Maggie Banys-Paluchowski

• Professor
• Head of Breast Cancer Center at University Hospital Schleswig-Holstein Campus Lübeck

This review summarizes the latest developments for the treatment of patients with early-stage breast cancer. Most of the clinically relevant changes were the result of using immune checkpoint inhibitors to treat patients with triple-negative breast cancer (TNBC) and CDK4/6 inhibitors to treat patients with hormone receptor-positive, HER2-negative (...

The use of CDK4/6 inhibitors, the new PI3K/AKT-kinase inhibitors, selective estrogen receptor-degraders (SERDs), antibody-drug conjugates, immune therapies and PARP inhibitors in recent years has resulted in a marked change in the therapy landscape for patients with advanced stage breast cancer. CDK4/6 inhibitors, trastuzumab deruxtecan, and sacitu...

Introduction The trinational survey project conducted by the Young Forums of the German, Austrian, and Swiss Societies for Gynecology and Obstetrics aims to assess the preferences of prospective and practicing gynecologists regarding various work-time models, educations systems, career and work-family-live balance. Materials and Methods Between Oct...

In breast tumors, a histological distinction is made between benign and malignant findings as well as lesions with uncertain biological potential. While 94–97% of all symptomatic breast findings are benign, malignant lesions are of highest clinical relevance. Over 90% of malignant breast tumors are nonspecial type (NST) or lobular carcinomas. The r...

Medical advancements in breast cancer are truly remarkable. Especially in recent years, numerous new therapeutics have been approved and surgical strategies have been de-escalated for specific patient groups. In the therapeutic setting, CDK4/6 inhibitors as oral maintenance therapy in early breast cancer and immune checkpoint inhibitors (Pembrolizu...

Background: The detection of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in breast cancer has seen significant progress over the last two decades. These blood-based biomarkers offer a minimally invasive alternative to traditional methods for assessing disease progression and monitoring treatment response, with the potential to...

This study provides an indirect treatment comparison of ribociclib combined with non-steroidal aromatase inhibitors and ovarian function suppression (ribociclib + NSAI + OFS) vs. a frequently used treatment option in German clinical routine (tamoxifen ± OFS) in premenopausal patients with HR-positive (HR+), HER2-negative (HER2−) early breast cancer...

Antibody–drug conjugates (ADCs) are therapeutics which have become a relevant option in the treatment of metastatic breast cancer (mBC) in every subtype. The combination of targeted therapy with a cytotoxic effect demonstrated remarkable benefits compared to conventional chemotherapy in advanced therapy lines. In addition, ADCs generally show favor...

The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2025 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer (mBC).

Optimal management of breast cancer requires a multidisciplinary strategy. Each year the interdisciplinary AGO Breast Committee provides updated state-of-the-art recommendations on the prevention, diagnosis and treatment of breast cancer. This update follows a defined algorithm. The most recent and relevant publications are reviewed and the scienti...

Background The optimal adjuvant endocrine treatment in premenopausal patients with hormone receptor-positive, HER2-negative (HRpos/HER2neg) early breast cancer (eBC) remains debated, particularly the choice between aromatase inhibitors plus ovarian function suppression (AI + OFS) or tamoxifen (TAM) with or without additional OFS. This study assesse...

Background Surgical staging procedures of the axilla in initially clinically node-positive (cN +) breast cancer patients receiving neoadjuvant chemotherapy (NACT) vary across countries. Different procedures such as axillary lymph node dissection, sentinel lymph node biopsy, target lymph node biopsy and targeted axillary dissection are currently in...

The trinational survey project conducted by the Young Forums of the German, Austrian, and Swiss Societies for Gynecology and Obstetrics aims to assess the preferences of prospective and practicing gynecologists regarding various work-time models, the compatibility of family and career, as well as parental leave. Between October 2023 and May 2024, a...

Axillary staging is an integral component of the surgical treatment of early stages of breast cancer. In patients with initially clinically and sonographically negative lymph nodes (cN0), sentinel lymph node excision (SLNE) represents the gold standard in cases of planned primary surgery and after neoadjuvant therapy. Following the publication of t...

Background/Objectives: This single-center analysis evaluated the number of potential candidates for endocrine-based oral maintenance therapy in a real-world setting, focusing on three therapeutic agents, namely, olaparib, abemaciclib, and ribociclib, for patients with hormone receptor-positive HER2-negative early breast cancer. Methods: All breast...

Klinische Evidenz wird auf Basis klinischer Studien und der persönlichen Erfahrung interpretiert. Dies kann in einer unterschiedlichen Deutung der Datenlage resultieren. Vor diesem Hintergrund sind Expertenpanels wie das Advanced Breast Cancer Panel, das im November 2023 zum 7. Mal zusammengekommen ist (ABC7), von besonderer Bedeutung. Aktuelle The...

Background/Objectives: This single-center analysis evaluated the number of potential candidates for endocrine based oral maintenance therapy in a real-world setting, focusing on three therapeutic agents: olaparib, abemaciclib and ribociclib for patients with hormone receptor positive HER2-negative early breast cancer. Methods: All breast cancer cas...

The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has successfully implemented risk-adapted breast cancer surveillance for women at high breast cancer risk in Germany. Women with a family history of breast and ovarian cancer but without pathogenic germline variants in recognized breast cancer risk genes are recommended annual...

The progress that has been made in recent years in relation to liquid biopsies in general and circulating tumor DNA (ctDNA) in particular can be seen as groundbreaking for the future of breast cancer treatment, monitoring and early detection. Cell-free DNA (cfDNA) consists of circulating DNA fragments released by various cell types into the bloodst...

PURPOSE The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in pat...

Die idiopathische granulomatöse Mastitis (IGM) ist eine seltene, meist chronische Brusterkrankung, die sich initial wie der entzündliche Brustkrebs präsentieren kann. Zur Differenzierung ist eine histologische Sicherung notwendig. IGM tritt meist bei Frauen im gebärfähigen Alter auf, in der Regel innerhalb der ersten Jahre nach einer Schwangerschaf...

Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory breast condition often mistaken for inflammatory breast cancer and, therefore, requires a biopsy for accurate diagnosis. Although not cancerous, IGM can cause emotional distress because of severe pain and ensuing breast deformity. Differentiating IGM from other brea...

We aimed to evaluate the role of adjuvant chemotherapy and loco‐regional therapy for stage IA (pT1, pN0) triple‐negative breast cancer (TNBC) in a real‐world setting. We identified patients with pT1, pN0 TNBC diagnosed between 2009 and 2021 within the Baden‐Württemberg cancer registry (BWCR), Germany. Overall survival (OS) was assessed using Kaplan...

Auf der Jahrestagung der American Society of Clinical Oncology (ASCO) in Chicago, IL/USA, wurden auch in diesem Jahr relevante Daten zum Mammakarzinom vorgetragen. Insbesondere wurden die Therapieoptionen bei Frauen und Männern mit Tumoren, die nur sehr gering den Östrogenrezeptor (ER-low) oder den HER2-Rezeptor (HER2-low und HER2-ultralow) exprimi...

524 Background: We aimed to evaluate the role of adjuvant chemotherapy and loco-regional therapy for stage IA (pT1, pN0) triple-negative breast cancer (TNBC) in a real-world setting. Methods: We identified patients with pT1, pN0 TNBC diagnosed between 2009 and 2021 within the clinical cancer registry of Baden-Wuerttemberg, Germany. Overall survival...

TPS623 Background: In the last decades, the proportion of breast cancer patients receiving breast-conserving surgery has increased, reaching 70-80% in developed countries. In case of non-palpable lesions, surgical excision requires some form of breast localization. While wire-guided localization has long been considered gold standard, it carries se...

579 Background: Surgical staging procedures of the axilla in breast cancer patients converting from a clinically positive (cN+) to a clinically negative (ycN0) lymph node status during neoadjuvant chemotherapy (NACT) vary across countries. The international prospective AXSANA study aims at comparatively evaluating outcomes of different procedures s...

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 aro...

Background: Despite the progressive de-escalation of breast cancer (BC) surgery, mastectomy rates remain around 30-40%. Furthermore, up to 1/3 of BC patients undergo a contralateral risk-reducing mastectomy and around 40% of mutation carriers choose a bilateral intervention. To date, immediate breast reconstruction (IBR) with implants is the most c...

Background The optimal surgical staging procedure of the axilla in patients who convert from a clinically positive (cN+) to a clinically negative node status (ycN0) through neoadjuvant chemotherapy is still controversial. Widely diverse techniques such as full Axillary Lymph Node Dissection (ALND), Targeted Axillary Dissection (TAD), Targeted Lymph...

Background The primary objective of the SerMa pilot study was to identify possible immunological or inflammatory factors related to seroma formation after mastectomy in cases with primary breast cancer. Preliminary data suggest a distinct association between age and seroma formation. The work presented here investigates therefore a possible link be...

Background: In the last decades, the proportion of breast cancer patients receiving breast-conserving surgery has increased, reaching 70-80% in developed countries. In case of non-palpable lesions, surgical excision requires some form of breast localization. While wire-guided localization has long been considered gold standard, it carries several l...

Background: Surgical strategies for axillary staging in patients with early breast cancer who convert from clinical lymph node positivity (cN+) to a clinically negative lymph node status (ycN0) after neoadjuvant therapy (NAT) vary between breast cancer centers and countries. The international prospective multicenter-cohort study AXSANA (EUBREAST-03...

Background: Surgical staging procedures of the axilla in breast cancer patients converting from a clinically positive (cN+) to a clinically negative (ycN0) lymph node status during neoadjuvant chemotherapy (NACT) vary across countries and within individual countries. The international prospective AXSANA (EUBREAST-03) study aims at comparatively eva...

Background: In patients with micro- and macrometastases in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC), additional positive nodes are found in >60% of cases and axillary lymph node dissection (ALND) is currently considered standard of care. The likelihood of finding additional positive lymph nodes in patients with residual is...

Antikörper-Wirkstoff-Konjugate („antibody-drug conjugates”; ADCs) sind Therapeutika, die zunehmend an Relevanz in der Behandlung des frühen und metastasierten Mammakarzinoms gewinnen. Zu den aktuell zugelassenen ADCs zählen Trastuzumab-Emtansin, Trastuzumab-Deruxtecan und Sacituzumab-Govitecan. Die Verbindung aus zielgerichteter Therapie und zytost...

Die Entwicklung innovativer, zielgerichteter HER2-basierter Substanzen hat die Therapielandschaft des HER2-positiven (HER2+) Mammakarzinoms grundlegend verändert und die Prognose dieser aggressiven Erkrankung entscheidend verbessert. Zugelassene Substanzen umfassen inzwischen monoklonale Antikörper („monoclonal antibodies“; mABs), Antikörper-Wirkst...

Importance Data on oncological outcomes after omission of axillary lymph node dissection (ALND) in patients with breast cancer that downstages from node positive to negative with neoadjuvant chemotherapy are sparse. Additionally, the best axillary surgical staging technique in this scenario is unknown. Objective To investigate oncological outcomes...

Systemic breast cancer treatment is currently based on the tumor subtype and the individual risk of recurrence. In the case of high-risk situations chemotherapy is usually administered, sometimes combined with targeted substances and preferably in the neoadjuvant setting. Due to the neoadjuvant concept, the response to treatment can be postoperativ...

Introduction: Each year the interdisciplinary AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, German Gynecological Oncology Group) Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer. Methods: The updated evidence-based treatment recommendations...

The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2024 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer (mBC).

Zusammenfassung Die adjuvante endokrine Behandlung von prämenopausalen Patientinnen mit einem hormonrezeptorpositiven, HER2-negativen (HR-pos./HER2-neg.) Mammakarzinom unterliegt bei bestehender Ovarialfunktion einigen Besonderheiten. Als therapeutische Optionen stehen Tamoxifen mit oder ohne GnRH-Analogon und Aromatasehemmer mit GnRH-Analogon zur...

Simple Summary In the quest for de-escalation strategies, the complete elimination of non-targeted cytotoxic chemotherapy is often considered the ultimate goal in oncological therapy. This is particularly evident in HER2-positive breast cancer, where expanding targeted anti-HER2 therapy is a focal point of the current research due to the groundbrea...

Purpose To summarize the radiotherapy-relevant statements of the 18th St. Gallen Breast Cancer Consensus Conference and interpret the findings in light of German guideline recommendations. Methods Statements and voting results from the 18th St. Gallen International Breast Cancer Consensus Conference were collected and analyzed according to their r...

Background The phenotypes of tumor cells change during disease progression, but invasive rebiopsies of metastatic lesions are not always feasible. Here we aimed to determine whether initially HER2-negative metastatic breast cancer (MBC) patients with HER2-positive circulating tumor cells (CTCs) benefit from a HER2-targeted therapy. Methods The ope...

De-escalation is currently taking place both in surgical and systemic treatment of breast cancer. The introduction of trastuzumab, the first monoclonal antibody against the HER2 receptor over 20 years ago was a milestone in the treatment of HER2 positive breast cancer and marked the beginning of a new era in targeted tumor therapy. In the sense of...

Over 90% of invasive breast cancers are histologically either of ductal (no special type, NST) or lobular origin. Furthermore, there are also a variety of rare malignant tumors of mesenchymal, fibroepithelial and lymphatic origins as well as special cancer types. This heterogeneous group is characterized by different clinical manifestations and an...

Zusammenfassung In einem 2-jährigen Rhythmus fand in St. Gallen in früheren Jahren und nun in Wien die „St. Gallen (SG) International Breast Cancer Conference“ statt. Dieses Jahr (2023) wurde diese Konferenz, die sich mit der Behandlung von Patientinnen in Frühstadien des Mammakarzinoms beschäftigt, zum 18. Mal durchgeführt. Am Ende dieser 4-tägige...

Zusammenfassung Eine Reihe von neuen Therapien hat in den letzten Jahren die Fortschritte in der Behandlung von Patientinnen mit fortgeschrittenem Mammakarzinom bestimmt. Diese Substanzen sind hauptsächlich die CDK4/6-Inhibitoren und weitere Substanzen, welche die endokrine Resistenz überwinden können, die oralen selektiven Östrogenrezeptor-Degradi...

Background. Breast cancer patients with residual disease after neoadjuvant systemic treatment (NAST) have a worse prognosis compared with those achieving a pathologic complete response (pCR). Earlier identification of these patients might allow timely, extended neoadjuvant treatment strategies. We explored the feasibility of a vacuum-assisted biops...

For more than 30 years, The St. Gallen (SG) International Consensus Conference on the treatment of patients with primary breast cancer (SGBCC) has been taking place regularly. As the St. Gallen consensus panel consists of experts from different countries and disciplines, the votes represent an international cross-section of opinions From the German...

Purpose Androgen receptor (AR) can serve as a new therapeutic target since it was shown to play a proliferative role in several breast cancer (BC) subtypes. Moreover, AR positivity has been suggested to reflect the metastatic potential of tumor cells in some BC subtypes. The aim of this study was to determine the AR expression on disseminated tumor...

Background: The past 3 decades have seen an unprecedented shift toward treatment de-escalation in surgical therapy of breast cancer. Summary: Radical mastectomy has been replaced by breast-conserving and oncoplastic approaches in most patients, and full axillary lymph node dissection by less radical staging procedures, such as sentinel lymph nod...

The St. Gallen (SG) International Breast Cancer Conference is held every two years, previously in St. Gallen and now in Vienna. This year (2023) marks the eighteenth edition of this conference, which focuses on the treatment of patients with early-stage breast carcinoma. A panel discussion will be held at the end of this four-day event, during whic...

This yearʼs 18th St. Gallen (SG) consensus conference on the treatment of early breast cancer (SGBCC: St. Gallen International Breast Cancer Conference) focused on practice-oriented questions. The individual situation and risk-benefit assessment were discussed in great detail. As in previous years, a German working group of leading breast cancer ex...

HER2 positivity is predictive of the response to anti-HER2 therapies. The treatment of HER2-positive tumors is continuously improving through the development of new anti-HER2-directed agents. Many different anti-HER2 therapies are now available which belong to the classes of anti-HER2 antibodies, tyrosine kinase inhibitors (TKI) and antibody-drug c...

Zusammenfassung Die diesjährige 18. St.-Gallen-(SG-)Konsensus-Konferenz zur Behandlung des frühen Mammakarzinoms (SGBCC: St. Gallen Breast Cancer Conference) fokussierte auf praxisorientierte Fragestellungen. Die individuelle Krankheitssituation und Nutzen-Risiko-Abwägung wurden sehr detailliert diskutiert. Wie schon in den vergangenen Jahren hat a...

Purpose of review For some time now, the question of de-escalation in axillary staging in breast cancer patients has been raised. The aim is to improve the patients’ quality of life and reduce morbidity by optimizing surgical strategies with a high level of oncological safety. This review offers a current overview of published evidence and clinical...

Purpose Currently, various techniques are available to mark and selectively remove initially suspicious axillary lymph nodes (target lymph nodes, TLNs) in breast cancer patients receiving neoadjuvant chemotherapy (NACT). To date, limited data are available on whether the use of magnetic seeds (MS) is suitable for localizing TLNs. This study aimed t...

Purpose The use of autologous tissues is considered gold standard for patients undergoing breast reconstruction and is the preferred method in the post-radiation setting. Although the latissimus dorsi flap (LDF) has been replaced by abdominal flaps as technique of choice, it remains a valuable option in several specific clinical situations and its...

Background: Each year the interdisciplinary Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), German Gynecological Oncology Group Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer. Summary: The updated evidence-based treatment recommendation for...

Zusammenfassung Die in den letzten Jahren begonnenen großen Studienprogramme zu den CDK4/6-Inhibitoren, den zielgerichteten Therapien und den Antikörper-Medikament-Konjugaten resultieren in Ergebnissen, die von aktuellen Studien auf internationalen Kongressen und Fachzeitschriften veröffentlicht werden. In diesem Zusammenhang sind neue Ergebnisse d...

The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2023 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer (mBC).

With abemaciclib (monarchE study) and olaparib (OlympiA study) gaining approval in the adjuvant treatment setting, a significant change in the standard of care for patients with early stage breast cancer has been established for some time now. Accordingly, some diverse developments are slowly being transferred from the metastatic to the adjuvant tr...

In recent years, a number of new therapies have led to advances in the treatment of patients with advanced breast carcinoma. These substances are mainly CDK4/6 inhibitors and other substances that can overcome endocrine resistance, oral selective estrogen receptor degraders, antibody drug conjugates (ADCs), and PARP inhibitors. This review summariz...

TPS626 Background: In the last decades, the proportion of breast cancer patients receiving breast-conserving surgery has increased, reaching 70-80% in developed countries. In case of non-palpable lesions, surgical excision requires some form of breast localization. While wire-guided localization has long been considered gold standard, it carries se...

Purpose Androgen receptor (AR) can serve as a new therapy target since it was shown to play a proliferative role in several BC subtypes. Moreover AR-positivity has been suggested to reflect the metastatic potential of tumor cells in some of BC subtypes. The aim of this study was to determine the AR-expression on disseminated tumor cells (DTCs) as a...

Purpose The development of a seroma after breast cancer surgery is a common postoperative complication seen after simple mastectomy and axillary surgery. We could recently demonstrate that breast cancer patients undergoing a simple mastectomy with subsequent seroma formation developed a T-helper cell increase within the aspirated fluid measured by...

In patients with existing ovarian function, there are some special aspects to adjuvant endocrine therapy in premenopausal patients with hormone receptor-positive, HER2-negative (HR pos./HER2 neg.) breast cancer. Treatment options include tamoxifen with or without a GnRH analog, and aromatase inhibitors with a GnRH analog. Furthermore, ovarian funct...

Neoadjuvant chemotherapy (NACT), with or without antibodies or immunotherapy, is indicated particularly in aggressive breast cancer subtypes before surgery. Pathological complete response (pCR) after NACT is associated with an improved prognosis. Thanks to modern treatment options, up to 60–70% of patients achieve pCR in clinical trials. “Post-neoa...

Physical activity is associated with beneficial health effects for both mother and her future child, as well as the course of pregnancy. The aim of this review was the comparison of international guidelines with Polish recommendations. Data were collected from PubMed platform and international guidelines and narrowed to open access studies published...

The aims of this Oncoplastic Breast Consortium and European Breast Cancer Research Association of Surgical Trialists initiative were to identify uncertainties and controversies in axillary management of early breast cancer and to recommend appropriate strategies to address them. By use of Delphi methods, 15 questions were prioritized by more than 2...