Breast Cancer Consensus Conference Research Articles

Abstract PO5-26-08: Caveats behind the improved outcomes observed in recent clinical trials for women with breast cancer: Korean breast cancer consensus meeting 2023

Abstract Introduction Korean Breast Cancer Society has organized the biennial Korean Breast Cancer Consensus Conference to find solutions to clinical situations that cannot be answered by randomized clinical trials or other definitive treatment research data. Unlike guidelines which are designed to apply to the majority of patients with early or advanced breast cancer encountered in daily practice, consensus meetings yield answers from clinicians’ perspectives and experiences. Therefore, this meeting aimed to integrate patient preferences, treatment availability, or other individual circumstances upon recent medical advances and available evidence. Materials and methods. Panelists were invited from various filed, such as medical oncology, surgical oncology, radiation oncology, pathology, radiology, nuclear medicine, hereditary cancer specialist. Results. 1. caveats behind optimizing treatment There had been strong interests in refinening thresholes for treatment and it can be more or less than previous standard treatment. Some patients clearly required escalated treatment, such as ovarian function suppression, combined HER2-targeted treatment, and utilization of immunotherapy during neoadjuvant systemic treatment. However, even same agent which showed great success for high risk patients showed Disappointing results and even failure. Furthermore, we need more sophisticated decision even for successful stories which introduced above, because of their serious adverse events. AntiPd-1/PD-L1 showed different serious adverse events profiles and Trastuzumab-deruxtecan is related with life-threatening pulmonary complication. Therefore, there is a clinical equipoise for an appropriate therapeutic threshold not only for low-risk patients but also high-risk patients who can safely forgo recommend treatment escalation in the newly introduced clinical trials. 2. Completely new serious adverse events observed in new drugs. Unlike chemotherapy, most targeted therapies cause lethal damage that clinicians may not have experienced. Some, such as pulmonary complications from trastuzumab deruxtecan, can be fatal if not treated immediately. Even if patients survive, they may suffer catastrophic outcomes because these agents leave a fatal disability that is too great for the patient's quality of life. Moreover, in South Korea, where government-run health insurance is the only payer and at the same time policy maker, non-medical constraints such as passive reimbursement plans, value-based medicine, and intentional delay or denial of certain drugs, panelist delivered varing opinions on the extent to which new agents can be utilized and which treatment plan could offer equal clinical benefit with less toxicity, or provide for a measurable improvement in outcomes. 3. utilizing genomic signatures Panelist raised issues genetic assay which analyzed genes currently we do not have treatment options which can modify disease process. Many questions were addressed such as, appropriate sampling time, which sample, liquid or tumor, can yield meaningful information. Conclusion Korean Breast Cancer consensus meeting highlighted important caveats behinds new promising findings. Clinical unmet need and uncertainty should be disclosed before patients because what clinician and patients work with is their life. Shared decision making is essential and patients should become well aware of science and medicine. Proactive approach of clinician is critical for these movements. Citation Format: Airi Han, Young-Joon Kang, Sei Hyun Kim, Eui Su Chae, Han Cho Kim, Kyong Hwa Park. Caveats behind the improved outcomes observed in recent clinical trials for women with breast cancer: Korean breast cancer consensus meeting 2023 [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-26-08.

Radiotherapy statements of the 18th St.Gallen International Breast Cancer Consensus Conference-aGerman expert perspective.

To summarize the radiotherapy-relevant statements of the 18th St.Gallen Breast Cancer Consensus Conference and interpret the findings in light of German guideline recommendations. Statements and voting results from the 18th St.Gallen International Breast Cancer Consensus Conference were collected and analyzed according to their relevance for the radiation oncology community. The voting results were discussed in two hybrid meetings among the authors of this manuscript on March 18 and 19, 2023, in light of the German S3 guideline and the 2023 version of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) guidelines. There was ahigh level of agreement between the radiotherapy-related statements of the 18th St.Gallen International Breast Cancer Consensus Conference and the German S3 and AGO guidelines. Discrepancies include the impact of number of lymph node metastases for the indication for postmastectomy radiotherapy.

Use of Diagnostic Imaging Modalities in Modern Screening, Diagnostics and Management of Breast Tumours 1st Central-Eastern European Professional Consensus Statement on Breast Cancer.

Breast radiologists and nuclear medicine specialists updated their previous recommendation/guidance at the 4th Hungarian Breast Cancer Consensus Conference in Kecskemét. A recommendation is hereby made that breast tumours should be screened, diagnosed and treated according to these guidelines. These professional guidelines include the latest technical developments and research findings, including the role of imaging methods in therapy and follow-up. It includes details on domestic development proposals and also addresses related areas (forensic medicine, media, regulations, reimbursement). The entire material has been agreed with the related medical disciplines.

Expert review on systemic treatment in the St. Gallen International Breast Cancer Conference 2021

: The 17th St. Gallen International Breast Cancer Consensus Conference was held in March 2021. The theme of this year’s conference was “customizing local and systemic therapies”. The conference focused on the controversies about the optimal primary treatment of early breast cancer. The St. Gallen expert panel reviewed substantial new evidences and voiced their expert opinions, hoping to provide guidance to clinicians. Despite that many randomized clinical trials provided evidence on managing breast cancer, not all the clinical scenarios can find definitive data to guide recommendations. When data from randomized clinical trials are lacking, the opinions of the St. Gallen expert panel can be used as an important reference for clinical decision making. However, the panelists’ recommendations may often be affected by the treatment availability, which vary from country to country. As a result, from Chinese experts’ perspectives, Professor Jian Zhang made an interpretation and comments of the expert opinions of the 17th St. Gallen Conference. This work focused on the field of systemic treatment, including neoadjuvant therapy (chemotherapy, HER2 targeted therapy and endocrine therapy), tailored post-neoadjuvant therapy based on neoadjuvant therapy response and adjuvant therapy. We hope this work could help clinicians understand the expert opinions of the 17th St. Gallen Conference better.

Breast cancer over-diagnosis: an adverse consequence of mammography screening - highlights of the 2018 Kyoto Breast Cancer Consensus Conference.

Breast cancer over-diagnosis: an adverse consequence of mammography screening - highlights of the 2018 Kyoto Breast Cancer Consensus Conference.

Expanding Progress for the Metastatic Breast Cancer Community: The SPARC MBC Challenge Reaches New Milestones

Background: An estimated 1.6 million women are diagnosed with breast cancer globally each year, and approximately one-third of these women will develop advanced disease (stages III and IV). The Seeding Progress and Resources for the Cancer Community (SPARC): Metastatic Breast Cancer Challenge was created with support from Pfizer Oncology to address the unique needs of women and men living with metastatic breast cancer (MBC) by offering grants to organizations initiating novel ways to fill gaps in support and services. Now in its second round, the program is building momentum to further support the MBC community. Aim: SPARC empowers advocacy groups, hospital networks, support groups and other organizations worldwide, addressing four key priorities: Closing the gap on patient information and navigation of care options; Raising awareness of specific needs and challenges faced by women with MBC; Ensuring MBC is embedded in national breast cancer policies; Helping to reduce the incidence of MBC at first diagnosis. Strategy: SPARC was first launched on World Cancer Day 2015 with a second call for proposals announced on International Women's Day 2017 . Proposals were assessed by an external Selection Advisory Group. Selection criteria focusing on impact included: Project's potential to improve the lives of women diagnosed with MBC Organization's ability to deliver the project Feasibility of project goals Sustainability of the project beyond the grant period. UICC provided ongoing monitoring and support including dedicated mentors and online training covering key topics to maximize projects' success. Grantee workshops at the start and end of projects (during ABC3/4-Advanced Breast Cancer Consensus conference and the World Cancer Congress) provided critical networking and knowledge sharing. Second round grantees are linked to first round grantees with similar projects for additional mentoring. Outcomes: UICC received over 80 initial applications from 46 countries in the first call, and 83 applications from 42 countries in 2017 demonstrating continued demand for MBC support. Altogether 40 organizations in 30 countries have benefited from SPARC grants. As well as mentorship and UICC support, grantees gained unparalleled access to both the UICC community and other MBC advocates. Grantees measured the reach of their projects, including numbers of patients supported, healthcare workers trained, institutional collaborations formed and awareness raised. Two years on, 1st round projects have trained 1500 healthcare workers, involved 400 institutions, created online support in 7 countries and continue to reach new MBC patients. Work to embed new practices in national policy and medical curricula is expanding in Brazil, Nigeria, Bulgaria and Uganda. What was learned: Results from 2nd round grantees and key learnings from the two rounds, including grantee to grantee mentorship and WhatsApp support, will be available to be presented at WCC.

Clinical practice guidelines in breast cancer.

A number of clinical practice guidelines (cpgs) concerning breast cancer (bca) screening and management are available. Here, we review the strengths and weaknesses of cpgs from various professional organizations and consensus groups with respect to their methodologic quality, recommendations, and implementability. Guidelines from four groups were reviewed with respect to two clinical scenarios: adjuvant ovarian function suppression (ofs) in premenopausal women with early-stage estrogen receptor-positive bca, and use of sentinel lymph node biopsy (slnb) after neoadjuvant chemotherapy (nac) for locally advanced bca. Guidelines from the American Society of Clinical Oncology (asco); Cancer Care Ontario's Program in Evidence Based Care (cco's pebc); the U.S. National Comprehensive Cancer Network (nccn); and the St. Gallen International Breast Cancer Consensus Conference were reviewed by two independent assessors. Guideline methodology and applicability were evaluated using the agree ii tool. The quality of the cpgs was greatest for the guidelines developed by asco and cco's pebc. The nccn and St. Gallen guidelines were found to have lower scores for methodologic rigour. All guidelines scored poorly for applicability. The recommendations for ofs were similar in three guidelines. Recommendations by the various organizations for the use of slnb after nac were contradictory. Our review demonstrated that cpgs can be heterogeneous in methodologic quality. Low-quality cpg implementation strategies contribute to low uptake of, and adherence to, bca cpgs. Further research examining the barriers to recommendations-such as intrinsic guideline characteristics and the needs of end users-is required. The use of bca cpgs can improve the knowledge-to-practice gap and patient outcomes.

4th International Consensus Conference on Advanced Breast Cancer (ABC4), Lisbon, November 4, 2017 : ABC4 Consensus: Assessment by a Panel of German Experts.

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.

Organisation for Oncology and Translational Research 12th Annual Conference Kyoto Breast Cancer Consensus Conference 2016 International Convention.

Organisation for Oncology and Translational Research 12th Annual Conference Kyoto Breast Cancer Consensus Conference 2016 International Convention.

Personalization of loco-regional care for primary breast cancer patients (part 2).

Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for radiation treatment, primary systemic therapies and management of genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of tumors with PST; use of preoperative hormonal therapy in premenopausal women with larger, node-negative luminal A-like tumors and managing increasing demands for contralateral prophylactic mastectomy in patients with a unilateral sporadic breast cancer.

Personalization of loco-regional care for primary breast cancer patients (part 1).

ABSTRACT Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the first of a two part conference scene, consensus recommendations for axillary management are presented and focus on the following topics: indications for completion axillary lymph node dissection in primary surgical patients with ≤2 macrometastases or any sentinel nodal deposits after PST; the timing of sentinel lymph node biopsy in the context of PST; use of axillary irradiation as a component of primary treatment plans and the role of intraoperative node assessment in the post-Z0011 era.

Highlights from the 14th St Gallen International Breast Cancer Conference 2015 in Vienna: Dealing with classification, prognostication, and prediction refinement to personalize the treatment of patients with early breast cancer

The refinement of the classification, the risk of relapse and the prediction of response to multidisciplinary treatment for early breast cancer has been the major theme of the 14th St Gallen International Breast Cancer Consensus Conference 2015. The meeting, held in Vienna, assembled 3500–4000 participants from 134 countries worldwide. It culminated, on the final day, with the International Consensus Session, delivered by 40–50 of the world’s most experienced opinion leaders in the field of breast cancer treatment. The panelist addressed the “semantic” classification of breast cancer subtypes by pathology-based biomarkers (e.g. estrogen receptor, progesterone receptor and HER2) vs genomic classifiers. They also refined the biomarker prognostication dissecting the impact of the various gene signatures and pathologic variables in predicting the outcome of patients with early breast cancer in terms of early and late relapse. Finally they addressed the challenges stemming from the intra- and inter-observer variability in the assessment of pathologic variables and the role of gene signatures for the prediction of response to specific therapeutic approach such as endocrine therapy and chemotherapy and for personalizing local treatment of patients with early breast cancer. The vast majority of the questions asked during the consensus were about controversial issues. The opinion of the panel members has been used to implement guidance for treatment choice. This is the unique feature of the St. Gallen Consensus, ensuring that the resulting recommendations will take due cognizance of the variable resource limitations in different countries. Information derived from evidence based medicine and large meta-analyses is of obvious and enormous value. The weakness of this approach is that it gives particular weight to older trials (which have accumulated more event endpoints) and is frequently unable to collect sufficient detail on the patients and tumors in the trials to allow assessment of whether the treatments which are better on average offer equal value to all currently definable patient subgroups. What St Gallen can provide is clinically useful updated breast cancer treatment consensus for the majority of patients treated outside of clinical trials (>90%) in most countries.

Preoperative systemic therapy in locoregional management of early breast cancer: highlights from the Kyoto Breast Cancer Consensus Conference

Data reviewed at the Kyoto Breast Cancer Consensus Conference (KBCCC) showed that preoperative systemic therapy (PST) could optimize surgery through the utilization of information relating to pre- and post-PST tumor stage, therapeutic sensitivity, and treatment-induced changes in the biological characteristics of the tumor. As such, it was noted that the biological characteristics of the tumor, such as hormone receptors, human epidermal growth factor receptor-2, histological grade, cell proliferative activity, mainly defined by the Ki67 labeling index, and the tumor's multi-gene signature, should be considered in the planning of both systemic and local therapy. Furthermore, the timing of axillary sentinel lymph node diagnosis (i.e., before or after the PST) was also noted to be critical in that it may influence the likelihood of axillary preservation, even in node positive cases. In addition, axillary diagnosis with ultrasound and concomitant fine needle aspiration cytology or core needle biopsy (CNB) was reported to contribute to the construction of a treatment algorithm for patient-specific or individualized axillary surgery. Following PST, planning for breast surgery should therefore be based on tumor subtype, tumor volume and extent, therapeutic response to PST, and patient preference. Nomograms for predicting nodal status and drug sensitivity were also recognized as a tool to support decision-making in the selection of surgical treatment. Overall, review of data at the KBCCC showed that PST increases the likelihood of patients receiving localized surgery and individualized treatment regimens.

Diagnosis and Local Management of Breast Cancer: Part II

This is the second of a two-part conference report and covers the other main themes of the Second Kyoto Breast Cancer Consensus Conference (KBCCC) including ductal carcinoma in situ, sentinel lymph node biopsy and therapeutic algorithms for local management of breast cancer. Once again, this report emphasizes conclusions from the consensus sessions that were a key feature of the KBCCC.

Diagnosis and Local Management of Breast Cancer: Part I

This is the first of a two-part conference report and focuses primary on newer technologies (e.g., molecular methods for intraoperative nodal assessment and MRI/PET imaging) and surgical management in the context of neoadjuvant chemotherapy. A notable feature of the Second Kyoto Breast Cancer Consensus Conference was a consensus session for which a series of key clinical questions in the aforementioned areas formed the basis for discussion. Preconference questionnaires had been issued to all delegates and the final consensus sessions focused on more controversial and problematic areas where there is divergence of opinion and clinical management.

Kyoto Breast Cancer Consensus Conference

Kyoto Breast Cancer Consensus Conference

Kyoto Breast Cancer Consensus Conference

Kyoto Breast Cancer Consensus Conference

Australia's first national breast cancer consensus conference

Medical Journal of AustraliaVolume 161, Issue S2 p. S5-S5 Article Australia's first national breast cancer consensus conference First published: 01 November 1994 https://doi.org/10.5694/j.1326-5377.1994.tb138392.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume161, IssueS2November 1994Pages S5-S5 RelatedInformation

Management of newly diagnosed early breast cancer A national approach to breast cancer control

Medical Journal of AustraliaVolume 161, Issue S2 p. S10-S16 Article Management of newly diagnosed early breast cancer A national approach to breast cancer control Report from the National Breast Cancer Consensus Conference 15-17 June 1994, Royal Pines Resort, Queensland, Australia First published: 01 November 1994 https://doi.org/10.5694/j.1326-5377.1994.tb138394.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume161, IssueS2November 1994Pages S10-S16 RelatedInformation