Preoperative systemic therapy in locoregional management of early breast cancer: highlights from the Kyoto Breast Cancer Consensus Conference
Identifieur interne : 005987 ( Main/Exploration ); précédent : 005986; suivant : 005988Preoperative systemic therapy in locoregional management of early breast cancer: highlights from the Kyoto Breast Cancer Consensus Conference
Auteurs : Masakazu Toi [Japon] ; John R. Benson [Royaume-Uni] ; Eric P. Winer [États-Unis] ; John F. Forbes [Australie] ; Gunter Von Minckwitz [Allemagne] ; Mehra Golshan [États-Unis] ; John F. R. Robertson [Royaume-Uni] ; Hironobu Sasano [Japon] ; Bernard F. Cole [États-Unis] ; Louis W. C. Chow [Hong Kong] ; Mark D. Pegram [États-Unis] ; Wonshik Han [Corée du Sud] ; Chiun-Sheng Huang [Taïwan] ; Tadashi Ikeda [Japon] ; Shotaro Kanao [Japon] ; Eun-Sook Lee [Corée du Sud] ; Shinzaburo Noguchi [Japon] ; Shinji Ohno [Japon] ; Ann H. Partridge [États-Unis] ; Roman Rouzier [France] ; Mitsuhiro Tozaki [Japon] ; Tomoharu Sugie [Japon] ; Akira Yamauchi [Japon] ; Takashi Inamoto [Japon]Source :
- Breast cancer research and treatment [ 0167-6806 ] ; 2012.
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Abstract
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.
Affiliations:
- Allemagne, Australie, Corée du Sud, France, Hong Kong, Japon, Royaume-Uni, Taïwan, États-Unis
- Angleterre, Angleterre de l'Est, Nottinghamshire, Région capitale de Séoul, Région de Kantō, Île-de-France
- Cambridge, Nottingham, Paris, Séoul, Tokyo
- Université de Cambridge, Université de Nottingham
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Cole</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>College of Engineering and Mathematical Sciences. University of Vermont</s1><s2>Burlington, VT</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>College of Engineering and Mathematical Sciences. University of Vermont</wicri:noRegion></affiliation></author><author><name sortKey="Chow, Louis W C" sort="Chow, Louis W C" uniqKey="Chow L" first="Louis W. C." last="Chow">Louis W. C. Chow</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>UNIMED Medical Institute, University of Hong Kong</s1><s3>HKG</s3><sZ>10 aut.</sZ></inist:fA14><country>Hong Kong</country><wicri:noRegion>UNIMED Medical Institute, University of Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Pegram, Mark D" sort="Pegram, Mark D" uniqKey="Pegram M" first="Mark D." last="Pegram">Mark D. Pegram</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Medical Oncology, Miller School of Medicine, University of Miami</s1><s2>Miami, FL</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Miami, FL</wicri:noRegion></affiliation></author><author><name sortKey="Han, Wonshik" sort="Han, Wonshik" uniqKey="Han W" first="Wonshik" last="Han">Wonshik Han</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Surgery, Seoul National University Hospital</s1><s2>Seoul</s2><s3>KOR</s3><sZ>12 aut.</sZ></inist:fA14><country>Corée du Sud</country><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Huang, Chiun Sheng" sort="Huang, Chiun Sheng" uniqKey="Huang C" first="Chiun-Sheng" last="Huang">Chiun-Sheng Huang</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University</s1><s2>Taipei</s2><s3>TWN</s3><sZ>13 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Ikeda, Tadashi" sort="Ikeda, Tadashi" uniqKey="Ikeda T" first="Tadashi" last="Ikeda">Tadashi Ikeda</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Surgery, Teikyo University</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>14 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Kanao, Shotaro" sort="Kanao, Shotaro" uniqKey="Kanao S" first="Shotaro" last="Kanao">Shotaro Kanao</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Diagnostic Radiology, Kyoto University Graduate School of Medicine</s1><s2>Kyoto</s2><s3>JPN</s3><sZ>15 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kyoto</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun-Sook" last="Lee">Eun-Sook Lee</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Division of Covergence Technology, Center for Breast Cancer, Research Institute and Hospital, National Cancer Center</s1><s2>Goyang-si, Gyeonggi-do</s2><s3>KOR</s3><sZ>16 aut.</sZ></inist:fA14><country>Corée du Sud</country><wicri:noRegion>Goyang-si, Gyeonggi-do</wicri:noRegion></affiliation></author><author><name sortKey="Noguchi, Shinzaburo" sort="Noguchi, Shinzaburo" uniqKey="Noguchi S" first="Shinzaburo" last="Noguchi">Shinzaburo Noguchi</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University</s1><s2>Osaka</s2><s3>JPN</s3><sZ>17 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Osaka</wicri:noRegion></affiliation></author><author><name sortKey="Ohno, Shinji" sort="Ohno, Shinji" uniqKey="Ohno S" first="Shinji" last="Ohno">Shinji Ohno</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of Breast Oncology, National Kyushu Cancer Center</s1><s2>Fukuoka</s2><s3>JPN</s3><sZ>18 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Fukuoka</wicri:noRegion></affiliation></author><author><name sortKey="Partridge, Ann H" sort="Partridge, Ann H" uniqKey="Partridge A" first="Ann H." last="Partridge">Ann H. Partridge</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School</s1><s2>Boston. MA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston. MA</wicri:noRegion></affiliation></author><author><name sortKey="Rouzier, Roman" sort="Rouzier, Roman" uniqKey="Rouzier R" first="Roman" last="Rouzier">Roman Rouzier</name><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>University Pierre et Marie Curie (Paris 6), Tenon Hospital</s1><s2>Paris</s2><s3>FRA</s3><sZ>20 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tozaki, Mitsuhiro" sort="Tozaki, Mitsuhiro" uniqKey="Tozaki M" first="Mitsuhiro" last="Tozaki">Mitsuhiro Tozaki</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Kameda Medical Center</s1><s2>Kamogawa</s2><s3>JPN</s3><sZ>21 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kameda Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Sugie, Tomoharu" sort="Sugie, Tomoharu" uniqKey="Sugie T" first="Tomoharu" last="Sugie">Tomoharu Sugie</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Breast Surgery, Graduate School of Medicine. Kyoto University, 54 Shogoin Kawara-cho</s1><s2>Sakyo-ku, Kyoto 606-8507</s2><s3>JPN</s3><sZ>1 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Sakyo-ku, Kyoto 606-8507</wicri:noRegion></affiliation></author><author><name sortKey="Yamauchi, Akira" sort="Yamauchi, Akira" uniqKey="Yamauchi A" first="Akira" last="Yamauchi">Akira Yamauchi</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Breast Surgery, The Tazuke Kofukai Medical Research Institute, Kitano Hospital</s1><s2>Osaka</s2><s3>JPN</s3><sZ>23 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Osaka</wicri:noRegion></affiliation></author><author><name sortKey="Inamoto, Takashi" sort="Inamoto, Takashi" uniqKey="Inamoto T" first="Takashi" last="Inamoto">Takashi Inamoto</name><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Department of Breast Surgery, Tenri Hospital</s1><s2>Nara</s2><s3>JPN</s3><sZ>24 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Nara</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0039534</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 13-0039534 INIST</idno><idno type="RBID">Pascal:13-0039534</idno><idno type="wicri:Area/PascalFrancis/Corpus">000D26</idno><idno type="wicri:Area/PascalFrancis/Curation">005138</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000E44</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000E44</idno><idno type="wicri:doubleKey">0167-6806:2012:Toi M:preoperative:systemic:therapy</idno><idno type="wicri:Area/Main/Merge">005C79</idno><idno type="wicri:Area/Main/Curation">005987</idno><idno type="wicri:Area/Main/Exploration">005987</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Preoperative systemic therapy in locoregional management of early breast cancer: highlights from the Kyoto Breast Cancer Consensus Conference</title><author><name sortKey="Toi, Masakazu" sort="Toi, Masakazu" uniqKey="Toi M" first="Masakazu" last="Toi">Masakazu Toi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Breast Surgery, Graduate School of Medicine. Kyoto University, 54 Shogoin Kawara-cho</s1><s2>Sakyo-ku, Kyoto 606-8507</s2><s3>JPN</s3><sZ>1 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Sakyo-ku, Kyoto 606-8507</wicri:noRegion></affiliation></author><author><name sortKey="Benson, John R" sort="Benson, John R" uniqKey="Benson J" first="John R." last="Benson">John R. Benson</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Cambridge Breast Unit, Addenbrooke's Hospital, University of Cambridge</s1><s2>Cambridge</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName><orgName type="university">Université de Cambridge</orgName></affiliation></author><author><name sortKey="Winer, Eric P" sort="Winer, Eric P" uniqKey="Winer E" first="Eric P." last="Winer">Eric P. Winer</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School</s1><s2>Boston. MA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston. MA</wicri:noRegion></affiliation></author><author><name sortKey="Forbes, John F" sort="Forbes, John F" uniqKey="Forbes J" first="John F." last="Forbes">John F. Forbes</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Surgical Oncology, University of Newcastle</s1><s2>Newcastle</s2><s3>AUS</s3><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Newcastle</wicri:noRegion></affiliation></author><author><name sortKey="Von Minckwitz, Gunter" sort="Von Minckwitz, Gunter" uniqKey="Von Minckwitz G" first="Gunter" last="Von Minckwitz">Gunter Von Minckwitz</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>German Breast Group</s1><s2>Neu-Isenburg</s2><s3>DEU</s3><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Neu-Isenburg</wicri:noRegion><wicri:noRegion>German Breast Group</wicri:noRegion><wicri:noRegion>German Breast Group</wicri:noRegion></affiliation></author><author><name sortKey="Golshan, Mehra" sort="Golshan, Mehra" uniqKey="Golshan M" first="Mehra" last="Golshan">Mehra Golshan</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Breast Surgery, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center. Harvard Medical School</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Robertson, John F R" sort="Robertson, John F R" uniqKey="Robertson J" first="John F. R." last="Robertson">John F. R. Robertson</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Breast Surgery, Royal Derby Hospital, University of Nottingham</s1><s2>Nottingham</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Nottingham</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Nottinghamshire</region></placeName><orgName type="university">Université de Nottingham</orgName></affiliation></author><author><name sortKey="Sasano, Hironobu" sort="Sasano, Hironobu" uniqKey="Sasano H" first="Hironobu" last="Sasano">Hironobu Sasano</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Pathology, Tohoku University School of Medicine</s1><s2>Sendai</s2><s3>JPN</s3><sZ>8 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Sendai</wicri:noRegion></affiliation></author><author><name sortKey="Cole, Bernard F" sort="Cole, Bernard F" uniqKey="Cole B" first="Bernard F." last="Cole">Bernard F. Cole</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>College of Engineering and Mathematical Sciences. University of Vermont</s1><s2>Burlington, VT</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>College of Engineering and Mathematical Sciences. University of Vermont</wicri:noRegion></affiliation></author><author><name sortKey="Chow, Louis W C" sort="Chow, Louis W C" uniqKey="Chow L" first="Louis W. C." last="Chow">Louis W. C. Chow</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>UNIMED Medical Institute, University of Hong Kong</s1><s3>HKG</s3><sZ>10 aut.</sZ></inist:fA14><country>Hong Kong</country><wicri:noRegion>UNIMED Medical Institute, University of Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Pegram, Mark D" sort="Pegram, Mark D" uniqKey="Pegram M" first="Mark D." last="Pegram">Mark D. Pegram</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Medical Oncology, Miller School of Medicine, University of Miami</s1><s2>Miami, FL</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Miami, FL</wicri:noRegion></affiliation></author><author><name sortKey="Han, Wonshik" sort="Han, Wonshik" uniqKey="Han W" first="Wonshik" last="Han">Wonshik Han</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Surgery, Seoul National University Hospital</s1><s2>Seoul</s2><s3>KOR</s3><sZ>12 aut.</sZ></inist:fA14><country>Corée du Sud</country><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Huang, Chiun Sheng" sort="Huang, Chiun Sheng" uniqKey="Huang C" first="Chiun-Sheng" last="Huang">Chiun-Sheng Huang</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University</s1><s2>Taipei</s2><s3>TWN</s3><sZ>13 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author><author><name sortKey="Ikeda, Tadashi" sort="Ikeda, Tadashi" uniqKey="Ikeda T" first="Tadashi" last="Ikeda">Tadashi Ikeda</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Surgery, Teikyo University</s1><s2>Tokyo</s2><s3>JPN</s3><sZ>14 aut.</sZ></inist:fA14><country>Japon</country><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Kanao, Shotaro" sort="Kanao, Shotaro" uniqKey="Kanao S" first="Shotaro" last="Kanao">Shotaro Kanao</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Diagnostic Radiology, Kyoto University Graduate School of Medicine</s1><s2>Kyoto</s2><s3>JPN</s3><sZ>15 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kyoto</wicri:noRegion></affiliation></author><author><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun-Sook" last="Lee">Eun-Sook Lee</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Division of Covergence Technology, Center for Breast Cancer, Research Institute and Hospital, National Cancer Center</s1><s2>Goyang-si, Gyeonggi-do</s2><s3>KOR</s3><sZ>16 aut.</sZ></inist:fA14><country>Corée du Sud</country><wicri:noRegion>Goyang-si, Gyeonggi-do</wicri:noRegion></affiliation></author><author><name sortKey="Noguchi, Shinzaburo" sort="Noguchi, Shinzaburo" uniqKey="Noguchi S" first="Shinzaburo" last="Noguchi">Shinzaburo Noguchi</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University</s1><s2>Osaka</s2><s3>JPN</s3><sZ>17 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Osaka</wicri:noRegion></affiliation></author><author><name sortKey="Ohno, Shinji" sort="Ohno, Shinji" uniqKey="Ohno S" first="Shinji" last="Ohno">Shinji Ohno</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of Breast Oncology, National Kyushu Cancer Center</s1><s2>Fukuoka</s2><s3>JPN</s3><sZ>18 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Fukuoka</wicri:noRegion></affiliation></author><author><name sortKey="Partridge, Ann H" sort="Partridge, Ann H" uniqKey="Partridge A" first="Ann H." last="Partridge">Ann H. Partridge</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School</s1><s2>Boston. MA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston. MA</wicri:noRegion></affiliation></author><author><name sortKey="Rouzier, Roman" sort="Rouzier, Roman" uniqKey="Rouzier R" first="Roman" last="Rouzier">Roman Rouzier</name><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>University Pierre et Marie Curie (Paris 6), Tenon Hospital</s1><s2>Paris</s2><s3>FRA</s3><sZ>20 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Tozaki, Mitsuhiro" sort="Tozaki, Mitsuhiro" uniqKey="Tozaki M" first="Mitsuhiro" last="Tozaki">Mitsuhiro Tozaki</name><affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Kameda Medical Center</s1><s2>Kamogawa</s2><s3>JPN</s3><sZ>21 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Kameda Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Sugie, Tomoharu" sort="Sugie, Tomoharu" uniqKey="Sugie T" first="Tomoharu" last="Sugie">Tomoharu Sugie</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Breast Surgery, Graduate School of Medicine. Kyoto University, 54 Shogoin Kawara-cho</s1><s2>Sakyo-ku, Kyoto 606-8507</s2><s3>JPN</s3><sZ>1 aut.</sZ><sZ>22 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Sakyo-ku, Kyoto 606-8507</wicri:noRegion></affiliation></author><author><name sortKey="Yamauchi, Akira" sort="Yamauchi, Akira" uniqKey="Yamauchi A" first="Akira" last="Yamauchi">Akira Yamauchi</name><affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Breast Surgery, The Tazuke Kofukai Medical Research Institute, Kitano Hospital</s1><s2>Osaka</s2><s3>JPN</s3><sZ>23 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Osaka</wicri:noRegion></affiliation></author><author><name sortKey="Inamoto, Takashi" sort="Inamoto, Takashi" uniqKey="Inamoto T" first="Takashi" last="Inamoto">Takashi Inamoto</name><affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Department of Breast Surgery, Tenri Hospital</s1><s2>Nara</s2><s3>JPN</s3><sZ>24 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Nara</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Breast cancer research and treatment</title><title level="j" type="abbreviated">Breast cancer res. treat.</title><idno type="ISSN">0167-6806</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Breast</term><term>Breast cancer</term><term>Clinical management</term><term>Consensus conference</term><term>Early</term><term>Mammary gland</term><term>Management</term><term>Preoperative</term><term>Sentinel lymph node</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Préopératoire</term><term>Traitement</term><term>Conduite à tenir</term><term>Gestion</term><term>Précoce</term><term>Cancer du sein</term><term>Conférence consensus</term><term>Ganglion sentinelle</term><term>Glande mammaire</term><term>Sein</term><term>Locorégional</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Gestion</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Corée du Sud</li><li>France</li><li>Hong Kong</li><li>Japon</li><li>Royaume-Uni</li><li>Taïwan</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Angleterre de l'Est</li><li>Nottinghamshire</li><li>Région capitale de Séoul</li><li>Région de Kantō</li><li>Île-de-France</li></region><settlement><li>Cambridge</li><li>Nottingham</li><li>Paris</li><li>Séoul</li><li>Tokyo</li></settlement><orgName><li>Université de Cambridge</li><li>Université de Nottingham</li></orgName></list><tree><country name="Japon"><noRegion><name sortKey="Toi, Masakazu" sort="Toi, Masakazu" uniqKey="Toi M" first="Masakazu" last="Toi">Masakazu Toi</name></noRegion><name sortKey="Ikeda, Tadashi" sort="Ikeda, Tadashi" uniqKey="Ikeda T" first="Tadashi" last="Ikeda">Tadashi Ikeda</name><name sortKey="Inamoto, Takashi" sort="Inamoto, Takashi" uniqKey="Inamoto T" first="Takashi" last="Inamoto">Takashi Inamoto</name><name sortKey="Kanao, Shotaro" sort="Kanao, Shotaro" uniqKey="Kanao S" first="Shotaro" last="Kanao">Shotaro Kanao</name><name sortKey="Noguchi, Shinzaburo" sort="Noguchi, Shinzaburo" uniqKey="Noguchi S" first="Shinzaburo" last="Noguchi">Shinzaburo Noguchi</name><name sortKey="Ohno, Shinji" sort="Ohno, Shinji" uniqKey="Ohno S" first="Shinji" last="Ohno">Shinji Ohno</name><name sortKey="Sasano, Hironobu" sort="Sasano, Hironobu" uniqKey="Sasano H" first="Hironobu" last="Sasano">Hironobu Sasano</name><name sortKey="Sugie, Tomoharu" sort="Sugie, Tomoharu" uniqKey="Sugie T" first="Tomoharu" last="Sugie">Tomoharu Sugie</name><name sortKey="Tozaki, Mitsuhiro" sort="Tozaki, Mitsuhiro" uniqKey="Tozaki M" first="Mitsuhiro" last="Tozaki">Mitsuhiro Tozaki</name><name sortKey="Yamauchi, Akira" sort="Yamauchi, Akira" uniqKey="Yamauchi A" first="Akira" last="Yamauchi">Akira Yamauchi</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Benson, John R" sort="Benson, John R" uniqKey="Benson J" first="John R." last="Benson">John R. Benson</name></region><name sortKey="Robertson, John F R" sort="Robertson, John F R" uniqKey="Robertson J" first="John F. R." last="Robertson">John F. R. Robertson</name></country><country name="États-Unis"><noRegion><name sortKey="Winer, Eric P" sort="Winer, Eric P" uniqKey="Winer E" first="Eric P." last="Winer">Eric P. Winer</name></noRegion><name sortKey="Cole, Bernard F" sort="Cole, Bernard F" uniqKey="Cole B" first="Bernard F." last="Cole">Bernard F. Cole</name><name sortKey="Golshan, Mehra" sort="Golshan, Mehra" uniqKey="Golshan M" first="Mehra" last="Golshan">Mehra Golshan</name><name sortKey="Partridge, Ann H" sort="Partridge, Ann H" uniqKey="Partridge A" first="Ann H." last="Partridge">Ann H. Partridge</name><name sortKey="Pegram, Mark D" sort="Pegram, Mark D" uniqKey="Pegram M" first="Mark D." last="Pegram">Mark D. Pegram</name></country><country name="Australie"><noRegion><name sortKey="Forbes, John F" sort="Forbes, John F" uniqKey="Forbes J" first="John F." last="Forbes">John F. Forbes</name></noRegion></country><country name="Allemagne"><noRegion><name sortKey="Von Minckwitz, Gunter" sort="Von Minckwitz, Gunter" uniqKey="Von Minckwitz G" first="Gunter" last="Von Minckwitz">Gunter Von Minckwitz</name></noRegion></country><country name="Hong Kong"><noRegion><name sortKey="Chow, Louis W C" sort="Chow, Louis W C" uniqKey="Chow L" first="Louis W. C." last="Chow">Louis W. C. Chow</name></noRegion></country><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Han, Wonshik" sort="Han, Wonshik" uniqKey="Han W" first="Wonshik" last="Han">Wonshik Han</name></region><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun-Sook" last="Lee">Eun-Sook Lee</name></country><country name="Taïwan"><noRegion><name sortKey="Huang, Chiun Sheng" sort="Huang, Chiun Sheng" uniqKey="Huang C" first="Chiun-Sheng" last="Huang">Chiun-Sheng Huang</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Rouzier, Roman" sort="Rouzier, Roman" uniqKey="Rouzier R" first="Roman" last="Rouzier">Roman Rouzier</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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