# A Decade of AGO QS-Mamma: Adherence to the Recommendations of the AGO Breast Committee for Diagnosis and Treatment in EBC in Routine Therapy in Germany.

**Organizacion:** AGO
**Autores:** Jackisch C, Janni W, M&#xfc;ller V et al.
**Revista:** Breast Care (Basel) (2025)
**PMID:** 40256678 | **PMCID:** PMC12005700
**DOI:** [10.1159/000543237](https://doi.org/10.1159/000543237)
**Fuente:** PubMed Central (open access)

## Relevancia
Recomendaciones anuales del grupo aleman de oncologia ginecologica (Arbeitsgemeinschaft Gynaekologische Onkologie). Cubren extensamente el manejo quirurgico axilar en cN+ post-NAC, incluyendo diseccion axilar dirigida (TAD), marcaje de ganglios y tecnicas de localizacion; con nivel de evidencia AGO (+ / ++ / +++).

## Recomendaciones clave (resumen)
- TAD (Targeted Axillary Dissection) recomendada para cN+ -> ycN0 (AGO ++).
- Marcaje del ganglio positivo confirmado por biopsia es mandatorio antes de NAC.
- BSGC sola post-NAC en cN1 inicial: aceptable si se utiliza doble trazador y se extraen >=3 ganglios centinela.
- Si TAD/BSGC es ypN0 -> omision de ALND aceptable.
- ALND axilar completa sigue indicada en caso de no respuesta o ypN+ macrometastatico.

## Abstract
The cure for early breast cancer (EBC) is increasing over the last decades due to the improvement of diagnosis and therapy. Individualization of cancer treatment in EBC requires constant optimization by implementing current guidelines. The AGO (working group gynecologic oncology) QS-Mamma initiative, a quality assurance program (QS) of the AGO Breast Committee, was introduced to provide insight in guideline adherence in real-world practice in Germany. We evaluated 10 years of QS-Mamma data to identify gaps and trends implementing those guidelines.

QS-Mamma is a retrospective sample survey providing a representative overview of the treatment landscape of breast cancer in Germany. The last six cohorts were analyzed over a period of 10 years. Across all cohorts, an average of 264 centers documented a total of= 4,577 patients with EBC.

Testing for BRCA mutations in triple-negative patients increased significantly. Breast conserving surgery has been standard of care since the start of data collection; choice of surgical procedure depends primarily on tumor size and nodal status according to the patient's preference, if possible. Axillary intervention has shifted toward SLNE or targeted axillary procedures in patients with negative preoperative nodal staging. Neoadjuvant systemic therapy in operable EBC is established. Anthracycline administration in the adjuvant setting decreases. We noted an uptake on using platinum-containing CTx in TNBC, corresponding to AGO recommendations. Dual HER2 blockade is established in HER2-positive EBC with increased risk of relapse. Changes in guidelines are reflected in real-world data.

Guideline adherence in breast cancer care is high and new treatments and diagnostic options are implemented promptly. Finally, escalation and de-escalation of treatment depend on individual tumor characteristics resulting in the individual risk of recurrence. Guidelines should be flanked by real-world evidence to ensure and survey their impact.

## Acceso
Disponible en PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC12005700/

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*Datos de PubMed. Citar: doi 10.1159/000543237*
