery must be larger. Systemic therapy is based on risk groups and comprises hormonal therapy, chemotherapy, and immune (antibody) therapy. Follow-up should focus in particular on determining whether relapse has occurred or contralateral breast carcinoma has developed.