Gynaecological Oncology
Gynaecological Oncology and Breast Cancer: Treatment of Breast Cancer and gynaecological cancers e.g. Ovarian Cancer, Endometrial cancer, Cervical Cancer and Vulval Cancer
Gynaecological Oncology
A cancer diagnosis changes many things — often suddenly and accompanied by many unanswered questions. This affects not only the patient herself, but also the people closest to her who provide support, reassurance and guidance.
In this situation, it is important to me that you understand what is happening within your body, which next steps may be appropriate and what treatment options are available. I support you with clear, evidence-based medical guidance and the commitment to finding a pathway that is tailored to your individual situation.
Gynaecological cancers include a broad spectrum of malignant diseases affecting the female reproductive organs. These include ovarian cancer, endometrial cancer, cervical cancer, vulval cancer and vaginal cancer. In addition, breast cancer also falls within the field of gynaecological oncology, regardless of gender.
As a Gynaecological Oncologist and Breast Specialist, I treat the full spectrum of these conditions and provide individual advice alongside comprehensive, holistic care.
Breast cancer is the most common cancer affecting women. The diagnosis is often first suspected following abnormal imaging findings or the discovery of a palpable lump. For many women, the immediate concern is understanding how treatment will proceed and which options are available.
How Is Breast Cancer Diagnosed?
Breast cancer diagnostics involve several steps and are designed to determine both the type of tumour and the extent of disease.
Typical investigations include:
If breast cancer or a precancerous lesion has been diagnosed, your case will be discussed in detail within a multidisciplinary tumour board together with all specialists involved in your treatment. During these meetings, all findings are reviewed collectively and the individual treatment steps are carefully coordinated.
This ensures that you receive guideline-based, personalised treatment tailored specifically to your situation.
What Treatment Options Are Available?
Alongside surgery, systemic drug therapy and local radiotherapy are often important components of treatment.
Surgical Treatment of Breast Cancer — Oncologically Safe and Aesthetically Considered
Breast surgery is often a central component of breast cancer treatment. Different surgical approaches may be used:
For malignant breast disease, I predominantly use modern oncoplastic breast-conserving techniques. These approaches combine oncological safety with an aesthetically pleasing outcome.
Incisions are planned individually, taking into account oncological requirements, aesthetic considerations and your personal wishes.
If complete removal of the breast tissue is medically necessary, it is often possible to preserve the skin envelope. This creates excellent conditions for immediate breast reconstruction using a silicone implant, should you wish to pursue this option.
The ideal timing for definitive reconstruction is determined individually and depends on the diagnosis, any additional treatments and your personal preferences.
For many patients, restoring body image is an important part of coping with the disease. I therefore provide comprehensive guidance regarding all reconstructive options and explain the advantages and disadvantages of each approach transparently and carefully.
Together, we will find the pathway that is both medically appropriate and personally right for you.
Holistic Support
Breast cancer affects far more than the body alone. The disease can influence relationships, professional life, self-image and emotional wellbeing.
For this reason, a holistic and multidisciplinary approach is particularly important to me. Collaboration with specialist physiotherapists, nutrition experts, complementary medicine practitioners and psycho-oncology professionals can meaningfully complement medical treatment.
A Breast Centre Close to You
Within our certified Breast Cancer Centre, I support you through every stage of your treatment in an individualised and guideline-based manner. Breast cancer specialists work closely together with other medical disciplines to ensure that your treatment plan is tailored specifically to your needs.
Ovarian cancer is a form of gynaecological cancer that often remains unnoticed in its early stages. Many symptoms are non-specific and develop gradually, meaning the disease is frequently diagnosed only at a more advanced stage.
Typical early changes noticed by women with ovarian cancer may include increasing abdominal girth, abdominal pressure or otherwise unexplained weight changes. Fluid accumulation within the abdomen (ascites) can also be a sign of advanced disease.
When ovarian cancer occurs between the ages of 30 and 35 — or even younger — this may indicate an inherited genetic predisposition. In such cases, genetic assessment plays an especially important role in understanding individual risk.
For many women and their families, a diagnosis of ovarian cancer initially causes significant uncertainty. This makes it all the more important to provide clear medical guidance and to explain, step by step, what the findings mean and which next steps may be appropriate.
Endometrial cancer, also referred to as cancer of the womb lining or uterine cancer, is one of the more common gynaecological malignancies. It develops within the lining of the uterus (endometrium). If not detected and treated early, the disease can spread further over time.
Compared with other gynaecological cancers, symptoms of endometrial cancer are often recognised relatively early. Typical warning signs include unusual bleeding, particularly bleeding after the menopause or bleeding outside the normal menstrual cycle.
Prolonged or unusually heavy bleeding may also be a sign and should always be medically assessed. However, altered bleeding patterns are not always caused by cancer and are more commonly associated with benign conditions.
Endometrial cancer is often diagnosed at an early stage and is highly treatable in many cases. For me, careful interpretation of the findings and personal dialogue are essential in order to define the next steps together in an individualised and guideline-based manner.
Cervical cancer develops within the cervix, including the external cervical opening and cervical canal. In many cases, it develops gradually over time from precancerous cellular changes that initially cause no noticeable symptoms.
An invasive cervical cancer is present when abnormal cells have penetrated beyond the superficial cell layer and may already have spread into surrounding tissue.
In its early stages, the condition often causes no clear symptoms. Later signs may include unusual bleeding, increased vaginal discharge or pelvic pain.
Metastatic spread generally occurs only in more advanced stages of disease.
Prevention plays a central role in cervical cancer care. HPV vaccination and regular cervical screening allow precancerous changes to be detected early and, where necessary, treated using minimally invasive procedures.
In some cases, close monitoring alone may be appropriate, as certain precancerous changes can regress spontaneously.
Vulval cancer affects the external female genital area. Many women initially notice subtle skin changes that are difficult to interpret.
Possible early signs may include persistent itching, small nodules, skin changes or sore areas. Pain may also occur. The appearance of vulval cancer can vary considerably, meaning the condition is not always immediately recognised.
Because symptoms affecting the intimate area are often associated with embarrassment or uncertainty, changes may sometimes be assessed late. Many women initially attribute symptoms to other, less serious causes. This makes regular gynaecological examinations particularly important.
If vulval cancer is diagnosed, I will support you with clear medical guidance and detailed counselling so that we can decide together on the most appropriate next steps.
Vaginal cancer is a rare gynaecological malignancy that develops within the vagina. Many women wonder how vaginal cancer can be recognised, as symptoms are often nonspecific. In its early stages, the disease frequently causes no obvious symptoms. As it progresses, unusual bleeding, vaginal discharge or pain may occur.
However, abnormal bleeding is not always a sign of vaginal cancer and is far more commonly caused by benign conditions.
In some cases, vaginal cancer may occur following a hysterectomy. For this reason, it is important to take any new symptoms seriously, even after previous gynaecological surgery, and to seek medical assessment where appropriate.
If vaginal cancer is diagnosed, I will support you with clear interpretation of your findings and comprehensive counselling so that we can define the next steps together.
Trophoblastic diseases are rare disorders involving tissue that develops during pregnancy. Normally, this tissue forms from cells involved in placental development.
In some cases, abnormal development occurs and the tissue begins to grow uncontrollably. Both benign and malignant forms exist.
Although trophoblastic diseases are rare overall, many cases can be treated successfully. Careful assessment and individually tailored follow-up care are essential.
Every oncological treatment journey begins with a detailed discussion about your current and previous symptoms, medical history, relevant life circumstances and any family history of cancer.
Based on this information, a comprehensive diagnostic assessment follows. In addition to clinical examination, this may include advanced imaging techniques as well as minimally invasive procedures for tissue sampling and histopathological confirmation.
The physical examination complements the consultation and helps guide further diagnostic and treatment decisions.
Imaging techniques are used to visualise changes within the body and assess the extent of disease more accurately.
Ultrasound examination (sonography) represents the essential first-line investigation in gynaecological oncology and is particularly important in differentiating pelvic findings and identifying conditions such as ovarian cancer.
Cross-sectional imaging, including CT and MRI scans, provides important information for treatment planning by helping to define the extent of disease as precisely as possible.
Additional investigations, such as blood tests for tumour markers in gynaecological malignancies, are primarily used to monitor treatment response.
In selected cases, tumour markers may also assist in clarifying unclear pelvic findings or in detecting recurrence at an early stage.
Tumour markers are not suitable for routine screening in asymptomatic women and should never be interpreted in isolation. They must always be assessed in the context of the overall clinical picture.
In many cases, a reliable diagnosis of gynaecological cancer can only be established through tissue sampling. Suspicious tissue is carefully removed and subsequently analysed by histopathological examination.
I provide specialist genetic counselling for patients and individuals with a significant family history of cancer or a particularly young age at diagnosis of breast or ovarian cancer.
Under certain circumstances, testing for known cancer risk genes and the initiation of preventive measures may be appropriate and can be arranged if desired.
If a gynaecological cancer diagnosis has been confirmed, your case will be discussed extensively within a multidisciplinary tumour board together with all specialists involved in your care. All findings are reviewed collectively and individual treatment steps are carefully coordinated. This ensures that you receive personalised, guideline-based treatment tailored specifically to your situation.
Alongside surgery, systemic drug therapy and, in selected cases, local radiotherapy often form part of the overall treatment concept.
Different surgical approaches are used depending on the type and extent of disease. Whenever possible, I use minimally invasive laparoscopic techniques, including robotassisted surgery using the da Vinci® system where appropriate. In surgery involving the external genital area, oncoplastic surgical techniques are used to minimise tissue loss while simultaneously restoring appearance and function.
In extensive disease — for example during ovarian cancer surgery — open abdominal surgery may be necessary. In complex situations, procedures are carried out in close collaboration with specialists from other disciplines to ensure optimal oncological safety.
Radiotherapy is often an integral component of multimodal treatment concepts for gynaecological cancers such as cervical cancer, endometrial cancer, vulval cancer and breast cancer. High-energy radiation is used to destroy tumour tissue within the target area.
Depending on the tumour type and stage, radiotherapy may be used as primary treatment, before surgery (neoadjuvant), after surgery (adjuvant) or for symptom control (palliative). A distinction is made between external beam radiotherapy and brachytherapy, in which the radiation source is placed directly within the tumour or surrounding tissue.
Combined radiochemotherapy — combining radiotherapy with chemotherapy — may be beneficial in more advanced stages because chemotherapy can both enhance the local effect of radiotherapy and target cancer cells outside the radiation field. Radiotherapy itself is usually painless and treatment sessions generally last only a few minutes.
Modern, highly precise radiotherapy techniques help minimise side effects affecting surrounding healthy tissue. It is also important to know that you are not radioactive after treatment and can safely spend time near other people.
The aim of systemic cancer therapy is to target tumour cells throughout the body, either destroying them or inhibiting their growth.
Treatment is delivered in individually tailored cycles and monitored closely to assess both effectiveness and tolerability.
Different forms of systemic therapy include chemotherapy, targeted therapies, immunotherapy and hormone therapy.
Treatment selection depends on tumour biology, molecular characteristics, tumour stage and the overall clinical situation.
Despite many advances in modern systemic therapies, chemotherapy remains an important part of treatment for certain gynaecological cancers, particularly ovarian cancer.
Following initial treatment, maintenance therapy may be beneficial in selected situations.
The aim is to reduce the risk of recurrence and maintain treatment success and quality of life over the long term.
Maintenance therapy following platinum-based chemotherapy for advanced ovarian cancer forms an essential part of modern treatment strategies.
Treatment selection depends on the molecular genetic profile of the tumour, including BRCA and HRD status, as well as the response to previous therapy. Two main therapeutic approaches are currently used:
• Angiogenesis inhibitors such as bevacizumab, which block the formation of new blood vessels supplying the tumour
• PARP inhibitors such as olaparib, niraparib and rucaparib, which impair DNA repair mechanisms within cancer cells and lead to tumour cell death
PARP inhibitors are particularly effective in tumours with BRCA mutations or homologous recombination deficiency (HRD-positive tumours).
Gynaecological cancers affect far more than physical health alone. The disease can influence relationships, professional life, self-image and emotional wellbeing.
For this reason, a holistic and multidisciplinary approach is particularly important to me.
Collaboration with specialist physiotherapists, nutrition experts, complementary medicine practitioners and psycho-oncology professionals can meaningfully complement medical treatment.
My specialist expertise in gynaecological oncology is formally recognised through subspecialty certification awarded by the State Medical Association.
This certification reflects many years of structured specialist training and extensive experience in the diagnosis and treatment of cancers affecting the female reproductive organs.
As a Senior Breast Surgeon within a certified Breast Cancer Centre accredited by the German Cancer Society (DKG), I also have extensive operative experience in breast cancer surgery which is reviewed regularly within structured interdisciplinary quality systems.
In addition, I provide specialist genetic counselling and am listed as a cooperation partner within the German Consortium for Hereditary Breast and Ovarian Cancer.
An oncological diagnosis often raises many questions — both medical and deeply personal.
Not every decision has to be made immediately, and not every possible next step is necessarily the right one for your individual diagnosis. The first priority is understanding your own situation: Which findings are present?
Which treatment options exist? And which pathway fits not only the medical assessment, but also your personal needs and life circumstances?
During a shared consultation, we take the time to clarify exactly these questions.
On this basis, an individual treatment pathway can be developed — one that is medically sound and feels sustainable and right for you personally.
Dr. med. Stefan Ollig
Specialist in Gynaecology and Obstetrics
