Rehabilitation (Stuttg) 2024; 63(02): 119-130
DOI: 10.1055/a-2129-9279
CME-Fortbildung

Onkologische Rehabilitation bei Mammakarzinom

Oncological Rehabilitation for Breast Cancer
Holger G. Hass

Die Prognose des Mammakarzinoms hat sich durch eine zunehmend individualisierte Therapie deutlich verbessert. Allerdings kann es infolge der multimodalen Behandlung und dem Einsatz neuer Medikamente zu einer Vielzahl von somatischen und psychischen Folgestörungen kommen. Nachfolgend werden typische sowie neue Therapie-induzierte Nebenwirkungen erörtert und die zur Rehabilitation notwendigen Maßnahmen vorgestellt.

Abstract

As a result of increasingly individualized and multimodal therapy, prognosis of breast cancer has improved significantly over the last years. However, multimodal treatment and the use of new medications can lead to a variety of somatic, sometimes new, side effects such as fatigue, polyneuropathy or autoimmune toxicities. This and the oncological diagnosis lead to a high level of psychological distress in the women affected and often to subsequent psychological disorders (sleep/anxiety disorders, depression, ...). Both the diverse complaints after oncological therapy and the increasingly improved overall prognosis underline the importance of multimodal rehabilitation concepts to improve quality of life and successful professional reintegration.

In the following, these secondary disorders after breast cancer, their multimodal therapy and their significance for social-medical performance assessment are presented in more detail.



Publication History

Article published online:
16 April 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Robert-Koch-Institut. Brustkrebs. Zentrum für Krebsregisterdaten. Berlin: Robert-Koch-Institut; 2023
  • 2 Perou CM, Sørlie T, Eisen MB. et al. Molecular portraits of human breast tumours. Nature 2000; 406: 747-752 DOI: 10.1038/35021093.
  • 3 Hass HG, Seywald M, Stepien J. et al. Early and late toxicities and socio-medical relevant disorders after oncological treatment for breast cancer--implications and assessment of rehabilitation requirement. Rehabilitation 2021; 60: 77-85
  • 4 Heuser C, Halbach S, Kowalski C. et al. Sociodemographic and disease-related determinants of return to work among women with breast cancer: a German longitudinal cohort study. BMC Health Services Res 2018; 18: 1000 DOI: 10.1186/s12913-018-3768-4.
  • 5 Arndt V, Koch-Gallenkamp L, Bertram H. et al. Return to work after cancer. A multi-regional population-based study from Germany. Acta Oncologica 2019; 58: 811-818 DOI: 10.1080/0284186X.2018.1557341.
  • 6 Herremans KM, Cribbin MP, Riner AN. et al. Five-year breast surgeon experience in LYMPHA at time of ALND for treatment of clinical T1-4N1-3M0 breast cancer. Ann Surg Oncol 2021; 28: 5775-5787 DOI: 10.1245/s10434-021-10551-8.
  • 7 Liu L, Yang Y, Guo Q. et al. Comparing hypofractionated to conventional fractionated radiotherapy in postmastectomy breast cancer: a meta-analysis and systematic review. Radiat Oncol 2020; 15: 17 DOI: 10.1186/s13014-020-1463-1.
  • 8 Beckwée D, Leysen L, Meuwis K. et al. Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis. Support Care Cancer 2017; 25: 1673-1686 DOI: 10.1007/s00520-017-3613-z.
  • 9 Wang C, Huang Q, Liang CL. et al. Effect of cimicifuga racemosa on menopausal syndrome caused by LHRH-a in breast cancer. J Ethnopharmacol 2019; 238: 111840 DOI: 10.1016/j.jep.2019.111840.
  • 10 Kleckner IR, Kamen C, Gewandter JS. et al. Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial. Support Care Cancer 2018; 26: 1019-1028 DOI: 10.1007/s00520-017-4013-0.
  • 11 Jones KF, Wechsler S, Zulewski D. et al. Pharmacological and nonpharmacological management of chemotherapy-induced peripheral neuropathy: A scoping review of randomized controlled trials. J Palliat Med 2022; 25: 964-995 DOI: 10.1089/jpm.2021.0512.
  • 12 Janelsins MC, Heckler CE, Peppone LJ. et al. Cognitive complaints in survivors of breast cancer after chemotherapy compared with age-matched controls: An analysis from a nationwide, multicenter, prospective longitudinal study. J Clin Oncol 2017; 35: 506-514 DOI: 10.1200/JCO.2016.68.5826.
  • 13 PAM study group. Koevoets EW, Schagen SB, de Ruiter MB. et al. Effect of physical exercise on cognitive function after chemotherapy in patients with breast cancer: a randomized controlled trial (PAM study). Breast Cancer Res 2022; 24: 36 DOI: 10.1186/s13058-022-01530-2.
  • 14 Puigpinós-Riera R, Serral G, Sala M. et al. Cancer-related fatigue and its determinants in a cohort of women with breast cancer: the DAMA Cohort. Support Care Cancer 2020; 28: 5213-5221 DOI: 10.1007/s00520-020-05337-9.
  • 15 Thong MSY, van Noorden CJF, Steindorf K. et al. Cancer-related fatigue: causes and current treatment options. Curr Treat Options Oncol 2020; 21: 17 DOI: 10.1007/s11864-020-0707-5.
  • 16 Kumar V, Chaudhary N, Garg M. et al Current diagnosis and management of immune related adverse events (irAEs) induced by immune checkpoint inhibitor therapy. Front Pharmacol 2017; 8: 49 DOI: 10.3389/fphar.2017.00049. eCollection 2017;
  • 17 Marmé F. Antibody-drug conjugates for breast cancer. Oncol Res Treat 2022; 45: 26-36 DOI: 10.1159/000521499.
  • 18 AWMF. Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): Psychoonkologische Diagnostik, Beratung und Behandlung von erwachsenen Krebspatient*innen, Kurzversion 2.0, 2023, AWMF-Registernummer: 032-051OL
  • 19 Hass HG, Seywald M, Wöckel A. et al. Psychological distress in breast cancer patients during oncological inpatient rehabilitation: incidence, triggering factors and correlation with treatment-induced side effects. Arch Gynecol Obstet 2023; 307: 919-925 DOI: 10.1007/s00404-022-06657-3.
  • 20 MyBCC Study group. Ng CG, Mohamed S, Kaur K. et al Perceived distress and its association with depression and anxiety in breast cancer patients. PLoS One 2017; 12: e0172975 DOI: 10.1371/journal.pone.0172975.. eCollection 2017;
  • 21 Fauser D, Rimalis-Vogt E, Mattes J. et al. Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion. BMC Cancer 2023; 23: 1133 DOI: 10.1186/s12885-023-11576-w.