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Personalizing the treatment of women with early breast cancer: Highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013
- Source :
- Annals of oncology, 24 (9, Annals of Oncology
- Publication Year :
- 2013
-
Abstract
- The 13th St Gallen International Breast Cancer Conference (2013) Expert Panel reviewed and endorsed substantial new evidence on aspects of the local and regional therapies for early breast cancer, supporting less extensive surgery to the axilla and shorter durations of radiation therapy. It refined its earlier approach to the classification and management of luminal disease in the absence of amplification or overexpression of the Human Epidermal growth factor Receptor 2 (HER2) oncogene, while retaining essentially unchanged recommendations for the systemic adjuvant therapy of HER2-positive and 'triple-negative' disease. The Panel again accepted that conventional clinico-pathological factors provided a surrogate subtype classification, while noting that in those areas of the world where multi-gene molecular assays are readily available many clinicians prefer to base chemotherapy decisions for patients with luminal disease on these genomic results rather than the surrogate subtype definitions. Several multi-gene molecular assays were recognized as providing accurate and reproducible prognostic information, and in some cases prediction of response to chemotherapy. Cost and availability preclude their application in many environments at the present time. Broad treatment recommendations are presented. Such recommendations do not imply that each Panel member agrees: indeed, among more than 100 questions, only one (trastuzumab duration) commanded 100% agreement. The various recommendations in fact carried differing degrees of support, as reflected in the nuanced wording of the text below and in the votes recorded in supplementary Appendix S1, available at Annals of Oncology online. Detailed decisions on treatment will as always involve clinical consideration of disease extent, host factors, patient preferences and social and economic constraints.<br />SCOPUS: ar.j<br />info:eu-repo/semantics/published
- Subjects :
- medicine.medical_specialty
Receptor, ErbB-2
medicine.medical_treatment
Breast Neoplasms
Disease
radiation therapy
surgery
systemic adjuvant therapies
03 medical and health sciences
Special Article
0302 clinical medicine
Breast cancer
Trastuzumab
St Gallen Consensus
Adjuvant therapy
Medicine
Humans
Precision Medicine
early breast cancer
Intensive care medicine
Letters to the Editor
Early Detection of Cancer
Mastectomy
030304 developmental biology
0303 health sciences
business.industry
subtypes
Hematology
Sciences bio-médicales et agricoles
Precision medicine
medicine.disease
Chemotherapy regimen
Combined Modality Therapy
Individualized Medicine -- methods
3. Good health
Surgery
Radiation therapy
Receptor, ErbB-2 -- antagonists & inhibitors -- metabolism
Oncology
Breast Neoplasms -- drug therapy -- surgery -- therapy
Chemotherapy, Adjuvant
030220 oncology & carcinogenesis
Female
Personalized medicine
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Annals of oncology, 24 (9, Annals of Oncology
- Accession number :
- edsair.doi.dedup.....cdf6ae63884adf1a92f91b7fe130514e