Abstract
The fourth international advanced breast cancer consensus conference (ABC4) on the diagnosis and treatment of advanced breast cancer (ABC) headed by Professor Fatima Cardoso was once again held in Lisbon on November 2 – 4, 2017. To simplify matters, the abbreviation ABC will be used hereinafter in the text. In clinical practice, the abbreviation corresponds to metastatic breast cancer or locally far-advanced disease. This year the focus was on new developments in the treatment of ABC. Topics discussed included the importance of CDK4/6 inhibition in hormone receptor (HR)-positive ABC, the use of dual antibody blockade to treat HER2-positive ABC, PARP inhibition in triple-negative ABC and the potential therapeutic outcomes. Another major area discussed at the conference was BRCA-associated breast cancer, the treatment of cerebral metastasis, and individualized treatment decisions based on molecular testing (so-called precision medicine). As in previous years, close cooperation with representatives from patient organizations from around the world is an important aspect of the ABC conference. This cooperation was reinforced and expanded at the ABC4 conference. A global alliance was founded at the conclusion of the consensus conference, which aims to promote and coordinate the measures considered necessary by patient advocates worldwide. Because the panel of experts was composed of specialists from all over the world, it was inevitable that the ABC consensus also reflected country-specific features. As in previous years, a team of German breast cancer specialists who closely followed the consensus voting of the ABC panelists in Lisbon and intensively discussed the votes has therefore commented on the consensus in the context of the current German guidelines on the diagnosis and treatment of breast cancer 1 , 2 used in clinical practice in Germany. The ABC consensus is based on the votes of the ABC panelists in Lisbon.
Highlights
The international ABC (Advanced Breast Cancer) consensus conference focuses on the diagnosis and treatment of advanced breast cancer and has been held in Lisbon every two years since 2011
A global alliance was founded at the conclusion of the consensus conference, which aims to promote and coordinate the measures considered necessary by patient advocates worldwide
A team of German breast cancer specialists who closely followed the consensus voting of the ABC panelists in Lisbon and intensively discussed the votes has commented on the consensus in the context of the current German guidelines on the diagnosis and treatment of breast cancer [1, 2] used in clinical practice in Germany
Summary
The international ABC (Advanced Breast Cancer) consensus conference focuses on the diagnosis and treatment of advanced breast cancer and has been held in Lisbon every two years since 2011. Breast-conserving surgery plus axillary dissection can be considered in individual cases (if the patient responds well to preoperative treatment) (LoE: 2B) In this context the ABC4 panelists agreed on the following new statement: if patients with a low axillary tumor load or clinically unsuspicious axilla (cN0–cN1) at primary diagnosis achieve complete remission (ycN0) following neoadjuvant systemic therapy, sentinel lymph node biopsy (SLNB) may be an option. This requires SLNB to be carried out in accordance with the guidelines and recommendations for SLNB after primary systemic therapy. Ensure that patients receive the best possible therapy and care from insurance companies
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