Interdisciplinary Screening, Diagnosis, Therapy and Follow-up of Breast Cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) – Part 2 with Recommendations for the Therapy of Primary, Recurrent and Advanced Breast Cancer
Authors: Wöckel Achim , Festl Jasmin , Stüber Tanja , Brust Katharina , Krockenberger Mathias , Heuschmann Peter , Jírů-Hillmann Steffi , Albert Ute-Susann , Budach Wilfried , Follmann Markus , Janni Wolfgang , Kopp Ina , Kreienberg Rolf , Kühn Thorsten , Langer Thomas , Nothacker Monika , Scharl Anton , Schreer Ingrid , Link Hartmut , Engel Jutta , Fehm Tanja , Weis Joachim , Welt Anja , Steckelberg Anke , Feyer Petra , König Klaus , Hahne Andrea , Baumgartner Traudl , Kreipe Hans , Knoefel Wolfram , Denkinger Michael , Brucker Sara , Lüftner Diana , Kubisch Christian , Gerlach Christina , Lebeau Annette , Siedentopf Friederike , Petersen Cordula , Bartsch Hans , Schulz-Wendtland Rüdiger , Hahn Markus , Hanf Volker , Müller-Schimpfle Markus , Henscher Ulla , Roncarati Renza , Katalinic Alexander , Heitmann Christoph , Honegger Christoph , Paradies Kerstin , Bjelic-Radisic Vesna , Degenhardt Friedrich , Wenz Frederik , Rick Oliver , Hölzel Dieter , Zaiss Matthias , Kemper Gudrun , Budach Volker , Denkert Carsten , Gerber Bernd , Tesch Hans , Hirsmüller Susanne , Sinn Hans-Peter , Dunst Jürgen , Münstedt Karsten , Bick Ulrich , Fallenberg Eva , Tholen Reina , Hung Roswita , Baumann Freerk , Beckmann Matthias , Blohmer Jens , Fasching Peter , Lux Michael , Harbeck Nadia , Hadji Peyman , Hauner Hans , Heywang-Köbrunner Sylvia , Huober Jens , Hübner Jutta , Jackisch Christian , Loibl Sibylle , Lück Hans-Jürgen , von Minckwitz Gunter , Möbus Volker , Müller Volkmar , Nöthlings Ute , Schmidt Marcus , Schmutzler Rita , Schneeweiss Andreas , Schütz Florian , Stickeler Elmar , Thomssen Christoph , Untch Michael , Wesselmann Simone , Bücker Arno , Buck Andreas , Stangl Stephanie 
Published: November 2018

Abstract
Purpose The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer.
Method The process of updating the S3 guideline published in 2012 was based on the adaptation of identified source guidelines. They were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and with the results of a systematic search of literature databases followed by the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point and used them to develop suggestions for recommendations and statements, which were then modified and graded in a structured consensus process procedure.
Recommendations Part 2 of this short version of the guideline presents recommendations for the therapy of primary, recurrent and metastatic breast cancer. Loco-regional therapies are de-escalated in the current guideline. In addition to reducing the safety margins for surgical procedures, the guideline also recommends reducing the radicality of axillary surgery. The choice and extent of systemic therapy depends on the respective tumor biology. New substances are becoming available, particularly to treat metastatic breast cancer.