Official websites use. Share sensitive information only on official, secure websites. Correspondence to : Prof. For commercial re-use, please contact journals. The 13th St Gallen International Breast Cancer Conference 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.
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. 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.
Keywords: surgery, radiation therapy, systemic adjuvant therapies, early breast cancer, St Gallen Consensus, subtypes. The 2 years since the St Gallen Consensus [ 1 ] have seen substantial progress in evidence relevant to various aspects of the treatment of early invasive breast cancer.
The genomic atlas of the disease [ 2 ] has emphasized its heterogeneity, and suggested that genomic studies may potentially inform treatment decisions such as the use of aromatase inhibitors [ 3 , 4 ]. Further data became available reducing the necessity for axillary dissection [ 5 , 6 ]. The duration of adjuvant tamoxifen was addressed by the ATLAS study, which suggested a significant benefit for extending such treatment to 10 years rather than 5 years [ 9 ].
