To support doctors in counselling women with genetic predisposition for breast or gynecologic cancers on endocrine interventions. Evidence on the safety of endocrine interventions for fertility treatment, contraception, hormone replacement therapy after risk-reducing salpingo-oophorectomy (RRSO) or treatment of symptoms during peri- and postmenopause was analysed for carriers of probably pathogenic and pathogenic variants in BRCA1 or BRCA2 (BRCA1/2-pV), in other breast and ovarian cancer genes and the Lynch Syndrome. Cancer risks were compared with data on risks for the general population. Data on risk modulation of endocrine interventions in women with genetic predisposition is limited. Ovarian hyperstimulation for fertility treatment may be performed. Oral contraceptives should not be used to reduce ovarian cancer risk in BRCA1/2-pV carriers. Premenopausal BRCA1/2-pV carriers and carriers of pV in Lynch Syndrome genes should be offered hormone replacement therapy (HRT) after RRSO, to prevent diseases caused by estrogen deficiency. Effect direction and strength of risk modulation by endocrine interventions is similar to the general population. Participation of individuals at risk in prospective registries is recommended.

Ovarian cancer remains one of the leading causes of cancer-related deaths in women. There are several processes that are described to have a causal relationship in ovarian cancer development, progression, and metastasis formation, that occur both at the genetic and epigenetic level. One of the mechanisms involved in its pathogenesis and progression is estrogen signaling. Estrogen receptors (ER) α, ERβ, and G-protein coupled estrogen receptor 1 (GPER1), in concert with various coregulators and pioneer transcription factors, mediate the effects of estrogens primarily by the transcriptional regulation of estrogen responsive genes, thereby exerting pleiotropic effects including the regulation of cellular proliferation and apoptosis. The expression and activity of estrogen receptors and their coregulators have been demonstrated to be regulated by epigenetic mechanisms like histone modifications and DNA methylation. Here, we intend to summarize and to provide an update on the current understanding of epigenetic mechanisms regulating estrogen signaling and their role in ovarian cancer. For this purpose, we reviewed publications on this topic listed in the PubMed database. Finally, we assess to which extent drugs acting on the epigenetic level might be suitable for the treatment of ovarian cancer.

Einleitung Imiquimod ist ein Medikament aus der Gruppe der Immunmodulatoren, das für die Behandlung von Hauterkrankungen wie aktinischer Keratose, oberflächlichem Basalzellkarzinom und Genitalwarzen, die durch das humane Papillomavirus (HPV) verursacht werden, zugelassen ist.

Einleitung „WAVES“ (Wechselseitiger Patienten-Arzt-Austausch in der Versorgung bei Brustkrebs mit dem Ziel der gemeinsamen Erarbeitung neuer Patienten-orientierter Strukturen) ist die erste im Rahmen des BZKF (Bayerisches Zentrum für Krebsforschung mit Beteiligung aller 6 Universitätsklinika) geförderte Studie zum Thema Brustkrebs.

Einleitung Der optimale Zeitpunkt für den Beginn einer adjuvanten Chemotherapie ist bei Patientinnen mit triple negativem Mammakarzinom (TNBC) unbekannt. Ziel der vorliegenden Arbeit ist es, den Einfluss des Zeitintervalles bis zum Beginn der adjuvanten Chemotherapie auf das Gesamtüberleben zu beurteilen.

Background There is mounting evidence that tumor irradiation can be applied as monotherapy or in a combination approach to elicit immunogenic anti-tumor activity within the treated primary solid tumor by enhanced presentation of individual tumor associated epitopes (“in situ vaccination”). Moreover, the combination of radiation and an anti-immune checkpoint treatment might trigger a potent immune response that in addition prevents metastatic tumor progression (abscopal effect).

Einleitung Perivaskuläre Epitheloidzelltumore (PECome) sind seltene mesenchymale Neoplasien, die von perivaskulären epitheloiden Zellen ausgehen. Sie zeichnen sich durch einen sowohl glattmuskulären als auch melanozytären Immunphänotyp aus [1]. Etwa 30% der PECome sind im Uterus lokalisiert [2].

Hintergrund Bisher liegen nur wenige Daten zu Brustkrebs bei Männern vor. Die Therapieempfehlungen orientieren sich hauptsächlich an denen für postmenopausale Frauen. Die vorliegende Studie verglich klinische, histopathologische und therapeutische Faktoren sowie Überlebensraten zwischen Männern und Frauen mit bösartigen Neubildungen der Brust.

Zusammenfassung Ektopes Mammagewebe kann überall im Bereich der Milchleiste gefunden werden und ist auf eine unvollständige Rückbildung dieser embryonalen Anlage zurückzuführen. In seltenen Fällen werden Tumoren beschrieben, die von ektopem Mammagewebe ausgehen. Ein primäres Mammakarzinom, das aus ektopem Brustgewebe der Vulva entsteht, ist äußert selten.

Einleitung Der "Invenia Automated Breast Ultrasound Screening" (ABUS) ist in den USA bereits als Ergänzung zur Mammographie für das Brustkrebs-Screening bei asymptomatischen Frauen mit dichtem Brustdrüsengewebe zugelassen. Die Rolle des ABUS in der Routineuntersuchung während einer neoadjuvanten Chemotherapie ist unklar. Ziel dieser monozentrischen, nicht-interventionellen retrospektiven Studie ist es, die Verwendung des ABUS zur Ansprechkontrolle bei Mammakarzinompatientinnen unter neoadjuvanten Chemotherapie zu evaluieren.

OBJECTIVE:The aim of this study was to investigate the impact of pre-operative conization on disease-free survival (DFS) in early-stage cervical cancer.METHODS:In this population-based cohort study we analysed from clinical cancer registries to determine DFS of women with International Federation of Gynecology and Obstetrics (FIGO) stage IA1-IB1 cervical cancer with respect to conization preceding radical hysterectomy performed between January 2010 and December 2015.RESULTS:Out of 993 datasets available for the analysis, 235 patients met the inclusion criteria of the current study. The median follow-up was 5.4 years. During the study period, 28 (11.9%) recurrences were observed. All of these occurred in patients with FIGO stage IB1. For further evaluation, patients with FIGO IB1 tumors <2 cm were further analysed and divided into two groups, based on pre-operative conization. Pre-operative conization was associated with a reduced rate of recurrence (p = 0.007), with only three (5.2%) recurrences in this group (CO) compared to 25 recurrences (21.0%) in the group without conization (NCO) preceding radical hysterectomy. DFS was estimated at 79.0% and 94.8% in NCO and CO, respectively (p = 0.008). After adjustment for other prognostic covariates, conization remained a favourable prognostic factor for DFS (HR 0.27; 95% CI 0.08-0.93, p = 0.037). Lymph node involvement was the only unfavourable factor (HR 4.38; 95% CI 1.36-14.14, p = 0.014) in the multivariable analysis.CONCLUSIONS:Pre-operative conization is associated with improved DFS in early-stage cervical cancer independently of the surgical approach.