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<p>More than 80% of newly diagnosed breast cancers are early&#xa0;stage cases, which are curable for most patients. Due to progress in imaging, pathology and molecular biology, personalised treatment strategies are becoming more common. Studies such as INSEMA and SOUND have shown that for certain low-risk patients, it can be safe to forego axillary surgery, including sentinel node biopsy. In systemic therapy of hormone-sensitive tumors, genomic assays enable accurate risk stratification and informed choices regarding adjuvant chemotherapy. In high-risk HR+/HER2 patients, cyclin-dependent kinase (CDK)&#xa0;4/6&#xa0;inhibitors have transformed adjuvant endocrine therapy. HER2-positive patients benefit from treatment with antibody drug conjugates, whereas checkpoint inhibitors are now commonly used in triple negative breast cancer patients. Poly(adenosine diphosphate–ribose) polymerase (PARP) inhibitors provide survival advantages for <i>BRCA</i>-mutated subgroups. Radiation therapy remains an important part of local treatment, though current evidence supports its omission or reduction in carefully selected low-risk populations. Diagnosis now also emphasises comprehensive histological profiling and genetic testing. This review summarises the latest evidence, guideline updates and clinical implications, highlighting a&#xa0;shift toward highly individualised treatment concepts in early breast cancer care.</p>

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Diagnostik und Therapie des frühen Mammakarzinoms

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • Franziska Ulrich,
  • Tanja Schlaiß

摘要

More than 80% of newly diagnosed breast cancers are early stage cases, which are curable for most patients. Due to progress in imaging, pathology and molecular biology, personalised treatment strategies are becoming more common. Studies such as INSEMA and SOUND have shown that for certain low-risk patients, it can be safe to forego axillary surgery, including sentinel node biopsy. In systemic therapy of hormone-sensitive tumors, genomic assays enable accurate risk stratification and informed choices regarding adjuvant chemotherapy. In high-risk HR+/HER2 patients, cyclin-dependent kinase (CDK) 4/6 inhibitors have transformed adjuvant endocrine therapy. HER2-positive patients benefit from treatment with antibody drug conjugates, whereas checkpoint inhibitors are now commonly used in triple negative breast cancer patients. Poly(adenosine diphosphate–ribose) polymerase (PARP) inhibitors provide survival advantages for BRCA-mutated subgroups. Radiation therapy remains an important part of local treatment, though current evidence supports its omission or reduction in carefully selected low-risk populations. Diagnosis now also emphasises comprehensive histological profiling and genetic testing. This review summarises the latest evidence, guideline updates and clinical implications, highlighting a shift toward highly individualised treatment concepts in early breast cancer care.