De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017.
Identifieur interne : 000E72 ( Main/Exploration ); précédent : 000E71; suivant : 000E73De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017.
Auteurs : G. Curigliano [Italie] ; H J Burstein [États-Unis] ; E. P Winer [États-Unis] ; M. Gnant [Autriche] ; P. Dubsky [Autriche] ; S. Loibl [Allemagne] ; M. Colleoni [Italie] ; M M Regan [États-Unis] ; M. Piccart-Gebhart [Belgique] ; H-J Senn ; B. Thürlimann [Suisse] ; F. André [France] ; J. Baselga [États-Unis] ; J. Bergh [Suède] ; H. Bonnefoi [France] ; S. Y Brucker [Allemagne] ; F. Cardoso [Portugal] ; L. Carey [États-Unis] ; E. Ciruelos [Espagne] ; J. Cuzick [Royaume-Uni] ; C. Denkert [Allemagne] ; A. Di Leo [Italie] ; B. Ejlertsen [Danemark] ; P. Francis [Australie] ; V. Galimberti [Italie] ; J. Garber [États-Unis] ; B. Gulluoglu [Turquie] ; P. Goodwin [Canada] ; N. Harbeck [Allemagne] ; D F Hayes [États-Unis] ; C-S Huang [Taïwan] ; J. Huober [Allemagne] ; K. Hussein [Égypte] ; J. Jassem [Pologne] ; Z. Jiang [République populaire de Chine] ; P. Karlsson [Suède] ; M. Morrow [États-Unis] ; R. Orecchia [Italie] ; K C Osborne [États-Unis] ; O. Pagani [Suisse] ; A H Partridge [États-Unis] ; K. Pritchard [Canada] ; J. Ro [Corée du Sud] ; E J T. Rutgers [Pays-Bas] ; F. Sedlmayer [Autriche] ; V. Semiglazov [Russie] ; Z. Shao [République populaire de Chine] ; I. Smith [Royaume-Uni] ; M. Toi [Japon] ; A. Tutt [Royaume-Uni] ; G. Viale [Italie] ; T. Watanabe [Japon] ; T J Whelan [Canada] ; B. Xu [République populaire de Chine]Source :
- Annals of oncology : official journal of the European Society for Medical Oncology [ 1569-8041 ] ; 2017.
Abstract
The 15th St. Gallen International Breast Cancer Conference 2017 in Vienna, Austria reviewed substantial new evidence on loco-regional and systemic therapies for early breast cancer. Treatments were assessed in light of their intensity, duration and side-effects, seeking where appropriate to escalate or de-escalate therapies based on likely benefits as predicted by tumor stage and tumor biology. The Panel favored several interventions that may reduce surgical morbidity, including acceptance of 2 mm margins for DCIS, the resection of residual cancer (but not baseline extent of cancer) in women undergoing neoadjuvant therapy, acceptance of sentinel node biopsy following neoadjuvant treatment of many patients, and the preference for neoadjuvant therapy in HER2 positive and triple-negative, stage II and III breast cancer. The Panel favored escalating radiation therapy with regional nodal irradiation in high-risk patients, while encouraging omission of boost in low-risk patients. The Panel endorsed gene expression signatures that permit avoidance of chemotherapy in many patients with ER positive breast cancer. For women with higher risk tumors, the Panel escalated recommendations for adjuvant endocrine treatment to include ovarian suppression in premenopausal women, and extended therapy for postmenopausal women. However, low-risk patients can avoid these treatments. Finally, the Panel recommended bisphosphonate use in postmenopausal women to prevent breast cancer recurrence. The Panel recognized that recommendations are not intended for all patients, but rather to address the clinical needs of the majority of common presentations. Individualization of adjuvant therapy means adjusting to the tumor characteristics, patient comorbidities and preferences, and managing constraints of treatment cost and access that may affect care in both the developed and developing world.
DOI: 10.1093/annonc/mdx308
PubMed: 28838210
Affiliations:
- Allemagne, Australie, Autriche, Belgique, Canada, Corée du Sud, Danemark, Espagne, France, Italie, Japon, Pays-Bas, Pologne, Portugal, Royaume-Uni, Russie, République populaire de Chine, Suisse, Suède, Taïwan, Turquie, Égypte, États-Unis
- Angleterre, Aquitaine, Bade-Wurtemberg, Bavière, Berlin, Communauté de Madrid, District de Haute-Bavière, District de Tübingen, Grand Londres, Hollande-Septentrionale, Hovedstaden, Lombardie, Massachusetts, Nouvelle-Aquitaine, Ontario, Région de Bruxelles-Capitale, Svealand, Texas, Victoria (État), Vienne (Autriche), État de New York
- Amsterdam, Berlin, Bordeaux, Boston, Bruxelles, Copenhague, Hamilton (Ontario), Houston, Londres, Madrid, Melbourne, Milan, Munich, Pékin, Stockholm, Toronto, Tübingen, Ulm, Vienne (Autriche)
- Université Louis-et-Maximilien de Munich, Université McMaster, Université d'Ulm, Université de Londres, Université de Toronto
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Y Brucker</name><affiliation wicri:level="3"><nlm:affiliation>Universitäts-Frauenklinik Tübingen, Tübingen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Universitäts-Frauenklinik Tübingen, Tübingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Cardoso, F" sort="Cardoso, F" uniqKey="Cardoso F" first="F" last="Cardoso">F. Cardoso</name><affiliation wicri:level="1"><nlm:affiliation>Champalimaud Cancer Centre, Lisbon, Portugal.</nlm:affiliation><country xml:lang="fr">Portugal</country><wicri:regionArea>Champalimaud Cancer Centre, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Carey, L" sort="Carey, L" uniqKey="Carey L" first="L" last="Carey">L. Carey</name><affiliation wicri:level="1"><nlm:affiliation>Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill</wicri:regionArea><wicri:noRegion>Chapel Hill</wicri:noRegion></affiliation></author><author><name sortKey="Ciruelos, E" sort="Ciruelos, E" uniqKey="Ciruelos E" first="E" last="Ciruelos">E. Ciruelos</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario 12 de Octubre, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Cuzick, J" sort="Cuzick, J" uniqKey="Cuzick J" first="J" last="Cuzick">J. 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Denkert</name><affiliation wicri:level="3"><nlm:affiliation>Institut für Pathologie, Charité Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institut für Pathologie, Charité Universitätsmedizin Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Di Leo, A" sort="Di Leo, A" uniqKey="Di Leo A" first="A" last="Di Leo">A. Di Leo</name><affiliation wicri:level="1"><nlm:affiliation>Azienda Usl Toscana Centro, Prato, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Azienda Usl Toscana Centro, Prato</wicri:regionArea><wicri:noRegion>Prato</wicri:noRegion></affiliation></author><author><name sortKey="Ejlertsen, B" sort="Ejlertsen, B" uniqKey="Ejlertsen B" first="B" last="Ejlertsen">B. Ejlertsen</name><affiliation wicri:level="3"><nlm:affiliation>Rigshospitalet, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Francis, P" sort="Francis, P" uniqKey="Francis P" first="P" last="Francis">P. Francis</name><affiliation wicri:level="3"><nlm:affiliation>Peter McCallum Cancer Centre, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Peter McCallum Cancer Centre, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Galimberti, V" sort="Galimberti, V" uniqKey="Galimberti V" first="V" last="Galimberti">V. Galimberti</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Breast Cancer Program, Istituto Europeo di Oncologia, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Garber, J" sort="Garber, J" uniqKey="Garber J" first="J" last="Garber">J. Garber</name><affiliation wicri:level="3"><nlm:affiliation>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Gulluoglu, B" sort="Gulluoglu, B" uniqKey="Gulluoglu B" first="B" last="Gulluoglu">B. Gulluoglu</name><affiliation wicri:level="1"><nlm:affiliation>Marmara University School of Medicine, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Goodwin, P" sort="Goodwin, P" uniqKey="Goodwin P" first="P" last="Goodwin">P. Goodwin</name><affiliation wicri:level="4"><nlm:affiliation>University of Toronto, Mount Sinai Hospital, Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Mount Sinai Hospital, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Harbeck, N" sort="Harbeck, N" uniqKey="Harbeck N" first="N" last="Harbeck">N. Harbeck</name><affiliation wicri:level="4"><nlm:affiliation>University of Munich, München, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>University of Munich, München</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement><settlement type="city">Munich</settlement></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Hayes, D F" sort="Hayes, D F" uniqKey="Hayes D" first="D F" last="Hayes">D F Hayes</name><affiliation wicri:level="1"><nlm:affiliation>Comprehensive Cancer Center, University of Michigan, Ann-Arbor, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Comprehensive Cancer Center, University of Michigan, Ann-Arbor</wicri:regionArea><wicri:noRegion>Ann-Arbor</wicri:noRegion></affiliation></author><author><name sortKey="Huang, C S" sort="Huang, C S" uniqKey="Huang C" first="C-S" last="Huang">C-S Huang</name><affiliation wicri:level="1"><nlm:affiliation>National Taiwan University Hospital, Taipei, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>National Taiwan University Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Huober, J" sort="Huober, J" uniqKey="Huober J" first="J" last="Huober">J. Huober</name><affiliation wicri:level="4"><nlm:affiliation>University of Ulm, Ulm, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>University of Ulm, Ulm</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement><settlement type="city">Ulm</settlement></placeName><orgName type="university">Université d'Ulm</orgName></affiliation></author><author><name sortKey="Hussein, K" sort="Hussein, K" uniqKey="Hussein K" first="K" last="Hussein">K. Hussein</name><affiliation wicri:level="1"><nlm:affiliation>The National Cancer Institute, Cairo University, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>The National Cancer Institute, Cairo University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Jassem, J" sort="Jassem, J" uniqKey="Jassem J" first="J" last="Jassem">J. Jassem</name><affiliation wicri:level="1"><nlm:affiliation>Medical University of Gdansk, Gdansk, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Medical University of Gdansk, Gdansk</wicri:regionArea><wicri:noRegion>Gdansk</wicri:noRegion></affiliation></author><author><name sortKey="Jiang, Z" sort="Jiang, Z" uniqKey="Jiang Z" first="Z" last="Jiang">Z. Jiang</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Affiliated to Military Medical Science, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Hospital Affiliated to Military Medical Science, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Karlsson, P" sort="Karlsson, P" uniqKey="Karlsson P" first="P" last="Karlsson">P. Karlsson</name><affiliation wicri:level="1"><nlm:affiliation>Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrensky University Hospital, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrensky University Hospital, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Morrow, M" sort="Morrow, M" uniqKey="Morrow M" first="M" last="Morrow">M. Morrow</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Orecchia, R" sort="Orecchia, R" uniqKey="Orecchia R" first="R" last="Orecchia">R. Orecchia</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Breast Cancer Program, Istituto Europeo di Oncologia, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Osborne, K C" sort="Osborne, K C" uniqKey="Osborne K" first="K C" last="Osborne">K C Osborne</name><affiliation wicri:level="3"><nlm:affiliation>Baylor College of Medicine, Houston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Baylor College of Medicine, Houston</wicri:regionArea><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Pagani, O" sort="Pagani, O" uniqKey="Pagani O" first="O" last="Pagani">O. Pagani</name><affiliation wicri:level="1"><nlm:affiliation>Institute of Oncology Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Oncology Southern Switzerland, Ospedale San Giovanni, Bellinzona</wicri:regionArea><wicri:noRegion>Bellinzona</wicri:noRegion></affiliation></author><author><name sortKey="Partridge, A H" sort="Partridge, A H" uniqKey="Partridge A" first="A H" last="Partridge">A H Partridge</name><affiliation wicri:level="3"><nlm:affiliation>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Pritchard, K" sort="Pritchard, K" uniqKey="Pritchard K" first="K" last="Pritchard">K. Pritchard</name><affiliation wicri:level="4"><nlm:affiliation>Sunnybrook Odette Cancer Center, University of Toronto, Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Sunnybrook Odette Cancer Center, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Ro, J" sort="Ro, J" uniqKey="Ro J" first="J" last="Ro">J. Ro</name><affiliation wicri:level="1"><nlm:affiliation>National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do</wicri:regionArea><wicri:noRegion>Gyeonggi-do</wicri:noRegion></affiliation></author><author><name sortKey="Rutgers, E J T" sort="Rutgers, E J T" uniqKey="Rutgers E" first="E J T" last="Rutgers">E J T. Rutgers</name><affiliation wicri:level="3"><nlm:affiliation>Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Sedlmayer, F" sort="Sedlmayer, F" uniqKey="Sedlmayer F" first="F" last="Sedlmayer">F. Sedlmayer</name><affiliation wicri:level="1"><nlm:affiliation>LKH Salzburg, Paracelsus Medical University Clinics, Salzburg, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>LKH Salzburg, Paracelsus Medical University Clinics, Salzburg</wicri:regionArea><wicri:noRegion>Salzburg</wicri:noRegion></affiliation></author><author><name sortKey="Semiglazov, V" sort="Semiglazov, V" uniqKey="Semiglazov V" first="V" last="Semiglazov">V. Semiglazov</name><affiliation wicri:level="1"><nlm:affiliation>N.N. Petrov Research Institute of Oncology, St. Petersburg, Russian Federation.</nlm:affiliation><country xml:lang="fr">Russie</country><wicri:regionArea>N.N. Petrov Research Institute of Oncology, St. Petersburg</wicri:regionArea><wicri:noRegion>St. Petersburg</wicri:noRegion></affiliation></author><author><name sortKey="Shao, Z" sort="Shao, Z" uniqKey="Shao Z" first="Z" last="Shao">Z. Shao</name><affiliation wicri:level="1"><nlm:affiliation>Fudan University Cancer Hospital, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Fudan University Cancer Hospital, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Smith, I" sort="Smith, I" uniqKey="Smith I" first="I" last="Smith">I. Smith</name><affiliation wicri:level="1"><nlm:affiliation>The Royal Marsden, Sutton, Surrey, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Royal Marsden, Sutton, Surrey</wicri:regionArea><wicri:noRegion>Surrey</wicri:noRegion></affiliation></author><author><name sortKey="Toi, M" sort="Toi, M" uniqKey="Toi M" first="M" last="Toi">M. Toi</name><affiliation wicri:level="1"><nlm:affiliation>Graduate School of Medicine Kyoto University, Sakyo-ku, Kyoto City, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Graduate School of Medicine Kyoto University, Sakyo-ku, Kyoto City</wicri:regionArea><wicri:noRegion>Kyoto City</wicri:noRegion></affiliation></author><author><name sortKey="Tutt, A" sort="Tutt, A" uniqKey="Tutt A" first="A" last="Tutt">A. Tutt</name><affiliation wicri:level="3"><nlm:affiliation>Breast Cancer Now Research Centre, The Institute of Cancer Research, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Now Research Centre, The Institute of Cancer Research, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Viale, G" sort="Viale, G" uniqKey="Viale G" first="G" last="Viale">G. Viale</name><affiliation wicri:level="3"><nlm:affiliation>University of Milan, Milan.</nlm:affiliation><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName><wicri:orgArea>University of Milan</wicri:orgArea></affiliation></author><author><name sortKey="Watanabe, T" sort="Watanabe, T" uniqKey="Watanabe T" first="T" last="Watanabe">T. Watanabe</name><affiliation wicri:level="1"><nlm:affiliation>Hamamatsu Oncology Center, Hamamatsu, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Hamamatsu Oncology Center, Hamamatsu</wicri:regionArea><wicri:noRegion>Hamamatsu</wicri:noRegion></affiliation></author><author><name sortKey="Whelan, T J" sort="Whelan, T J" uniqKey="Whelan T" first="T J" last="Whelan">T J Whelan</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University, Hamilton, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>McMaster University, Hamilton</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Xu, B" sort="Xu, B" uniqKey="Xu B" first="B" last="Xu">B. Xu</name><affiliation wicri:level="3"><nlm:affiliation>National Cancer Center, Chaoyang District, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>National Cancer Center, Chaoyang District, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28838210</idno><idno type="pmid">28838210</idno><idno type="doi">10.1093/annonc/mdx308</idno><idno type="wicri:Area/PubMed/Corpus">000692</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000692</idno><idno type="wicri:Area/PubMed/Curation">000689</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000689</idno><idno type="wicri:Area/PubMed/Checkpoint">000689</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000689</idno><idno type="wicri:Area/Ncbi/Merge">004D33</idno><idno type="wicri:Area/Ncbi/Curation">004D33</idno><idno type="wicri:Area/Ncbi/Checkpoint">004D33</idno><idno type="wicri:Area/Main/Merge">000E67</idno><idno type="wicri:Area/Main/Curation">000E72</idno><idno type="wicri:Area/Main/Exploration">000E72</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017.</title><author><name sortKey="Curigliano, G" sort="Curigliano, G" uniqKey="Curigliano G" first="G" last="Curigliano">G. Curigliano</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Breast Cancer Program, Istituto Europeo di Oncologia, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Burstein, H J" sort="Burstein, H J" uniqKey="Burstein H" first="H J" last="Burstein">H J Burstein</name><affiliation wicri:level="3"><nlm:affiliation>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="P Winer, E" sort="P Winer, E" uniqKey="P Winer E" first="E" last="P Winer">E. P Winer</name><affiliation wicri:level="3"><nlm:affiliation>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Gnant, M" sort="Gnant, M" uniqKey="Gnant M" first="M" last="Gnant">M. Gnant</name><affiliation wicri:level="3"><nlm:affiliation>Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Dubsky, P" sort="Dubsky, P" uniqKey="Dubsky P" first="P" last="Dubsky">P. Dubsky</name><affiliation wicri:level="3"><nlm:affiliation>Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Surgery, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Loibl, S" sort="Loibl, S" uniqKey="Loibl S" first="S" last="Loibl">S. Loibl</name><affiliation wicri:level="1"><nlm:affiliation>German Breast Group, Neu-Isenburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>German Breast Group, Neu-Isenburg</wicri:regionArea><wicri:noRegion>Neu-Isenburg</wicri:noRegion><wicri:noRegion>Neu-Isenburg</wicri:noRegion><wicri:noRegion>Neu-Isenburg</wicri:noRegion></affiliation></author><author><name sortKey="Colleoni, M" sort="Colleoni, M" uniqKey="Colleoni M" first="M" last="Colleoni">M. Colleoni</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Breast Cancer Program, Istituto Europeo di Oncologia, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Regan, M M" sort="Regan, M M" uniqKey="Regan M" first="M M" last="Regan">M M Regan</name><affiliation wicri:level="3"><nlm:affiliation>Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Piccart Gebhart, M" sort="Piccart Gebhart, M" uniqKey="Piccart Gebhart M" first="M" last="Piccart-Gebhart">M. Piccart-Gebhart</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Oncology, Institut Jules Bordet, UniversitÕ Libre de Bruxelles, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Medical Oncology, Institut Jules Bordet, UniversitÕ Libre de Bruxelles, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Senn, H J" sort="Senn, H J" uniqKey="Senn H" first="H-J" last="Senn">H-J Senn</name><affiliation><nlm:affiliation>Tumor and Breast Center ZeTuP, St. Gallen.</nlm:affiliation><wicri:noCountry code="subField">St</wicri:noCountry></affiliation></author><author><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B" last="Thürlimann">B. Thürlimann</name><affiliation wicri:level="1"><nlm:affiliation>Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Breast Center, Kantonsspital St. Gallen, St. Gallen</wicri:regionArea><wicri:noRegion>St. Gallen</wicri:noRegion></affiliation></author><author><name sortKey="Andre, F" sort="Andre, F" uniqKey="Andre F" first="F" last="André">F. André</name><affiliation wicri:level="1"><nlm:affiliation>Institut de Cancérologie Gustave Roussy, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Cancérologie Gustave Roussy, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Baselga, J" sort="Baselga, J" uniqKey="Baselga J" first="J" last="Baselga">J. Baselga</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Bergh, J" sort="Bergh, J" uniqKey="Bergh J" first="J" last="Bergh">J. Bergh</name><affiliation wicri:level="3"><nlm:affiliation>Karolinska Institute and University Hospital, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Karolinska Institute and University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Bonnefoi, H" sort="Bonnefoi, H" uniqKey="Bonnefoi H" first="H" last="Bonnefoi">H. Bonnefoi</name><affiliation wicri:level="3"><nlm:affiliation>University of Bordeaux, Bordeaux, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>University of Bordeaux, Bordeaux</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Y Brucker, S" sort="Y Brucker, S" uniqKey="Y Brucker S" first="S" last="Y Brucker">S. Y Brucker</name><affiliation wicri:level="3"><nlm:affiliation>Universitäts-Frauenklinik Tübingen, Tübingen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Universitäts-Frauenklinik Tübingen, Tübingen</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Cardoso, F" sort="Cardoso, F" uniqKey="Cardoso F" first="F" last="Cardoso">F. Cardoso</name><affiliation wicri:level="1"><nlm:affiliation>Champalimaud Cancer Centre, Lisbon, Portugal.</nlm:affiliation><country xml:lang="fr">Portugal</country><wicri:regionArea>Champalimaud Cancer Centre, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Carey, L" sort="Carey, L" uniqKey="Carey L" first="L" last="Carey">L. Carey</name><affiliation wicri:level="1"><nlm:affiliation>Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill</wicri:regionArea><wicri:noRegion>Chapel Hill</wicri:noRegion></affiliation></author><author><name sortKey="Ciruelos, E" sort="Ciruelos, E" uniqKey="Ciruelos E" first="E" last="Ciruelos">E. Ciruelos</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Universitario 12 de Octubre, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario 12 de Octubre, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Cuzick, J" sort="Cuzick, J" uniqKey="Cuzick J" first="J" last="Cuzick">J. Cuzick</name><affiliation wicri:level="4"><nlm:affiliation>Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Denkert, C" sort="Denkert, C" uniqKey="Denkert C" first="C" last="Denkert">C. Denkert</name><affiliation wicri:level="3"><nlm:affiliation>Institut für Pathologie, Charité Universitätsmedizin Berlin, Berlin, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institut für Pathologie, Charité Universitätsmedizin Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Di Leo, A" sort="Di Leo, A" uniqKey="Di Leo A" first="A" last="Di Leo">A. Di Leo</name><affiliation wicri:level="1"><nlm:affiliation>Azienda Usl Toscana Centro, Prato, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Azienda Usl Toscana Centro, Prato</wicri:regionArea><wicri:noRegion>Prato</wicri:noRegion></affiliation></author><author><name sortKey="Ejlertsen, B" sort="Ejlertsen, B" uniqKey="Ejlertsen B" first="B" last="Ejlertsen">B. Ejlertsen</name><affiliation wicri:level="3"><nlm:affiliation>Rigshospitalet, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Rigshospitalet, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Francis, P" sort="Francis, P" uniqKey="Francis P" first="P" last="Francis">P. Francis</name><affiliation wicri:level="3"><nlm:affiliation>Peter McCallum Cancer Centre, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Peter McCallum Cancer Centre, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Galimberti, V" sort="Galimberti, V" uniqKey="Galimberti V" first="V" last="Galimberti">V. Galimberti</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Breast Cancer Program, Istituto Europeo di Oncologia, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Garber, J" sort="Garber, J" uniqKey="Garber J" first="J" last="Garber">J. Garber</name><affiliation wicri:level="3"><nlm:affiliation>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Gulluoglu, B" sort="Gulluoglu, B" uniqKey="Gulluoglu B" first="B" last="Gulluoglu">B. Gulluoglu</name><affiliation wicri:level="1"><nlm:affiliation>Marmara University School of Medicine, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Goodwin, P" sort="Goodwin, P" uniqKey="Goodwin P" first="P" last="Goodwin">P. Goodwin</name><affiliation wicri:level="4"><nlm:affiliation>University of Toronto, Mount Sinai Hospital, Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Mount Sinai Hospital, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Harbeck, N" sort="Harbeck, N" uniqKey="Harbeck N" first="N" last="Harbeck">N. Harbeck</name><affiliation wicri:level="4"><nlm:affiliation>University of Munich, München, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>University of Munich, München</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement><settlement type="city">Munich</settlement></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Hayes, D F" sort="Hayes, D F" uniqKey="Hayes D" first="D F" last="Hayes">D F Hayes</name><affiliation wicri:level="1"><nlm:affiliation>Comprehensive Cancer Center, University of Michigan, Ann-Arbor, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Comprehensive Cancer Center, University of Michigan, Ann-Arbor</wicri:regionArea><wicri:noRegion>Ann-Arbor</wicri:noRegion></affiliation></author><author><name sortKey="Huang, C S" sort="Huang, C S" uniqKey="Huang C" first="C-S" last="Huang">C-S Huang</name><affiliation wicri:level="1"><nlm:affiliation>National Taiwan University Hospital, Taipei, Taiwan.</nlm:affiliation><country xml:lang="fr">Taïwan</country><wicri:regionArea>National Taiwan University Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Huober, J" sort="Huober, J" uniqKey="Huober J" first="J" last="Huober">J. Huober</name><affiliation wicri:level="4"><nlm:affiliation>University of Ulm, Ulm, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>University of Ulm, Ulm</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement><settlement type="city">Ulm</settlement></placeName><orgName type="university">Université d'Ulm</orgName></affiliation></author><author><name sortKey="Hussein, K" sort="Hussein, K" uniqKey="Hussein K" first="K" last="Hussein">K. Hussein</name><affiliation wicri:level="1"><nlm:affiliation>The National Cancer Institute, Cairo University, Cairo, Egypt.</nlm:affiliation><country xml:lang="fr">Égypte</country><wicri:regionArea>The National Cancer Institute, Cairo University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Jassem, J" sort="Jassem, J" uniqKey="Jassem J" first="J" last="Jassem">J. Jassem</name><affiliation wicri:level="1"><nlm:affiliation>Medical University of Gdansk, Gdansk, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Medical University of Gdansk, Gdansk</wicri:regionArea><wicri:noRegion>Gdansk</wicri:noRegion></affiliation></author><author><name sortKey="Jiang, Z" sort="Jiang, Z" uniqKey="Jiang Z" first="Z" last="Jiang">Z. Jiang</name><affiliation wicri:level="3"><nlm:affiliation>Hospital Affiliated to Military Medical Science, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Hospital Affiliated to Military Medical Science, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Karlsson, P" sort="Karlsson, P" uniqKey="Karlsson P" first="P" last="Karlsson">P. Karlsson</name><affiliation wicri:level="1"><nlm:affiliation>Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrensky University Hospital, Gothenburg, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrensky University Hospital, Gothenburg</wicri:regionArea><wicri:noRegion>Gothenburg</wicri:noRegion></affiliation></author><author><name sortKey="Morrow, M" sort="Morrow, M" uniqKey="Morrow M" first="M" last="Morrow">M. Morrow</name><affiliation wicri:level="2"><nlm:affiliation>Memorial Sloan Kettering Cancer Center, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Memorial Sloan Kettering Cancer Center, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Orecchia, R" sort="Orecchia, R" uniqKey="Orecchia R" first="R" last="Orecchia">R. Orecchia</name><affiliation wicri:level="1"><nlm:affiliation>Breast Cancer Program, Istituto Europeo di Oncologia, Milano, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Breast Cancer Program, Istituto Europeo di Oncologia, Milano</wicri:regionArea><wicri:noRegion>Milano</wicri:noRegion></affiliation></author><author><name sortKey="Osborne, K C" sort="Osborne, K C" uniqKey="Osborne K" first="K C" last="Osborne">K C Osborne</name><affiliation wicri:level="3"><nlm:affiliation>Baylor College of Medicine, Houston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Baylor College of Medicine, Houston</wicri:regionArea><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Pagani, O" sort="Pagani, O" uniqKey="Pagani O" first="O" last="Pagani">O. Pagani</name><affiliation wicri:level="1"><nlm:affiliation>Institute of Oncology Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Oncology Southern Switzerland, Ospedale San Giovanni, Bellinzona</wicri:regionArea><wicri:noRegion>Bellinzona</wicri:noRegion></affiliation></author><author><name sortKey="Partridge, A H" sort="Partridge, A H" uniqKey="Partridge A" first="A H" last="Partridge">A H Partridge</name><affiliation wicri:level="3"><nlm:affiliation>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston</wicri:regionArea><placeName><settlement type="city">Boston</settlement><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Pritchard, K" sort="Pritchard, K" uniqKey="Pritchard K" first="K" last="Pritchard">K. Pritchard</name><affiliation wicri:level="4"><nlm:affiliation>Sunnybrook Odette Cancer Center, University of Toronto, Toronto, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Sunnybrook Odette Cancer Center, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Ro, J" sort="Ro, J" uniqKey="Ro J" first="J" last="Ro">J. Ro</name><affiliation wicri:level="1"><nlm:affiliation>National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>National Cancer Center, Ilsandong-gu, Goyang-si, Gyeonggi-do</wicri:regionArea><wicri:noRegion>Gyeonggi-do</wicri:noRegion></affiliation></author><author><name sortKey="Rutgers, E J T" sort="Rutgers, E J T" uniqKey="Rutgers E" first="E J T" last="Rutgers">E J T. Rutgers</name><affiliation wicri:level="3"><nlm:affiliation>Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Sedlmayer, F" sort="Sedlmayer, F" uniqKey="Sedlmayer F" first="F" last="Sedlmayer">F. Sedlmayer</name><affiliation wicri:level="1"><nlm:affiliation>LKH Salzburg, Paracelsus Medical University Clinics, Salzburg, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>LKH Salzburg, Paracelsus Medical University Clinics, Salzburg</wicri:regionArea><wicri:noRegion>Salzburg</wicri:noRegion></affiliation></author><author><name sortKey="Semiglazov, V" sort="Semiglazov, V" uniqKey="Semiglazov V" first="V" last="Semiglazov">V. Semiglazov</name><affiliation wicri:level="1"><nlm:affiliation>N.N. Petrov Research Institute of Oncology, St. Petersburg, Russian Federation.</nlm:affiliation><country xml:lang="fr">Russie</country><wicri:regionArea>N.N. Petrov Research Institute of Oncology, St. Petersburg</wicri:regionArea><wicri:noRegion>St. Petersburg</wicri:noRegion></affiliation></author><author><name sortKey="Shao, Z" sort="Shao, Z" uniqKey="Shao Z" first="Z" last="Shao">Z. Shao</name><affiliation wicri:level="1"><nlm:affiliation>Fudan University Cancer Hospital, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Fudan University Cancer Hospital, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Smith, I" sort="Smith, I" uniqKey="Smith I" first="I" last="Smith">I. Smith</name><affiliation wicri:level="1"><nlm:affiliation>The Royal Marsden, Sutton, Surrey, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Royal Marsden, Sutton, Surrey</wicri:regionArea><wicri:noRegion>Surrey</wicri:noRegion></affiliation></author><author><name sortKey="Toi, M" sort="Toi, M" uniqKey="Toi M" first="M" last="Toi">M. Toi</name><affiliation wicri:level="1"><nlm:affiliation>Graduate School of Medicine Kyoto University, Sakyo-ku, Kyoto City, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Graduate School of Medicine Kyoto University, Sakyo-ku, Kyoto City</wicri:regionArea><wicri:noRegion>Kyoto City</wicri:noRegion></affiliation></author><author><name sortKey="Tutt, A" sort="Tutt, A" uniqKey="Tutt A" first="A" last="Tutt">A. Tutt</name><affiliation wicri:level="3"><nlm:affiliation>Breast Cancer Now Research Centre, The Institute of Cancer Research, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Breast Cancer Now Research Centre, The Institute of Cancer Research, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Viale, G" sort="Viale, G" uniqKey="Viale G" first="G" last="Viale">G. Viale</name><affiliation wicri:level="3"><nlm:affiliation>University of Milan, Milan.</nlm:affiliation><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName><wicri:orgArea>University of Milan</wicri:orgArea></affiliation></author><author><name sortKey="Watanabe, T" sort="Watanabe, T" uniqKey="Watanabe T" first="T" last="Watanabe">T. Watanabe</name><affiliation wicri:level="1"><nlm:affiliation>Hamamatsu Oncology Center, Hamamatsu, Japan.</nlm:affiliation><country xml:lang="fr">Japon</country><wicri:regionArea>Hamamatsu Oncology Center, Hamamatsu</wicri:regionArea><wicri:noRegion>Hamamatsu</wicri:noRegion></affiliation></author><author><name sortKey="Whelan, T J" sort="Whelan, T J" uniqKey="Whelan T" first="T J" last="Whelan">T J Whelan</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University, Hamilton, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>McMaster University, Hamilton</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Xu, B" sort="Xu, B" uniqKey="Xu B" first="B" last="Xu">B. Xu</name><affiliation wicri:level="3"><nlm:affiliation>National Cancer Center, Chaoyang District, Beijing, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>National Cancer Center, Chaoyang District, Beijing</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author></analytic><series><title level="j">Annals of oncology : official journal of the European Society for Medical Oncology</title><idno type="eISSN">1569-8041</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The 15th St. Gallen International Breast Cancer Conference 2017 in Vienna, Austria reviewed substantial new evidence on loco-regional and systemic therapies for early breast cancer. Treatments were assessed in light of their intensity, duration and side-effects, seeking where appropriate to escalate or de-escalate therapies based on likely benefits as predicted by tumor stage and tumor biology. The Panel favored several interventions that may reduce surgical morbidity, including acceptance of 2 mm margins for DCIS, the resection of residual cancer (but not baseline extent of cancer) in women undergoing neoadjuvant therapy, acceptance of sentinel node biopsy following neoadjuvant treatment of many patients, and the preference for neoadjuvant therapy in HER2 positive and triple-negative, stage II and III breast cancer. The Panel favored escalating radiation therapy with regional nodal irradiation in high-risk patients, while encouraging omission of boost in low-risk patients. The Panel endorsed gene expression signatures that permit avoidance of chemotherapy in many patients with ER positive breast cancer. For women with higher risk tumors, the Panel escalated recommendations for adjuvant endocrine treatment to include ovarian suppression in premenopausal women, and extended therapy for postmenopausal women. However, low-risk patients can avoid these treatments. Finally, the Panel recommended bisphosphonate use in postmenopausal women to prevent breast cancer recurrence. The Panel recognized that recommendations are not intended for all patients, but rather to address the clinical needs of the majority of common presentations. Individualization of adjuvant therapy means adjusting to the tumor characteristics, patient comorbidities and preferences, and managing constraints of treatment cost and access that may affect care in both the developed and developing world.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Belgique</li><li>Canada</li><li>Corée du Sud</li><li>Danemark</li><li>Espagne</li><li>France</li><li>Italie</li><li>Japon</li><li>Pays-Bas</li><li>Pologne</li><li>Portugal</li><li>Royaume-Uni</li><li>Russie</li><li>République populaire de Chine</li><li>Suisse</li><li>Suède</li><li>Taïwan</li><li>Turquie</li><li>Égypte</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Aquitaine</li><li>Bade-Wurtemberg</li><li>Bavière</li><li>Berlin</li><li>Communauté de Madrid</li><li>District de Haute-Bavière</li><li>District de Tübingen</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Hovedstaden</li><li>Lombardie</li><li>Massachusetts</li><li>Nouvelle-Aquitaine</li><li>Ontario</li><li>Région de Bruxelles-Capitale</li><li>Svealand</li><li>Texas</li><li>Victoria (État)</li><li>Vienne (Autriche)</li><li>État de New York</li></region><settlement><li>Amsterdam</li><li>Berlin</li><li>Bordeaux</li><li>Boston</li><li>Bruxelles</li><li>Copenhague</li><li>Hamilton (Ontario)</li><li>Houston</li><li>Londres</li><li>Madrid</li><li>Melbourne</li><li>Milan</li><li>Munich</li><li>Pékin</li><li>Stockholm</li><li>Toronto</li><li>Tübingen</li><li>Ulm</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université Louis-et-Maximilien de Munich</li><li>Université McMaster</li><li>Université d'Ulm</li><li>Université de Londres</li><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Senn, H J" sort="Senn, H J" uniqKey="Senn H" first="H-J" last="Senn">H-J Senn</name></noCountry><country name="Italie"><noRegion><name sortKey="Curigliano, G" sort="Curigliano, G" uniqKey="Curigliano G" first="G" last="Curigliano">G. Curigliano</name></noRegion><name sortKey="Colleoni, M" sort="Colleoni, M" uniqKey="Colleoni M" first="M" last="Colleoni">M. Colleoni</name><name sortKey="Di Leo, A" sort="Di Leo, A" uniqKey="Di Leo A" first="A" last="Di Leo">A. Di Leo</name><name sortKey="Galimberti, V" sort="Galimberti, V" uniqKey="Galimberti V" first="V" last="Galimberti">V. Galimberti</name><name sortKey="Orecchia, R" sort="Orecchia, R" uniqKey="Orecchia R" first="R" last="Orecchia">R. Orecchia</name><name sortKey="Viale, G" sort="Viale, G" uniqKey="Viale G" first="G" last="Viale">G. Viale</name></country><country name="États-Unis"><region name="Massachusetts"><name sortKey="Burstein, H J" sort="Burstein, H J" uniqKey="Burstein H" first="H J" last="Burstein">H J Burstein</name></region><name sortKey="Baselga, J" sort="Baselga, J" uniqKey="Baselga J" first="J" last="Baselga">J. Baselga</name><name sortKey="Carey, L" sort="Carey, L" uniqKey="Carey L" first="L" last="Carey">L. Carey</name><name sortKey="Garber, J" sort="Garber, J" uniqKey="Garber J" first="J" last="Garber">J. Garber</name><name sortKey="Hayes, D F" sort="Hayes, D F" uniqKey="Hayes D" first="D F" last="Hayes">D F Hayes</name><name sortKey="Morrow, M" sort="Morrow, M" uniqKey="Morrow M" first="M" last="Morrow">M. Morrow</name><name sortKey="Osborne, K C" sort="Osborne, K C" uniqKey="Osborne K" first="K C" last="Osborne">K C Osborne</name><name sortKey="P Winer, E" sort="P Winer, E" uniqKey="P Winer E" first="E" last="P Winer">E. P Winer</name><name sortKey="Partridge, A H" sort="Partridge, A H" uniqKey="Partridge A" first="A H" last="Partridge">A H Partridge</name><name sortKey="Regan, M M" sort="Regan, M M" uniqKey="Regan M" first="M M" last="Regan">M M Regan</name></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Gnant, M" sort="Gnant, M" uniqKey="Gnant M" first="M" last="Gnant">M. Gnant</name></region><name sortKey="Dubsky, P" sort="Dubsky, P" uniqKey="Dubsky P" first="P" last="Dubsky">P. Dubsky</name><name sortKey="Sedlmayer, F" sort="Sedlmayer, F" uniqKey="Sedlmayer F" first="F" last="Sedlmayer">F. Sedlmayer</name></country><country name="Allemagne"><noRegion><name sortKey="Loibl, S" sort="Loibl, S" uniqKey="Loibl S" first="S" last="Loibl">S. Loibl</name></noRegion><name sortKey="Denkert, C" sort="Denkert, C" uniqKey="Denkert C" first="C" last="Denkert">C. Denkert</name><name sortKey="Harbeck, N" sort="Harbeck, N" uniqKey="Harbeck N" first="N" last="Harbeck">N. Harbeck</name><name sortKey="Huober, J" sort="Huober, J" uniqKey="Huober J" first="J" last="Huober">J. Huober</name><name sortKey="Y Brucker, S" sort="Y Brucker, S" uniqKey="Y Brucker S" first="S" last="Y Brucker">S. Y Brucker</name></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Piccart Gebhart, M" sort="Piccart Gebhart, M" uniqKey="Piccart Gebhart M" first="M" last="Piccart-Gebhart">M. Piccart-Gebhart</name></region></country><country name="Suisse"><noRegion><name sortKey="Thurlimann, B" sort="Thurlimann, B" uniqKey="Thurlimann B" first="B" last="Thürlimann">B. Thürlimann</name></noRegion><name sortKey="Pagani, O" sort="Pagani, O" uniqKey="Pagani O" first="O" last="Pagani">O. Pagani</name></country><country name="France"><noRegion><name sortKey="Andre, F" sort="Andre, F" uniqKey="Andre F" first="F" last="André">F. André</name></noRegion><name sortKey="Bonnefoi, H" sort="Bonnefoi, H" uniqKey="Bonnefoi H" first="H" last="Bonnefoi">H. Bonnefoi</name></country><country name="Suède"><region name="Svealand"><name sortKey="Bergh, J" sort="Bergh, J" uniqKey="Bergh J" first="J" last="Bergh">J. Bergh</name></region><name sortKey="Karlsson, P" sort="Karlsson, P" uniqKey="Karlsson P" first="P" last="Karlsson">P. Karlsson</name></country><country name="Portugal"><noRegion><name sortKey="Cardoso, F" sort="Cardoso, F" uniqKey="Cardoso F" first="F" last="Cardoso">F. Cardoso</name></noRegion></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Ciruelos, E" sort="Ciruelos, E" uniqKey="Ciruelos E" first="E" last="Ciruelos">E. Ciruelos</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Cuzick, J" sort="Cuzick, J" uniqKey="Cuzick J" first="J" last="Cuzick">J. Cuzick</name></region><name sortKey="Smith, I" sort="Smith, I" uniqKey="Smith I" first="I" last="Smith">I. Smith</name><name sortKey="Tutt, A" sort="Tutt, A" uniqKey="Tutt A" first="A" last="Tutt">A. Tutt</name></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Ejlertsen, B" sort="Ejlertsen, B" uniqKey="Ejlertsen B" first="B" last="Ejlertsen">B. Ejlertsen</name></region></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Francis, P" sort="Francis, P" uniqKey="Francis P" first="P" last="Francis">P. Francis</name></region></country><country name="Turquie"><noRegion><name sortKey="Gulluoglu, B" sort="Gulluoglu, B" uniqKey="Gulluoglu B" first="B" last="Gulluoglu">B. Gulluoglu</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Goodwin, P" sort="Goodwin, P" uniqKey="Goodwin P" first="P" last="Goodwin">P. Goodwin</name></region><name sortKey="Pritchard, K" sort="Pritchard, K" uniqKey="Pritchard K" first="K" last="Pritchard">K. Pritchard</name><name sortKey="Whelan, T J" sort="Whelan, T J" uniqKey="Whelan T" first="T J" last="Whelan">T J Whelan</name></country><country name="Taïwan"><noRegion><name sortKey="Huang, C S" sort="Huang, C S" uniqKey="Huang C" first="C-S" last="Huang">C-S Huang</name></noRegion></country><country name="Égypte"><noRegion><name sortKey="Hussein, K" sort="Hussein, K" uniqKey="Hussein K" first="K" last="Hussein">K. Hussein</name></noRegion></country><country name="Pologne"><noRegion><name sortKey="Jassem, J" sort="Jassem, J" uniqKey="Jassem J" first="J" last="Jassem">J. Jassem</name></noRegion></country><country name="République populaire de Chine"><noRegion><name sortKey="Jiang, Z" sort="Jiang, Z" uniqKey="Jiang Z" first="Z" last="Jiang">Z. Jiang</name></noRegion><name sortKey="Shao, Z" sort="Shao, Z" uniqKey="Shao Z" first="Z" last="Shao">Z. Shao</name><name sortKey="Xu, B" sort="Xu, B" uniqKey="Xu B" first="B" last="Xu">B. Xu</name></country><country name="Corée du Sud"><noRegion><name sortKey="Ro, J" sort="Ro, J" uniqKey="Ro J" first="J" last="Ro">J. Ro</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Rutgers, E J T" sort="Rutgers, E J T" uniqKey="Rutgers E" first="E J T" last="Rutgers">E J T. Rutgers</name></region></country><country name="Russie"><noRegion><name sortKey="Semiglazov, V" sort="Semiglazov, V" uniqKey="Semiglazov V" first="V" last="Semiglazov">V. Semiglazov</name></noRegion></country><country name="Japon"><noRegion><name sortKey="Toi, M" sort="Toi, M" uniqKey="Toi M" first="M" last="Toi">M. Toi</name></noRegion><name sortKey="Watanabe, T" sort="Watanabe, T" uniqKey="Watanabe T" first="T" last="Watanabe">T. Watanabe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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