[Outpatient breast cancer treatment after the hospital: what's next? - Adjuvant medical therapies, management of side effects and common fears, planing and coordination of optimal follow-up care in view of current guidelines]

Abstract

Outpatient breast cancer treatment after the hospital: what's next? - Adjuvant medical therapies, management of side effects and common fears, planing and coordination of optimal follow-up care in view of current guidelines Abstract. Following successful breast cancer surgery patients will generally be facing a certain prolonged period of medical treatment accompanied by several years of follow-up care, usually in the setting of a private practice or outpatient clinic. These medical treatments, which have proven by evidence to substantially reduce the risk of breast cancer recurrence and thereby significantly added to the boost in overall prognosis of this disease, are discussed in the light of current international treatment guidelines in this article. The standard approach to modern medical therapies is outlined on the basis of clinical pathological risk factors and tumor biology for different breast cancer subtypes (e. g. luminal, HER2-positiv, triple negativ / basal-like) accordingly. We hereby focus particularly upon the management of therapy-induced side effects, typical substance-specific toxicities as well as offering remedy to common fears and myths concerning medical breast cancer treatment. Last but not least we describe our perspective of the "ideal outpatient follow-up care", outlining a time-plan, implementing interdisciplinary expertise and stressing the necessity for good teamwork and interaction among all health care specialists involved, to optimise patient comfort and outcome.