Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Beyond Milk and Nurture: Breastfeeding's Powerful Impact on Breast Cancer.","authors":"Muhammad Mustafa, Sadaf Sarfraz, Gullelalah Saleem, Touqeer Ahmad Khan, Damiya Shahid, Saba Taj, Noor Amir","doi":"10.1055/a-2313-0637","DOIUrl":"10.1055/a-2313-0637","url":null,"abstract":"<p><p>Breast cancer (BC) stands as a global concern, given its high incidence and impact on women's mortality. This complex disease has roots in various risk factors, some modifiable and others not. Understanding and identifying these factors can be instrumental in both preventing BC and improving survival rates. Remarkably, women's reproductive behaviors have emerged as critical determinants of BC susceptibility. Numerous studies have shed light on how aspects including age of menarche, first pregnancy and menopause along with number of pregnancies, hormone replacement therapies, can influence one's risk of developing BC. Furthermore, the act of breastfeeding and its duration have shown an inverse relationship with BC risk. This review delves into the biological and molecular mechanisms associated with breastfeeding that contribute to BC protection. It highlights the role of endocrine processes triggered by suckling stimulation, the gradual onset of lactational amenorrhea, delayed weaning, reduced lifetime menstrual cycles, chromosomal repair mechanisms, and immunological events throughout the lactation cycle. These insights provide a potential explanation for the protective effects conferred by breastfeeding against breast carcinomas.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 6","pages":"541-554"},"PeriodicalIF":2.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Reviews on the Prevention of Adverse Pregnancy Outcomes Related to Maternal Obesity to Improve Evidence-Based Counselling.","authors":"Susann Behnam, Birgit Arabin","doi":"10.1055/a-2295-1725","DOIUrl":"10.1055/a-2295-1725","url":null,"abstract":"<p><strong>Background: </strong>Health professionals and their patients should understand the importance of evidence. In the case of gestational diabetes mellitus, which is often associated with an abnormally high body mass index, the immediate and long-term outcome of women and their offspring depends in part on advice and implementation of lifestyle changes before, during and after pregnancy.</p><p><strong>Methods: </strong>Up to September 2023, MEDLINE, CENTRAL, and WEB OF SCIENCE were used to identify systematic reviews and meta-analyses on the prevention of gestational diabetes. The ROBIS and AMSTAR criteria were analyzed for all systematic reviews.</p><p><strong>Results: </strong>A total of 36 systematic reviews were identified. Dietary interventions, physical activity or a combined approach all reduced adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension and related morbidities. Within the randomized controlled trials included in the 36 systematic reviews, the type, intensity and frequency of interventions varied widely. The primary outcomes, reporting and methodological quality of the 36 systematic reviews and meta-analyses also varied.The meta-analysis with the highest ROBIS and AMSTAR-2 scores was selected to design an icon array based on a fact box simulating 100 patients.</p><p><strong>Conclusions: </strong>We propose a methodology for selecting the best evidence and transforming it into a format that illustrates the benefits and harms in a way that can be understood by lay patients, even if they cannot read. This model can be applied to counselling for expectant mothers in low and high-income countries, regardless of socioeconomic status, provided that women have access to appropriately trained healthcare providers.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 6","pages":"564-572"},"PeriodicalIF":2.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hallmarks of Endometriosis.","authors":"Iason Psilopatis, Stefanie Burghaus, Katharina Au, Louisa Hofbeck, Lisa Windischbauer, Laura Lotz, Matthias W Beckmann","doi":"10.1055/a-2306-8759","DOIUrl":"10.1055/a-2306-8759","url":null,"abstract":"<p><p>A heuristic tool called \"the hallmarks of cancer\" helps to reduce the enormous complexity of cancer phenotypes and genotypes to a preliminary set of guiding principles. Other aspects of cancer have surfaced as possible improvements in our understanding of the disease's mechanisms. Endometriosis is a gynecological disease condition negatively impacting the quality of life of many women. To date, there is no curative treatment for endometriosis. Therapy is aimed at treating the symptoms using hormone therapy, pain therapy and complementary therapy. Chronic pain and overlapping pain syndromes and illnesses can also be treated with multimodal pain therapy and psychosomatic therapy. Endometriosis is, however, a chronic and complex entity which, in this regard, resembles cancer. The present work investigates the hallmarks of endometriosis with a view to summarizing the current research status and paving new ways for future research projects.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 6","pages":"555-563"},"PeriodicalIF":2.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussion of ABC7 Consensus and German Recommendations.","authors":"Michael Untch, Nina Ditsch, Peter A Fasching, Steffi Busch, Johannes Ettl, Renate Haidinger, Nadia Harbeck, Christian Jackisch, Diana Lüftner, Lothar Müller, Eugen Ruckhäberle, Eva Schumacher-Wulf, Christoph Thomssen, Rachel Wuerstlein, Volkmar Müller","doi":"10.1055/a-2263-5152","DOIUrl":"10.1055/a-2263-5152","url":null,"abstract":"<p><p>The rationale behind the \"International Consensus Conference for Advanced Breast Cancer\" (ABC) is to standardize the treatment of patients with advanced or metastatic breast cancer worldwide using an evidence-based approach. The aim is also to ensure that patients in all countries receive adequate treatment based on current treatment recommendations and standards. The 7th International Consensus Conference on Advanced Breast Cancer (ABC7) took place from November 9 to 12, 2023 in Lisbon/Portugal. ABC7 focused on metastatic disease as well as on locally advanced and inflammatory breast cancer. Special topics included the treatment of oligometastatic patients, leptomeningeal disease, treatment of brain metastases, and pregnant women with ABC. As in previous years, patient advocates from all over the world participated in the consensus conference and were involved in decision making.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 5","pages":"431-442"},"PeriodicalIF":2.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CDK4/6 Inhibition - Therapy Sequences and the Quest to Find the Best Biomarkers - an Overview of Current Programs.","authors":"Andreas Schneeweiss, Sara Y Brucker, Hanna Huebner, Lea L Volmer, Carolin C Hack, Katharina Seitz, Matthias Ruebner, Sabine Heublein, Verena Thewes, Diana Lüftner, Michael P Lux, Ingolf Jurhasz-Böss, Florin-Andrei Taran, Pauline Wimberger, Daniel Anetsberger, Milena Beierlein, Marcus Schmidt, Julia Radosa, Volkmar Müller, Wolfgang Janni, Brigitte Rack, Erik Belleville, Michael Untch, Marc Thill, Nina Ditsch, Bahriye Aktas, Ivonne Nel, Hans-Christian Kolberg, Tobias Engerle, Hans Tesch, Christian Roos, Christina Budden, Hans Neubauer, Andreas D Hartkopf, Tanja N Fehm, Peter A Fasching","doi":"10.1055/a-2286-6066","DOIUrl":"10.1055/a-2286-6066","url":null,"abstract":"<p><p>In recent years, new targeted therapies have been developed to treat patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer. Some of these therapies have not just become the new therapy standard but also led to significantly longer overall survival rates. The cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) have become the therapeutic standard for first-line therapy. Around 70 - 80% of patients are treated with a CDK4/6i. In recent years, a number of biomarkers associated with progression, clonal selection or evolution have been reported for CDK4/6i and their endocrine combination partners. Understanding the mechanisms behind treatment efficacy and resistance is important. A better understanding could contribute to planning the most effective therapeutic sequences and utilizing basic molecular information to overcome endocrine resistance. One study with large numbers of patients which aims to elucidate these mechanisms is the Comprehensive Analysis of sPatial, TempORal and molecular patterns of ribociclib efficacy and resistance in advanced Breast Cancer patients (CAPTOR BC) trial. This overview summarizes the latest clinical research on resistance to endocrine therapies, focusing on CDK4/6 inhibitors and discussing current study concepts.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 5","pages":"443-458"},"PeriodicalIF":2.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Greener Choice: Vaginal Hysterectomy's Environmental Edge Over Laparoscopic Techniques.","authors":"Cihan Kaya, Murat Yassa, Koray Gorkem Sacinti, Fatih Aktoz, Ali Can Gunes","doi":"10.1055/a-2280-5530","DOIUrl":"10.1055/a-2280-5530","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 5","pages":"477-478"},"PeriodicalIF":2.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attrition in the First Three Therapy Lines in Patients with Advanced Breast Cancer in the German Real-World PRAEGNANT Registry.","authors":"Andreas D Hartkopf, Christina B Walter, Hans-Christian Kolberg, Peyman Hadji, Hans Tesch, Peter A Fasching, Johannes Ettl, Diana Lüftner, Markus Wallwiener, Volkmar Müller, Matthias W Beckmann, Erik Belleville, Hanna Huebner, Sabrina Uhrig, Chloë Goossens, Theresa Link, Carsten Hielscher, Christoph Mundhenke, Christian Kurbacher, Rachel Wuerstlein, Michael Untch, Wolfgang Janni, Florin-Andrei Taran, Laura L Michel, Michael P Lux, Diethelm Wallwiener, Sara Y Brucker, Tanja N Fehm, Lothar Häberle, Andreas Schneeweiss","doi":"10.1055/a-2286-5372","DOIUrl":"10.1055/a-2286-5372","url":null,"abstract":"<p><p><b>Background</b> With more effective therapies for patients with advanced breast cancer (aBC), therapy sequences are becoming increasingly important. However, some patients might drop out of the treatment sequence due to deterioration of their life status. Since little is known about attrition in the real-world setting, this study assessed attrition in the first three therapy lines using a real-world registry. <b>Methods</b> Patients with information available on the first three therapy lines were selected from the German PRAEGNANT registry (NCT02338167). Attrition was determined for each therapy line using competing risk analyses, with the start of the next therapy line or death as endpoints. Additionally, a simple attrition rate was calculated based on the proportion of patients who completed therapy but did not start the next therapy line. <b>Results</b> Competitive risk analyses were performed on 3988 1st line, 2651 2nd line and 1866 3rd line patients. The probabilities of not starting the next therapy line within 5 years after initiation of 1st, 2nd and 3rd line therapy were 30%, 24% and 24% respectively. Patients with HER2-positive disease had the highest risk for attrition, while patients with HRpos/HER2neg disease had the lowest risk. Attrition rates remained similar across molecular subgroups in the different therapy lines. <b>Conclusion</b> Attrition affects a large proportion of patients with aBC, which should be considered when planning novel therapy concepts that specifically address the sequencing of therapies. Taking attrition into account could help understand treatment effects resulting from sequential therapies and might help develop treatment strategies that specifically aim at maintaining quality of life.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 5","pages":"459-469"},"PeriodicalIF":2.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Breast Cancer 2024 Part 1 - Expert Opinion on Advanced Breast Cancer.","authors":"Rachel Würstlein, Hans-Christian Kolberg, Andreas D Hartkopf, Tanja N Fehm, Manfred Welslau, Florian Schütz, Peter A Fasching, Wolfgang Janni, Isabell Witzel, Christoph Thomssen, Annika Krückel, Erik Belleville, Diana Lüftner, Michael Untch, Marc Thill, Manuel Hörner, Hans Tesch, Nina Ditsch, Michael P Lux, Bahriye Aktas, Maggie Banys-Paluchowski, Florin-Andrei Taran, Achim Wöckel, Nadia Harbeck, Elmar Stickeler, Rupert Bartsch, Andreas Schneeweiss, Johannes Ettl, David Krug, Volkmar Müller","doi":"10.1055/a-2300-5326","DOIUrl":"10.1055/a-2300-5326","url":null,"abstract":"<p><p>Clinical evidence is interpreted based on clinical studies and personal experience which can lead to different interpretations of data. This makes the opinions issued by panels of experts such as the Advanced Breast Cancer Panel which convened in November 2023 for the seventh time (ABC7) particularly important. At the conference, current issues around advanced breast cancer were evaluated by an international team of experts. In 2023 the data on CDK4/6 inhibitors was so extensive that the answers to questions about the sequencing of therapy and the potential use of chemotherapy as an alternative therapy were relatively clear. Moreover, data on antibody drug conjugates which provides a good overview of their uses is available for all molecular subtypes. Some therapeutic settings, including patients with brain metastases or leptomeningeal disease, older patients, locally advanced breast cancer and visceral crises, continue to be particularly important and were discussed in structured sessions. The scientific context of some of the topics discussed at ABC7 is presented and assessed here.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 6","pages":"529-540"},"PeriodicalIF":2.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Surgical Evaluation of Sentinel Node Biopsy in Patients with Early-Stage Endometrial Cancer and Atypical Hyperplasia.","authors":"Patrik Pöschke, Paul Gass, Annika Krückel, Katharina Keller, Ramona Erber, Arndt Hartmann, Matthias W Beckmann, Julius Emons","doi":"10.1055/a-2293-5700","DOIUrl":"10.1055/a-2293-5700","url":null,"abstract":"<p><strong>Introduction: </strong>The medical and surgical treatment of endometrial cancer (EC) is evolving toward a more patient-centered and personalized approach. The role of laparoscopic sentinel node biopsy (SNB) for early-stage EC is unclear, and very few data are available for atypical endometrial hyperplasia (AEH). The present study investigated the effectiveness of SNB combined with laparoscopic hysterectomy in patients with early-stage EC and AEH.</p><p><strong>Patients and methods: </strong>This was a retrospective, single-center cohort study for the period from January 2018 to December 2023. A total of 102 patients with atypical hyperplasia (n = 20) and early-stage EC (n = 82) findings on diagnostic curettage underwent pelvic sentinel node biopsy during the final operation.</p><p><strong>Results: </strong>Eleven patients (55%) who had initially been diagnosed with AEH were found to have EC in the final pathology report. No lymph node metastases were detected in patients who had initially been diagnosed with AEH; a 3.6% rate of positive SNBs was found in patients with EC. Changes in tumor grade occurred in 31.3% of the patients and changes in FIGO stage in 33%. Bilateral sentinel node (SN) mapping was successful in 94.1% of the patients. The postoperative outcomes were comparable to those of routine clinical practice without SNB.</p><p><strong>Conclusions: </strong>SNB can be safely offered to patients who have precursor lesions and early-stage EC without notably extending surgical times or increasing postoperative morbidity. This approach can be considered and is safe for patients diagnosed with AEH, but it appears to have a rather small impact on these patients.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 5","pages":"470-476"},"PeriodicalIF":2.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Long-term Follow-up and Safety of Patients after an Upfront Therapy with Letrozole for Early Breast Cancer in Routine Clinical Care - The PreFace Study.","authors":"Carolin C Hack, Nicolai Maass, Bahriye Aktas, Sherko Kümmel, Christoph Thomssen, Christopher Wolf, Hans-Christian Kolberg, Cosima Brucker, Wolfgang Janni, Peter Dall, Andreas Schneeweiss, Frederik Marme, Matthias Ruebner, Anna-Katharin Theuser, Nadine M Hofmann, Sybille Böhm, Katrin Almstedt, Sara Kellner, Naiba Nabieva, Paul Gass, Marc W Sütterlin, Hans-Joachim Lück, Sabine Schmatloch, Matthias Kalder, Christoph Uleer, Ingolf Juhasz-Böss, Volker Hanf, Christian Jackisch, Volkmar Müller, Brigitte Rack, Erik Belleville, Diethelm Wallwiener, Achim Rody, Claudia Rauh, Christian M Bayer, Sabrina Uhrig, Chloë Goossens, Hanna Huebner, Sara Y Brucker, Lothar Häberle, Tanja N Fehm, Alexander Hein, Peter A Fasching","doi":"10.1055/a-2314-3693","DOIUrl":"https://doi.org/10.1055/a-2314-3693","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2238-3153.].</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 2","pages":"e10"},"PeriodicalIF":2.7,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}